[Total intravenous anesthesia (TIVA) with propofol/ketamine as an alternative for patients at risk in abdominal surgery]. / Totalna intravenozna anesteziia (TIVA) s propofol/ketamine kato alternativa pri riskovi bolni v koremnata khirurgiia.

Propofol/ketamine combination, used in total intravenous anesthesia (TIVA), is assayed in patients with abdominal diseases presenting surgical and anesthesiological risk of a varying degree. The aim of the study is to outline an optimal regimen of propofol infusion as a hypnotic agent and ketamine as analgetic during TIVA with a special reference to the hemodynamic effects and characteristic features of the recovery period. Anesthesia is applied to 15 patients presenting physical condition III--IV degree according to ASA and indications for various intraabdominal surgical interventions, including operations on an emergency basis. To improve anesthesia control, microprocessor infusion pumps Ohmeda and Becton-Dickinson, allowing for prompt dosage correction, consistent with individual needs, are employed. The strategy of dosing each of the drugs used is described. The basic hemodynamic parameters are followed with parallel assessment of the quality of anesthesia with a view to prevent operative stress, working conditions of the operative team, and characteristic features of the recovery period. From clinical viewpoint the technique proves to be satisfactory, and may be used as an alternative to conventional anesthesia in poor-risk patients indicated for abdominal surgery.

[Is propofol (Diprivan) indicated in emergency surgery?]. / Pokazan li e propofol (Diprivan) v speshnata khirurgiia.

Propofol is an anesthetic characterized by specific pharmacologic qualities, conditioning compliance of the clinical picture with the drug infusional rate, high-degree safety and facilitated anesthesia conduction--qualities by which it bears resemblance to inhalation anesthesia. This is an assessment of the qualities of TIVA with Propofol in poor-risk patients according to ASA, operated on an emergency basis. Proceeding from the obtained results, the inference is reached that continuous Propofol infusion provides for adequate anesthesia control and safety of the patients with heightened anesthesiologic and operative risk.

[Prolonged propofol (Diprivan) infusion for sedation in the critically ill]. / Produlzhitelna infuziia na propofol (Diprivan) za sedirane na kritichni bolni.

Continued sedation has important practical implications on overcoming the physical and psychic stress which in turn, has important practical implications on the well-being of patients in conditions of intensive care unit. It is the purpose of the study to assess the quality and characteristics of sustained sedation with constant propofol (Diprivan) and fentanyl infusion. As a result of the study the inference is reached that sedation with Diprivan and fentanyl, administered as constant infusion, lends itself readily to control, and what is more, it is free of noteworthy side effects. To secure permanent sedation it is necessary to adapt the infusional rate to the clinical signs in compliance with the concrete patient and individual needs.

[Changes in the water-electrolyte and protein balance of the body in acute gastrointestinal ulcerative hemorrhage]. / Promeni na vodno-elektrolitniia i beltuchniia balans na organizma pri ostrata gastrointestinalna iazvena khemoragiia.

The authors studied 127 patients, divided into 4 groups, relating to the haemorrhage stage in accordance with the classification of Lutsevich. It has been established that there exist changes in the hydroelectrolytic and protein balance of the patients having acute gastrointestinal ulcerative haemorrhage.