Method for spinal anesthesia at prolonged adrenoganglioplegia
FIELD: medicine, anesthesiology, surgery.
SUBSTANCE: in preoperational and early postoperational periods after planned and urgent operations one should intramuscularly inject adrenogangliolytics: benzohexonium 0.18 - 0.22 mg/kg, droperidol 0.078 - 0.083 mg/kg and obzidan 0.016 - 0.022 mg/kg thrice daily; moreover, the time for their introduction after operation depends upon the type of anesthetic preparation applied to carry out spinal anesthesia, that is: if one applied lidocaine as local anesthetic the above-mentioned adrenogangliolytics should be introduced 2 h after the end of operation, and if marcaine was applied as local anesthetic - 3 h after the end of operation. The innovation enables to prevent disorders of central and peripheral hemodynamics at carrying out spinal anesthesia in perioperational period.
EFFECT: higher efficiency.
The invention relates to medicine, namely to anaesthesia and surgery.
- spinal anaesthesia with the use of agonists for prevention of arterial hypotension include premedication with 0.5-1 ml of 5% solution of ephedrine , using 5% solution of ephedrine in the development of hypotension ;
- spinal anaesthesia with holding giperwolemicescoy hemodilution: before anesthesia spend infusion of 1.2-1.6 l of saline solution .
The disadvantages of these methods: for the prevention of arterial hypotension include sedation adrenoceptor agonist or spend giperwolemicescoy hemodilution before or after intrathecal injection of local anesthetic. These methods do not always prevent the development of arterial hypotension, often breaking the Central  and peripheral blood .
The closest is the way spinal anesthesia proposed Ipinapaalam and Neerajanam . This way the SA includes an introduction to the patient during the days before the planned operation to be performed three times intramuscularly: 0,18-0,22 mg/kg benzogeksoniya, 0,078-0,083 mg/kg droperidola, 0,016-0,022 mg/kg obsidan; and twice intramuscularly: 0,13-0,18 mg/kg Dimedrol, and 0.09-0.16 mg/kg Relanium; emergency anesthesiology intramuscularly for 30-50 minutes before surgery: 0.18 to 0.22 mg/kg benzogeksoniya, 0,078-0,083 mg/kg droperidola, 0,016-0,mg/kg obsidan; on the operating table intravenously: 0,06-0,085 mg/kg benzogeksoniya, 0,039-0,043 mg/kg droperidola, 0,016-0,022 mg/kg obsidan, 0,13-0,18 mg/kg Dimedrol, 0.12 to 0.16 mg/kg Relanium, then on the operating table - the treatment of the skin with an antiseptic before manipulation, the definition of anatomical landmarks and infiltration of the skin with local anesthetic solution at the level of the selected intervertebral space, the puncture of the subarachnoid space and intrathecal injection of local anesthetic solution.
Disadvantages: in the early postoperative period, after the expiration of the local anesthetic and termination medical sympathectomy in patients, especially those with concomitant diseases of the cardiovascular system, develop violations of the first, Central (hypertension or significantly less hypotension), and then and peripheral hemodynamics.
The objective of the invention to prevent the development of disorders of the Central and peripheral hemodynamics in the perioperative period, to improve the quality and safety of anesthesia.
The task to solve due to the fact that the patient in the early postoperative period three times a day intramuscularly: 0,18-0,22 mg/kg benzogeksoniya, 0,078-0,083 mg/kg droperidola, 0,016-0,022 mg/kg obsidan; introduction of adrenocorticolytic begin after the operation: after 2 hours the - when used as a local anesthetic is lidocaine or 3 hours when using marcaine.
The method is carried out: the patient during the days before the planned operation to be performed three times intramuscularly: 0,18-0,22 mg/kg benzogeksoniya, 0,078-0,083 mg/kg droperidola, 0,016-0,022 mg/kg obsidan; and twice intramuscularly: 0,13-0,18 mg/kg Dimedrol, and 0.09-0.16 mg/kg Relanium; emergency anesthesiology intramuscularly for 30-50 minutes before surgery: 0.18 to 0.22 mg/kg benzogeksoniya, 0,078-0,083 mg/kg droperidola, 0,016-0,022 mg/kg obsidan; on the operating table intravenously: 0,06-0,085 mg/kg benzogeksoniya, 0,039-0,043 mg/kg droperidola, 0,016-0,022 mg/kg obsidan, 0,13-0,18 mg/kg Dimedrol, 0.12 to 0.16 mg/kg Relanium. In the early postoperative period in patients after conducting both scheduled and emergency operations three times a day intramuscularly: 0,18-0,22 mg/kg benzogeksoniya, 0,078-0,083 mg/kg droperidola, 0,016-0,022 mg/kg obsidan. The introduction of adrenocorticolytic begin after the operation: after 2 hours when used as a local anesthetic is lidocaine or 3 hours when using marcaine.
