RESUMO
We described our experience in using the new noninvasive hemodynamic monitoring (esCCO), which allowed recording most important parameters of heart capacity. Infusion therapy during laparoscopic operations might be based on dynamic of systolic blood volume. This functional approach can be used for evaluation of heart reaction on bolus fluid load, to optimike volemic status in situations associated with dynamical blood circulation changes. We compared intraoperative infused fluid volumes, calculated by traditional approach and by target approach. The obtained results had significant differences among groups, and didn't correspond with "liberal" and "restrictive" strategy for infusion therapy.
Assuntos
Hidratação/métodos , Coração/fisiologia , Hemodinâmica/fisiologia , Soluções Isotônicas/administração & dosagem , Laparoscopia/métodos , Monitorização Intraoperatória/métodos , Adulto , Soluções Cristaloides , Eletrocardiografia , Feminino , Decúbito Inclinado com Rebaixamento da Cabeça , Humanos , Hipovolemia/prevenção & controle , Masculino , Pessoa de Meia-IdadeRESUMO
So far, the ongoing debate about the appropriateness of combining drugs with different mechanisms of analgesic action for optimal antinociceptive protection. The review deals with the theoretical calculations arguing with the physiological rationality for the inclusion of central α2-agonists in the scheme of modern multimodal analgesia. We have presented data from recent reviews regarding the efficacy and safety of intraoperative application of dexmedetomidine as a one of the latest drugs in this class.
Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Analgésicos não Narcóticos/uso terapêutico , Dexmedetomidina/uso terapêutico , Dor/tratamento farmacológico , Agonistas de Receptores Adrenérgicos alfa 2/administração & dosagem , Agonistas de Receptores Adrenérgicos alfa 2/efeitos adversos , Agonistas de Receptores Adrenérgicos alfa 2/farmacocinética , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/efeitos adversos , Analgésicos não Narcóticos/farmacocinética , Dexmedetomidina/administração & dosagem , Dexmedetomidina/efeitos adversos , Dexmedetomidina/farmacocinética , Quimioterapia Combinada , Humanos , Dor/metabolismo , Receptores Adrenérgicos alfa 2/metabolismo , Transdução de Sinais , Transmissão Sináptica/efeitos dos fármacos , Distribuição TecidualRESUMO
UNLABELLED: The article deals with a study of efficacy and safety of the dexmedetomidine as an analgesic adjuvant drug for anaesthesia during laparoscopic gynecological and abdominal surgeries. Patients and methods: 32 patients received intraoperative infusion of dexmedetomidine. We assessed an effects of dexmedetomidine on data of central circulation during surgeries. CONCLUSIONS: The use of dexmedetomidine allows to decrease an amount of opioid analgesics, inhalation anaesthetics and to avoid severe changes of circulation during traumatic phases of surgeries.
Assuntos
Analgesia/métodos , Analgésicos não Narcóticos/uso terapêutico , Anestesia Geral/métodos , Dexmedetomidina/uso terapêutico , Laparoscopia/métodos , Dor Pós-Operatória/prevenção & controle , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/efeitos adversos , Dexmedetomidina/administração & dosagem , Dexmedetomidina/efeitos adversos , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Infusões Intravenosas , Cuidados Intraoperatórios , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
The study deals with two mostly discussed techniques of postoperative analgesia for total knee joint arthroplasty. Surgeries were performed under subarachnoid anaesthesia with intravenous sedation. 9 patients of first group in received prolonged femoral nerve blockade as a component of multimodal analgesia. 8 patients of second group received epidural infusion of naropine. If basic technique of analgesia was not effective patients received trimeperidine 20 mg intramuscular. Patients of second group had less pain syndrome (in order to visual analogue scale) and did not need additional administration of opioids.
