[Improved conductor for nasotracheal intubation]. / Usovershenstvovannyi provodnik dlia nazotrakheal'noi intubatsii.

To facilitate nasotracheal intubation a conductor made from esophageal tube is recommended. The advantage of this conductor is that the tube could be directed into the trachea without intubation forceps. No special material is required and it is available for any anesthesiologist.

[Total spinal paralysis as complication of brachial plexus block]. / Total'nyi spinal'nyi paralich kak oslozhnenie blokady plechevogo spleteniia.

Local anesthesia of the brachial plexus by interscalenic approach was a cause of total spinal blockade due to the administration of a local anesthetic into subarachnoid space. To prevent this it is necessary to administer a test dose of a local anesthetic with pre-aspiration of the liquor with a syringe. Intensive care procedures should be aimed at maintenance of adequate hemodynamics and gas exchange and to liquidation of circulating blood volume deficiency.

[The volume of circulating blood during surgery of the aorta performed under epidural anesthesia]. / Ob"em tsirkuliruiushchei krovi pri operatsiiakh na aorte v usloviiakh épidural'noi anestezii.

Various methods of circulating blood volume (CBV) determination have been compared. The calculation method based on anthropometric to hemodynamic parameter ratio was shown to be optimal during surgery on the aorta and major vessels. Epidural anesthesia in 15% CBV deficit in the preoperative period and anesthetic administration into the epidural space intraoperatively in 10% CBV deficit were contraindicated. Epidural anesthesia caused CBV reduction, with its maximum changes observed upon blood flow recovery in the vascular bed. 10-15 ml/kg, 15-20 ml/kg and 20-30 ml/kg blood loss was 2.5,3 and 3.5 times overcompensated, respectively.

[Venous occlusive plethysmography in assessment of hemodynamics in arterial thrombosis of the lower extremities]. / Primenenie venoznoi okkliuzionnoi pletizmografii v otsenke gemodinamiki pri tromboze arterii nizhnikh konechnostei.

With the use of a method of venous occlusive plethysmography changes, in regional arterial and venous hemodynamics in 75 patients with arterial thrombosis as well as in 47 after reconstructive intervention at the immediate period, and in 25--at the late period were studied. It was established that in ischemia progression, the volume blood flow rate at rest and maximum rate decreased, indicating severe impairement in reserve possibilities of blood flow, maximum venous outflow reduced, venous filling of the vessels increased. In thrombosis, rough disorders in reserve possibilities of blood flow in the aorto-iliac segment were noted. After operation, dynamics of the indices didn't depend on type of reconstructive intervention and was determined only by adequacy of blood flow restoration in the extremity.

[A failure of conduction anesthesia in a patient with latent pathology of the peripheral nervous system]. / Neudacha provodnikovoi anestezii u patsienta so skrytoi patologiei perifericheskoi nervnoi sistemy.

Patients who have been long exposed to ultrasound and high-frequency currents at work are likely to develop diseases of the peripheral nervous system and thus the risk of nerve damage during conduction anesthesia. Profound examination of the peripheral nervous system before surgery is necessary in such patients. In patients with this pathology general anesthesia will be the technique of choice during surgery on the lower extremities.

[Characteristics of prolonged epidural anesthesia in surgery of the magistral vessels]. / Nekotorye osobennosti dlitel'noi épidural'noi anestezii v khirurgii magistral'nykh sosudov.

Prolonged epidural anesthesia has been analysed in 288 patients operated on for atherosclerosis and vascular stenosis. To prolong anesthesia the authors have for the first time administered morphilong into the epidural space. The efficacy of anesthesia was assessed by Nanovoltaampere meter P-341 used for the measurement of skin potential, which in the course of anesthesia decreased by 40-50%. The quality of anesthesia was assessed by microcirculation state. It is recommended during surgery on major vessels to extend the area of epidural anesthesia towards the lower extremities. Analgesia with morphilong was effective for 22.3 +/- 4 h. Complications during anesthesia were observed in 31.2% of patients, in 6.2% of cases they required drug therapy. The incidence of postoperative pneumonias after epidural anesthesia reduced from 8 to 1.6% as compared to conventional anesthesia techniques.

[The characteristics of epidural anesthesia in operations on the aorta and vessels of the lower extremities]. / Osobennosti épidural'noi anestezii pri operatsiikh na aorte i sosudakh nizhnikh konechnostei.

Under study were the parameters of microcirculation in 84 patients operated on the vessels in the aorto-ilio-femoral zone, in 33 patients operated on the vessels in the femoro-popliteal zone. In all of them epidural anesthesia was used. In 25 patients operations on the aorta and main vessels were fulfilled under conditions of epidural anesthesia with catheterization of the epidural space at two levels. The dynamics of microcirculation parameters allows to state that the epidural anesthesia with catheterization of the epidural space at two levels is more rational for patients in operations on the vessels in the aorto-ilio-femoral zone since it gives adequate anesthesia during operation and better tissue blood flow in lower extremities.

[Evaluation of compensatory possibilities of the cardiovascular system in patients before reconstructive operations on the aorta and major arteries]. / Otsenka kompensatornykh vozmozhnostei serdechno-sosudistoi sistemy bol'nykh, podvergaiushchikhsia rekonstruktivnym operatsiiam na aorte i magistral'nykh arteriiakh.

To determine functional reserves of cardiovascular system, two procedures were comparatively studied in evaluation of central hemodynamics: tetrapolar chest rheography under isovolemic loading and rheopolyglucin test. Close correlation registered in results of the tests allowed the authors to employ subsequently the isovolemic test alone. The patients with circulatory subcompensation and decompensation received 7-14-day preoperative cardiostimulation.

[Water-electrolyte balance in patients during operation on the aorto-femoral segment using various types of anesthesia]. / Vodno-élektrolitnyi balans u bol'nykh vo vremia operatsii na aorto-bedrennom segmente pri ispol'zovanii razlichnykh vidov anestezii.

The indices of aqueous-electrolyte metabolism in patients, who underwent the reconstructive operations on the aorta, were studied. In patients with concomitant diabetes mellitus, a method of choice for anesthesia is an epidural anesthesia, with ischemic heart disease--combined epidural anesthesia. The most severe changes in electrolyte metabolism were noted after restoration of blood flow in blood loss of more than 10 ml/kg, under conditions of epidural anesthesia these shifts are less pronounced.

[Anesthesiologic management of surgery of the aorta and the major vessels in patients with diabetes mellitus]. / Anesteziologicheskoe obespechenie operatsii na aorte i magistral'nykh sosudov u bol'nykh sakharnym diabetom.

In 23 patients with diabetes mellitus, the effectiveness of anesthesiologic support of the operations on the aorta and major vessels, which was based on combined epidural anesthesia performed using the conventional technique, was analysed. Sugar concentration in the blood was maintained at a level of no more than 11 mmol/l. Use of the method permitted to provide an adequate anesthesia, stable concentration of glucose in the blood, constant aqueous-electrolyte balance and acid-base state.

[The ultraviolet irradiation of autologous blood and endolymphatic antibiotic therapy in treating pneumonia in patients with craniocerebral trauma]. / Ul'trafioletovoe obluchenie autokrovi i éndolimfaticheskaia antibiotikoterapiia pri lechenii pnevmonii u bol'nykh s cherepno-mozgovoi travmoi.

On the basis of analysis of 50 cases of craniocerebral injury complicated by pneumonia, the authors prove the efficacy of including ultraviolet irradiation of autologous blood and endolymphatic antibiotic therapy in the complex of therapeutic measures. The mortality and the period of in-hospital treatment of this group of patients reduced.