[Optimization of anesthesiological management of reoperations in patients with renal transplant]. / Puti optimizatsii anesteziologicheskogo obespecheniia povtornykh operatsii u bol'nykh s pochechnym transplantom.

Tasks of anesthesiology support of reoperations in patients with renal allografts are determined; a classification of reoperations is offered. Vital functions in patients subjected to reoperations are evaluated. A method of anesthesia for various types of reoperations is suggested.

[Perioperative hypotensive therapy of patients with chronic renal insufficiency]. / Perioperatsionnaia gipotenzivnaia terapiia bol'nykh s khronicheskoi pochechnoi nedostatochnost'iu.

Overall 281 patients with arterial hypertension (AH) and renal insufficiency were examined, who had been operated on for renal diseases and those of the urinary tract. It is ascertained that patients with similar degree of AH can have both hyperkinetic and hypokinetic type of circulation. It is shown that most patients do not receive regular antihypertensive therapy before their admission into the hospital and are in want of its institution during the process of the preoperative preparation. Variants are proposed of prescription of hypotensive drugs with special reference to the type of circulation in the patient and to the chosen method of anesthesia. The conclusion in that a rational selection of antihypertensive therapy and optimum method of anesthesia ensure stability of hemodynamics in the perioperative period.

[Some aspects of epidural anesthesia in patients with chronic renal insufficiency]. / Osobennosti epidural'noi anestezii u bol'nykh s khronicheskoi pochechnoi nedostatochnost'iu.

In 231 patient with chronic renal impairment (CRI) the quality was studied of epidural anesthesia with different doses and concentrations of lidocaine hydrochloride, prilocaine hydrochloride, trimecaine hydrochloride, and bupivacaine. In patients in the terminal stage of CRI placed on the program-hemodialysis, the use of standard concentrations and volumes of the local anesthetsic (LA) has been found out to be associated with lower levels of the sensory and motor blocks than in CRI-free patients or in other stages of CRI. Intensification of epidural anesthesia in the above patients is achieved through employing a higher concentration of LA or epidural administration of narcotic analgesics and/or cloffelin. Patients with other stages of CRI do not require the renal-insufficiency stage-dependent correction of LA dose, an optimum option being administration of 2% solution of lidocaine and prilocaine, 2.5% solution of trimecaine and 0.5% solution of bupivacaine, 1.5% ml, on the spinal segment in combination with adjuvant drugs.

[The complications in surgical treatment of gastric cancer in elderly and senile patients]. / Vozniknovenie oslozhnenii pri khirurgicheskom lechenii raka zheludka u bol'nykh pozhilogo i starcheskogo vozrasta.

Causes of the perioperative complications occurrence in 736 elderly and senile patients, operated on for gastric cancer, were studied. It was established that the complications frequency and mortality were depended on the concomitant diseases presence, on the main disease complications, duration and volume of operation as well, but not from their age. The operation performance method and anesthesiological support perfection would permit to widen indications for the radical surgical intervention performance and raise the treatment of patients efficacy.

[Anesthesiological support of operative treatment in patients with infectious-toxic shock]. / Anesteziolohichne zabezpechennia operatyvnoho vtruchannia u khvorykh z infektsiino-toksychnym shokom.

The state of the vitally significant functions in patients with sepsis and infective-toxic shock (ITS), to whom operative intervention was done, was studied. The expediency of application in postoperative period of hypertonic and hypertonic hyperoncotic solutions in combination adrenomimetic preparations was proved. The advantages of multicomponent anesthesia, based on oxybate and ketamine in comparison with neuroleptanalgesia and ataralgesia were substantiated. The method of the anesthesiological securing was proposed, application of which have permitted to raise essentially the safety of the operative intervention in patients with ITS.

[Metabolic changes in patients operated on in gynecologic diseases under ketamine anesthesia]. / Metabolicheskie izmeneniia u bol'nykh, operirovannykh po povodu ginekologicheskikh zabolevanii v usloviiakh anestesii ketaminom.

Changes in biochemical parameters have been studied in 58 patients during short-term gynecological surgery performed under ketamine or ketamine-diazepam anesthesia. Surgery under ketamine monoanesthesia was accompanied by a considerable activation of sympathoadrenal and hypophyseal-adrenal systems, which was regarded as inadequate anesthesia. A significant decrease in plasma histamine level has been observed.