[Adequacy of combined spinal and epidural anesthesia during upper-abdominal operations].

The paper provides a comparative evaluation of the protective effects of combined spinal epidural anesthesia with artificial ventilation (AV) (n=86) versus combined general anesthesia with AV (n=53) from the surgical stress response at abdominal surgery. The surgical stress was estimated by the activities of the sympathoadrenal system, the hypothalamo-pituitary-adrenocortical system, the serum complement system, and lipid peroxidation, and by the blood level of glucose. The findings suggest that the combined spinal epidural anesthesia with AV has a more valid protective activity against poor surgery-associated neurohumoral, hemodynamic, and immunological changes.

[Concept of epidural and associated combined spinal-epidural anesthesia concerning prevention of a neurodystrophic component of intra- and postoperative complications in patients subjected to thoracic and abdominal surgery]. / Kontseptsiia épidural'noi i sochetannoi kombinirovannoi spinal'no-épidural'noi anestezii o preduprezhdenii neirodistroficheskogo komponenta intra- i posleoperatsionnykh oslozhnenii u bol'nykh, podvergnutykh torakal'nym i abdominal'nym operatsiiam.

The stimulation of reflexogenic zones and interoreceptors in experiments and in patients during operations on the heart, lungs and organs of the gastrointestinal tract induces hyperactivation of the sympatho-adrenal system and associated with it neurogenic dystrophic alterations of the internal organs (markedly decreased level of noradrenaline, destruction of the cell ultrastructure, mitochondria in particular) and energy metabolism. The use of high epidural anesthesia as the main component of narcosis in operations on the heart (mitral commissurotomy) and on the lung prevents the development of intra- and postoperative complications, the above mentioned dystrophic alterations in particular. Similar protecting effects in the abdominal operations are obtained when using associated combined spinal-epidural anesthesia.

[The history of the theory of nervous trophism]. / Istoriia ucheniia o nervnoi trofike.

Concepts "trophism" and "nervous trophism", development of views on trophic function of the nervous system and its disorders (neurogenic dystrophies) are reviewed. The problem on the ways of the trophic effects of the nervous system on the tissues is considered. The role of neuromediators in this process, particularly the significance of balance of norepinephrine, (NE), a mediator of the sympathetic nervous system (SNS), for maintaining trophism of tissues, their structure and functions is emphasized. The activating role of SNS and NE in the resistance and reparative regeneration of different tissues is shown under the experimental and clinical conditions. In this view a comprehensive definition of concepts "nervous trophism" is given.

[Action of adrenergic substances on the healing of experimental neurogenic mucosal damages and on the noradrenaline level in the stomach wall]. / Deistvie nekotorykh adrenergicheskikh veshchestv na zazhivlenie éksperimental'nykh neirogennykh povrezhdenii slizistoi i uroven' noradrenalina v stenke zheludka.

A study was made of the effect of the MAO inhibitor iprazide (50 mg/kg), alpha-methyldopa (150 mg/kg), and the beta-adrenoblocker inderal (15 mg/kg) on the rate of the healing of gastric mucosa erosions and noradrenaline content in the gastric wall of rats exposed to 3 hours of electric stimulation and immobilization. Iprazide accelerated the reparation of the gastric mucosa, alpha-methyldopa retarded it, whereas inderal did not influence that process. The drugs did not affect the rate of the recovery of noradrenaline content.

[Effect of neurotropic agents on the healing of experimental mucosal erosions and on the noradrenaline content in the stomach wall]. / Vliianie neirotropnykh sredstv na zazhivlenie éksperimental'nykh érozii slizistoi obolochki i na soderzhanie noradrenaeina v stenke zheludka.

In immobilized rats with hemorrhagic erosions of gastric mucosa induced by 8-hour electric stimulation, the neurotropic agents were injected intraperitoneally over three days after stimulation was discontinued. Phenamine and melipramine were conductive to healing of the mucous membrane erosions and produced no effect on the recovery of noradrenaline level in the intestinal wall. Clonidin and reserpin inhibited erosion healing and noradrenalline level recovery, whereas eterofen and atropin elicited no effect on the test parameters.

[Effect of L-dopa on the catecholamine content and myocardial ultrastructure and contractility in heart surgery]. / Vliianie L-dofa na soderzhanie katekholaminov, ul'trastrukturu i sokratitel'nuiu sposobnost' miokarda pri operatsiiakh na serdtse.

The fluorometric and histochemical methods of the catecholamines contents determination and electronic microscopy of the ultrastructure were used in the examination of myocardium biopsy preparations. The heart operations were followed with the decrease of catecholamines contents in the myocardium and disorder of the mitochondria ultrastructure. The l-DOPA injection resulted in the increase of the myocardium contractile ability before the operation, but did not prevent from its decrease in the postoperative period. The postoperative l-DOPA administration combined with digitalis, according to the described scheme, contributed to the preservation of the myocardium contractile ability at the optimal level.

[Effect of pharmacological substances on the development of hemorrhagic erosions and on the noradrenaline level in the stomach wall in rats]. / Vliianie farmakologicheskikh veshchestv na razvitie gemorragicheskikh érozii i uroven' noradrenalina v stenke zheludka u krys.

Hemorrhagic erosions of the gastric mucosa were produced through electric stimulation of immobilized rats via electrodes stuck into the muscles of the fore-paws. In the experiment there was applied square pulsed current of 5--7 v (per 10 rats) with frequency of 50 Hz and the pulse time of 10 ms. Prior to stimulation the rats received intraperitoneally one of the following drugs: clonidin (0.1 mg/kg), benactyzine (3 mg/kg), etherophen (20 mg/kg), benzohexonium (10 mg/kg), iprazid (100 mg/kg), amphethamine (4 mg/kg), atropine (1 mg/kg), tyrosine (300 mg/kg), aethimizol (10 mg/kg) and orotic acid (10 mg/kg). The animals were sacrificed directly after stimulation and the norepinephrine level in the gastric wall was determined after E. Sh. Matlina and T. B. Rakhmanova (1967). Introduction of clonidin, benacyzine, etherophen, benzohexonium and iprazid to immobilized rats after electric stimulation prevented the development of hemorrhagic erosions and a drop of the norepinephrine level in the gastric wall, whereas amphethamine and tyrosine intensified the process of the erosions development in the gastric mucosa and did not prevent a decline in the norepinephrine level. Atropine and aethimizol had no effect on the findings under study.

[Effect of phepracet and its derivatives on the development of neurogenic dystrophy of the stomach wall and the concentration of noradrenaline in it]. / Vliianie fepratseta i ego proizvodnykh na vozniknovenie neirogennoi distrofii stenki zheludka i soderzhanie v nei noradrenalina

The "weighted" phenamine derivatives--phepracet (beta-phenyl isopropylamide of paraaminophenylacetic acid) and preparations IZM-611 ((phenylisopropylamide of paradipropylaminophenylacetic acid) and IZM-487 (phenylisopropylamide of paradietylaminophenylacetic acid) positively prevented the development of hemorrhagic erosions in the gastric wall and forced down the nerepinephrine level in it caused by a 3-hour electric stimulation of immobilized rats. The greatest prophylactic effect produced the preparation IZM-611. A direct relation between intensity of the antiulcerous action of the drugs and their ability to block the reticular formations of the midbrain was noted.