Literature data on the application of SA in the Russian Federation is very heterogeneous. Thus, according to one research the use of SA, depending on the regions varies from 0 to 40% . Although an increasing number of authors gives the data of the regional preference is Nastasia (RA) over the total in obstetrics and gynecology, orthopedics and traumatology, vascular surgery [6, 20, 23]. But the other  Express an opinion about a cautious approach to the use of RA and that combined endotracheal anaesthesia is preferred. In some publications  note that in the presence of concomitant somatic pathology of RA is the method of choice when performing anesthesia.
Currently, patients of elderly and senile age are increasingly subjected to surgical intervention [3, 17]. As the age of patients with disorders of rhythm and conduction of the heart is on average about 60 years, the ageing surgical contingent led to a higher incidence of this pathology in anesthetic practice . Some authors consider that it is at risk (elderly age, comorbidities) in the provision of anesthesia care should be given preference RA .
SA is a simple and relatively safe method of anesthetic management. Major surgery, where spinal anesthesia can be a exclusive method, it gynaecology and urology[19, 20, 22].
Controversial is the age criterion in the planning of holding SA patients. Some authors believe that the safety of patients during the traditional SA is directly dependent on hell is tatiannah capabilities of the organism. For patients belonging to the group of increased risk (expressed atherosclerosis, diabetes mellitus, hypertension, chronic ischemic heart disease, heart failure, elderly and senile age), according to some authors, should be abandoned in favor of another method of pain [13, 18], as there has been a sharp (48,9%) increase in the number of hemodynamic disorders in persons older than 50 years. Other authors  believe that the application of CA in all groups of patients provides an adequate level of protection from operational stress, more stable hemodynamic parameters.
The main parameters of the circulation is largely dependent on the functional state of the terminal segment of the vascular bed. The blood flow in the terminal division of the vascular bed is regulated by nervous and humoral mechanisms . Neurological regulation is mainly due to vasoconstrictor fibers of the sympathetic nervous system and circulating in the blood vasoactive substances, changing the adaptation of blood vessels, affect their reactivity .
Ganglioblokatory, acting on autonomic ganglia, causing a break not only outward, but also the local viscero-visceral reflexes. Ganglion blockade causes a noticeable increase blood circulation, and increase krovatka skin vessels greater than in the blood vessels of muscles . Use in the preoperative preparation of alpha - and beta-blockers prevents excessive neuroendocrine response. The combined use of adrenergic and ganglioblokatorov in the preoperative preparation allows to strengthen the role of humoral regulation of vascular tone due to neuroendocrine inhibition [10, 11], and in the early postoperative period to prevent the pathological effects of the sympathetic nervous system on vascular tone after stopping medication sympathectomy .
The advantages of the proposed method: the prevention of disorders of the Central and peripheral hemodynamics when performing spinal anesthesia in the perioperative period, improving the quality and safety of anesthesia, especially in patients with concomitant diseases of the cardiovascular system.
1. Adigezalov SO, Negotino IV, Koklyaev NV Improve the quality of combined anesthesia cesarean section when using clonidine // all-Russian Congress of anesthesiology and resuscitation, 8: proc. Dokl. - Omsk, 2002. - P.41.
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6. Guryanov, VA, Bales V.L. Anesthesia for cesarean section in pregnant women with late gestosis // all-Russian Congress of anesthesiology and resuscitation, 8: proc. Dokl. - Omsk, 2002. - 49.
7. Getaref. Regional anesthesia and pain management // Clinical anesthesiology. - SPb., 2000. - S-273.
8. Dobson MB Anaesthesia at the district hospital // who. Geneva, 1989. - 106-109 C.
9. Nazarov Ippolita ganglioplegic in anesthesiology and surgery. - Krasnoyarsk, 1999. - P.61-63.
10. Nazarov I.P. Condition of some neuroendocrine systems in patients in the operative and postoperative period in terms of extended ganglion blockade with normotone // Anestesiol. and Reanimator. - 1981. No. 5. - P.17-21.
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13. The experience of pain in cancer patients older /Ovchinnikov, VA, Ivashchenko E.A., Voronkin YU. and others // all-Russian Congress of anesthesiology and intensive care, 7th: proc. Dokl. - SPb., 2000. - P.205.
14. Peculiarities of anesthesia in patients of elderly and senile age with operations osteosynthesis of hip /Antonkosenko, Achromatize, Masolov and others // all-Russian Congress of anesthesiology and resuscitation, 8: proc. Dokl. - Omsk, 2002. - S.
