[Femoral nerve repair with autografts for proximal retroperitoneal damage (case report and literature review)]. / Autoplastika bedrennogo nerva pri ego proksimal'nom zabryushinnom povrezhdenii (klinicheskoe nablyudenie i obzor literatury).

Femoral nerve damage, especially in proximal retroperitoneal space, is rare. Therefore, surgical strategy is still unclear for these patients. Various specialists discuss repair with autografts or neurotization by the obturator nerve or its muscular branch. OBJECTIVE: To demonstrate the diagnostic algorithm for proximal femoral nerve injury and favorable outcomes after repair with long autografts. MATERIAL AND METHODS: We assessed movements and sensitivity using a five-point scale, as well as ultrasound, magnetic resonance imaging and electroneuromyography data in a patient with extended iatrogenic femoral nerve damage before and after repair with long autografts (10.5 cm). RESULTS AND DISCUSSION: The patient had complete femoral nerve interruption in proximal retroperitoneal space with 10-cm defect that required repair with five autografts from two sural nerves. Postoperative ultrasound and magnetic resonance imaging revealed signs of graft survival and no neuroma within the nerve suture lines. The first signs of motor recovery occurred after 10 months. After 14 months, strength of quadriceps femoris muscle comprised 4 points, and electroneuromyography confirmed re-innervation. CONCLUSION: Femoral nerve repair with autografts for complete proximal anatomical interruption can provide sufficient restoration of movements and sensitivity. Therefore, this surgical option should be preferred instead of neurotization. Ultrasound, MRI and ENMG are valuable to clarify the diagnosis and state of the autografts.

[Enhanced recovery protocol in gerontological colon cancer patients]. / Programma uskorennogo vyzdorovleniya bol'nykh starshikh vozrastnykh grupp pri rake obodochnoi kishki (s kommentariem).

To develop enhanced recovery protocol for elderly and old patients in elective colon cancer surgery. In Russia as in the most world countries the biggest frequency of colon cancer are among elderly and old people. At the same time surgery treatment of elderly patients compared with young patients accompanied with increased frequency of complications, length of stay in hospital and mortality. Based on own and literature trials authors proposed enhanced recovery protocol for gerontological colon cancer patients. Protocol established on multidisciplinary approach to elderly and old patients treatment and include all stages of perioperative period.

[Hemodynamic features of anesthesiological maintenance of operations on the lungs in oncological practice when using high epidural anesthesia]. / Gemodinamicheskie osobennosti anesteziologicheskogo obespecheniia operatsii na legkikh v onkologicheskoi praktike pri ispol'zovanii vysokoi épidural'noi anestezii.

The investigation was aimed at studying the effects of epidural anesthesia with local anesthetics alone and in combination with Fentanyl on blood circulation (a comparison of effects of Markain with Naropin) against the background of the infusion of Diprivan by the purposeful concentration during anesthesiological maintenance of operations on the lungs in oncology. The investigation was carried out in 111 patients operated upon for lung cancer. Mildly reduced parameters of systemic hemodynamics when using local anesthetics with Fentanyl were revealed and more pronounced effects on blood circulation when using local anesthetics alone. Hemodynamic effects of Markain were not reliably different from those of Naropin. Thus, the both medicines can be equally used for epidural anesthesia as components of anesthesiological maintenance during operations on the lungs that provides an acceptable level of the antinociceptive protection.

[Use of the new non-depolarizing myorelaxant, Nimbex, for anesthesiologic maintenance in high-risk thoracic operations]. / Primenenie novogo nedepoliarizuiushchego miorelaksanta Nimbeksa pri anesteziologicheskom obespechenii torakal'nykh operatsii vysokogo riska

The article presents main results of the open randomized investigation of the effectiveness and safety of the new non-depolarizing myorelaxant Nimbex included in the composition of anesthesiological maintenance of thoracal operations of high risk. The authors give data of its influence on neuromuscular conduction and main hemodynamic indices during different periods of the operative intervention. The assessment of the intubation condition, depth of the neuromuscular block and of the dynamics of reestablishment of the neuromuscular conduction is shown. A conclusion is made of the possibility to use the myorelaxant in question as a preparation of choice for the maintenance of thoracal operations in high risk patients.

[Clinical and laboratory grounds for using solcoseryl in high-risk patients]. / Kliniko-laboratornoe obosnovanie ispol'zovaniia solkoserila u bol'nykh vysokogo riska.

In 56 patients aged from 58 to 82 years with the III and IV degrees of risk operated upon for malignant tumors of organs of the thoracic and abdominal organs Solcoseryl was included in the complex of anesthesia measures. It was given intravenously or as inhalation in dosage of 1000 mg. It was found that using Solcoseryl considerably reduced the amount of postoperative complications in high risk patients. It led to lower level of lipid peroxidation and activation of the antioxidant system and thus may be considered as an important component of therapy at the intra- and postoperative periods.

[Epidural anesthesia using local anesthetics and clopheline in geriatric urology]. / Epidural'naia anesteziia s ispol'zovaniem mestnykh anestetikov i klofelina v geriatricheskoi urologii.

Study of pharmacokinetics of lidocaine, trimecaine, and clofelin demonstrated rapid resorption of these drugs in the postoperative period. Comparison of two methods of epidural anesthesia in high-risk patients (ASA 3) subjected to urologic surgery showed the objective advantages of adrenergic regional anesthesia, ensuring the stability of vital functions during surgery and allowing operations in awaken patients with adequate spontaneous respiration.