[Dynamics of indicators of blood inorganic phosphorus during gastrointestinal surgery]. / Dinamika pokazatelei neorganicheskogo fosfora krovi pri operatsiiakh na organakh zheludochno-kishechnogo trakta.

Inorganic phosphorus and the associated potassium, magnesium, and sodium ion levels were measured in the serum and daily urine in the perioperative period in 210 patients of both sexes aged 31-84 years subjected to planned and urgent surgery on the abdominal organs. Control group consisted of 14 patients subjected to planned operations for inguinal hernias. Intraoperative hypophosphatemia was observed in all patients at the beginning, during, and immediately after the operation. The level of serum phosphorus decreased greater (48.1%) during operations performed under local anesthesia than under total anesthesia (by 24.5%) or under total anesthesia combined with epidural analgesia (by 20.4%). After the operation, changes in the serum phosphorus concentration directly depended on the severity of hemostatic disorders: after short operations, the level of serum phosphorus spontaneously normalized within the first 24 h after surgery. After more extensive interventions (resections of the stomach, large intestine, abdominoperineal operations), the decrease of serum phosphorus was 0.3 mmole/liter, on average, and persisted for at least 3-5 days after surgery. The changes were the greatest in patients subjected to urgent operations for ileus and peritonitis. In this group, manifest hypophosphatemia persisted for the entire period of observation, that is, for at least 5 days postoperation, and had to be corrected.

[Anesthesia safety problems in general-profile surgical patients with concomitant hypertension and ischemic heart disease]. / Problemy bezopasnosti anestezii u khirurgicheskikh bol'nykh obshchego profilia s soputstvuiushchei gipertonicheskoi bolezniu i ishemicheskoi bolezn'iu serdtsa.

The authors discuss the problems in the anesthesiological approach to surgical patients with concomitant essential hypertension and coronary disease. These patients form the high-risk group for surgery and anesthesia, and the hazard of total anesthesia consists in the actual potentiality of cardiovascular decompensation both during and after the operation. Problems in medicamentous preparation of such patients to surgery, preoperative identification of coronary disease, dynamic computer monitoring of hemodynamics, and choice of anesthesia are discussed.

[Hemo-hydrodynamic monitoring in intensive care of patients with severe course of peritonitis]. / Gemogidrodinamicheskii monitoring pri intensivnom lechenii bol'nykh s tiazhelym techeniem peritonita.

The central hemodynamics and aqueous spaces of the body were examined in patients with peritonitis running a grave clinical course. The authors developed rational methods to correct the hemodynamics and water balance at different stages of treating peritonitis and infectious toxic shock. Continuous hemohydrodynamic monitoring is recommended to be used during intensive care of patients with infectious toxic shock.

[Changes in central hemodynamics and the heart conduction system during total intravenous anesthesia using diprivan in extensive abdominal surgery]. / Izmeneniia tsentral'noi gemodinamiki i provodiashchei sistemy serdtsa pri total'noi vnutrivennoi anestezii s ispol'zovaniem diprivana vo vremia obshirnykh abdominal'nykh operatsii.

Diprivan was included in the multicomponent intravenous anesthesia during extensive prolonged and traumatic operations in abdominal surgery and gynecology. The investigations showed the minimal effect of anesthesia with diprivan, diazepam, and phentanyl on the central hemodynamics and conducting system of the heart. The suggested anesthetic scheme may be a method of choice in patients at a high risk of surgical anesthesiological injury.

[The effect of diprivan on the indices of central hemodynamics and the heart conduction system]. / Vliianie diprivana na pokazateli tsentralnoi gemodinamiki i provodiashchuiu sistemu serdtsa.

Using impedance tetrapolar plethysmography and transesophageal electrical stimulation of the left ventricle, changes in central hemodynamic parameters have been assessed in 46 women during brief (up to 10 min) anesthesias with diprivanum. Bolus injection of diprivanum at a dose of 2.5 mg per 1 kg body weight was used. It has been demonstrated that diprivanum administration decreased BP, which was associated with a drop in total peripheral resistance and stroke volume that led to the absence of compensatory tachycardia to an increase in the cardiac output. The absence of compensatory tachycardia upon diprivanum administration is accounted for by a combined effect of vagotonic diprivanum action and its ability to inhibit moderately the automatic function of the sinoatrial node.