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16. Indications for epidural, spinal and combined peridural-spinal anesthesia /Aigrette, Vauhan, Apiece and others // all-Russian Congress of anesthesiology and intensive care, 7th: proc. Dokl. - SPb., 2000. - P.62.
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21. Anesthetic management of parturients with cerebrovascular diseases /T.Abe, K.Kinouchi, T.Kita et al. // Masui. - 1999. - V.48, no. 7. - P.773-777.
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23. Stober H.D., Mencke T. General anesthesia or spinal anesthesia for hip replacement prosthesis? Studies of acceptance of both procedures by patients // Anaesthesiol. Reanim. - 1999. - V.24, No. 6. - R-156.
How spinal anesthesia with extended adenohypophysial, including the introduction in the preoperative period of adrenocorticolytic: benzogeksoniya 0,18-0,22 mg/kg, droperidola 0,078-0,083 mg/kg and obsidan 0,016-0,022 mg/kg, puncture of the subarachnoid space and intrathecal injection of local anesthetic solution: lidocaine or marcaine, characterized in that after elective and emergency operations in the early postoperative period three additional times during the day to enter these adrenocorticolytic intramuscularly in the same doses, with their introduction begin after the operation: after 2 hours when used as a local anesthetic, lidocai the a or 3 hours - when using marcaine.
FIELD: medicine, intensive therapy.
SUBSTANCE: the present innovation deals with body detoxication due to introducing sodium hypochlorite at concentration of 75-90 mg/l at the volume of 400 ml at the rate of 70-80 drops/min. The present innovation enables to restore hemodynamics, normalize the level of thyroid hormones and the values of immunological status and decrease the values of lipid peroxidation due to applying less concentration of sodium hypochlorite that, in its turn, also, prevents the damage of peripheral veins.
EFFECT: higher efficiency.
4 ex, 4 tbl
FIELD: veterinary science.
SUBSTANCE: the suggested preparation for treating puerperal endometritis in cows contains licorice root and loseval as active substances and water as an additional substance at the following ratio of components, weight%: licorice root 59-60, loseval 29-30, water - the rest. Curative effect of the suggested preparation at treating acute puerperal and purulent endometritis in cows corresponds to 96% and 90%, correspondingly. The preparation is of antiseptic and antiphlogistic activity, as well.
EFFECT: higher efficiency of therapy.
FIELD: medicine, proctology, pharmaceutics.
SUBSTANCE: the present innovation deals with obtaining medicinal forms as suppositories applied for treating proctological diseases. Medicinal preparation as suppositories containing active substance, anesthetic, purified water and foundation could additionally contain antiseptic and local irritating substance, as an active substance - glucocorticoid at the following ratio of components, weight%: glucocorticoid 0.0277-0.0368, anesthetic 1.8-2.2, antiseptic 2.8-3.52, local irritating substance 0.288-0.352, purified water 1.8-2.2, foundation - the rest. As glucocorticoid that inhibits the release of inflammation mediators and causes pronounced antiphlogistic and antiallergic action one should apply, for example, hydrocortisone or synaflane. As anesthetic one should apply, for example, anesthesin, lidocaine or trimecaine. As antiseptic being of astringent, drying off and analgesic actions one should apply, for example, dermatol or xeroform. As local irritating substance being of reflector, venotonic, analgesic and antiphlogistic and, also, antimicrobial actions one should apply, for example, racemic menthol or essential oils.
EFFECT: higher therapeutic efficiency.
5 cl, 3 ex, 4 tbl
FIELD: medicine; pharmaceutical engineering.
SUBSTANCE: pharmaceutical composition COMPRISES 5-(2-pyrazinyl)-4-methyl-1,2-dithyol -3-thion (oltipraze) and dimethyl-4,4'-dimetoxi-5,6,5',6'-dimethylene-dioxybiphenyl-2,2' dicarboxilate (DDB) as the main components. Oltipraze: DDB proportion is preferentially equal to 50-1:1-50, the most preferential being 5:1.
EFFECT: enhanced effectiveness of treatment.
6 cl, 6 dwg, 9 tbl
FIELD: veterinary medicine.
SUBSTANCE: method involves subcutaneously introducing immunomodulator like denatured suspended placenta at a dose of 20 ml/head/day 10 days before calving during 10 days.
EFFECT: enhanced effectiveness in preventing fetal envelopes from degradation.
2 cl, 9 dwg
SUBSTANCE: method involves determining vegetative nervous system tonus in preoperative period using Kerdo index and selecting intravenous anesthetic depending its value. Parasympathetic vegetative nervous system tonus being predominant, ketamine is introduced to patient at a dose of 1-1.5 mg/kg/h during the operation. Marked sympathetic vegetative nervous system tonus being predominant, propophol is administered at a dose of 2-4 mg/kg/h. Balanced vegetative nervous system divisions tonus being observed (eutonia), both ketamine and propophol are permitted for being used in generally applied doses.
EFFECT: enhanced effectiveness of treatment; avoided undesirable hemodynamic carbodioxyperitoneum effects.
SUBSTANCE: method involves introducing perfluoran bubbled with ozone-and-oxygen mixture with given ozone concentration of 3000 mkg/l during 15 min.
EFFECT: restricted peritoneal inflammation.
FIELD: medicine, toxicology, pharmacy.
SUBSTANCE: according with the first variant the composition contains neutral lipid and therapeutically effective amount of cholanic acid or cholanic acid salt and phospholipid. Neutral lipid presents in the amount from 3% to 50% by mass relatively to the total amount of lipid. According with the second variant the composition contains from 3% to 30% by mass of bile acid or bile acid salt, from 3% to 50% by mass of neutral lipid and from 10% to 95% by mass of phospholipid. Composition is designated for treatment in poisoning with endotoxins. Composition no containing peptides and proteins but containing the combination of phospholipid with cholanic acid proves effective relief or prophylaxis of endotoxemia.
EFFECT: enhanced effectiveness and valuable medicinal properties of composition.
23 cl, 10 dwg, 2 tbl, 10 ex
SUBSTANCE: method involves exposing erythrocytic mass, produced in apparatus, to ultraviolet radiation of wavelength equal to 256 nm produced with a lamp source operating during 15-20 min. Then it is modified with an antibiotic and returned to patient.
EFFECT: enhanced effectiveness of treatment; increased sensitivity to antibiotics; reduced drug consumption.
FIELD: medicine, surgery, transplantology.
SUBSTANCE: embryonic spleen should be sampled, washed in nutritive medium № 199 to be placed into fresh medium № 199 to obtain homogenate in teflon homogenizer followed by centrifuging; then one should isolate the upper, medium and inferior layers, suck off medium layer and the upper part of inferior layer; the cell mixture obtained should be diluted in nutritive medium № 199 to be then introduced by injections into mesentery of small intestine or rectus muscle of abdomen. The present innovation favors the activation of immune system in patients undergone splenectomic operation and in those in case of surgical immunodefficient state due to high functional and regenerating activity of transferred embryonic splenic cells.
EFFECT: higher efficiency of prophylaxis.
6 dwg, 2 tbl
FIELD: medicine, orthopedics, traumatology.
SUBSTANCE: one should perform blockades in crossing points of vertical line located along anterior surface of the inferior third of patient's shin at equal distance against median and lateral ankles and the line connecting supramalleolar areas, and, also, in crossing points of vertical line and horizontal one that connects the tops of ankles to improve the accuracy of injections made.
EFFECT: higher efficiency of conservative therapy.
1 dwg, 1 ex
FIELD: medicine, surgery, anesthesiology, traumatology, orthopedics.
SUBSTANCE: before operation one should perform premedication by prescribing individual dosages of tranquilizers and analgesics followed by subarachnoidal anesthesia by applying anesthetizing preparations being 2-3 segments higher against the site of operation, moreover, anesthetizing preparations should be introduced simultaneously into subarachnoidal space and the quantity of anesthetic introduced should not exceed 75% against the standard dosage. The present innovation provides reliable protection before operation and raise the development of tolerant impact of adaptation processes to higher power, improves the flow of postoperational period by preventing the development of postoperational pain syndrome, catabolic reaction and immunosuppression.
EFFECT: higher efficiency.
1 ex, 2 tbl
FIELD: medicine, anesthesiology.
SUBSTANCE: as the values of anesthesiological efficiency one should apply temperature alteration in area of local anesthetic's action and at decreased temperature by 0.6 C and more one should conclude upon efficiency of anesthesia; moreover, the temperature in area of anesthetic injection should be measured not earlier than 2 min after its injection. The present innovation enables to objectively evaluate the efficiency of infiltration anesthesia followed by its correction in the course of operative interference.
EFFECT: higher accuracy of detection.
1 cl, 2 ex
FIELD: organic chemistry, medicine.
SUBSTANCE: invention relates to new compound: N-[2-hydroxy-3(1-piperidinyl)-propoxy]-pyridine-1-oxyde-3-carboxyimidoyl chloride, stereoisomers thereof acid additional salts useful in treatment of pathological insulin resistance.
EFFECT: new compound useful in medicine.
5 cl, 10 tbl, 10 ex