scholarly journals The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients

2021 ◽  
pp. 43-47
Author(s):  
Marine Georgiyants ◽  
Olexii Popsuishapka ◽  
Victor Ryndenko ◽  
Sergiy Kursov ◽  
Volodymyr Babalian ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
Young Patients ◽  
The Body ◽  
Lower Limbs ◽  
Optimal Method ◽  
Systematic Analysis ◽  
Surgical Interventions ◽  
Vital Functions ◽  
Working Age

The relevance of the topic is due to the prevalence of lower limbs injuries in people of working age, the complexity of the methods of their surgical treatment and the problem of finding the optimal method of anesthesia in terms of efficiency and safety. Objective of the study: to conduct a systematic analysis of modern scientific literature data on the possibility of using anesthesia methods during surgical interventions and in the case of anesthesia for injuries of the lower limbs in people of working age. Materials and methods. A search for scientific sources was carried out in the scientometric databases Scopus and Web of Science, Google Scholar, archives of journals using the keywords "general anesthesia", "regional anesthesia", "injuries of the lower limbs", "young people", "general anesthesia". The search depth was 8 years. Conclusions. The problem of choosing the method of anesthesia during traumatological surgeries in people of working age has no final solution. In general, both general and regional anesthesia can be used, despite their advantages and the possibility of complications in each case. However, in clinical practice over the past decade, general anesthesia is not always the best method of pain relief. But regional methods have less effect on the vital functions of the body, and the use of ultrasound navigation and modern local anesthetics in a minimum sufficient amount makes anesthesia conduction more effective and safe. The disadvantages of regional anesthesia can be avoided by combining it with general anesthesia. However, in the available literature, there are no recommendations on the differentiated choice of the method of anesthesia for surgical interventions on the lower limbs in people of working age and the factors that influence this

Regional anesthesia for scapular fracture surgery: an educational review of anatomy and techniques

2020 ◽  
pp. rapm-2020-101819
Author(s):  
Kartik Sonawane ◽  
J Balavenkatasubramanian ◽  
Hrudini Dixit ◽  
Harshitha Tayi ◽  
Vipin Kumar Goel
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
Combine Approach ◽  
Scapular Fracture ◽  
Surgical Interventions ◽  
Scapular Fractures ◽  
Fracture Surgery ◽  
The Way

Scapular fractures are very rare, and those requiring surgical interventions are even rarer. Most scapula surgeries are done under general anesthesia with or without the regional anesthesia (RA) technique as an adjunct. Since scapular innervation is complicated, a thorough review of the relevant anatomy is warranted. In this RAPM educational article, we aimed to summarize the target nerves and blocks needed to optimize analgesia or even to provide surgical anesthesia for scapula surgeries. In this review, we are describing an algorithmic “identify-select-combine” approach, which enables the anesthesiologist to understand detailed innervation of the scapula and to obtain a procedure-specific RA technique. Procedure-specific RA would probably be the way forward for defining future RA practices.

scholarly journals Treatment of critical limb ischemia in patients with multilevel arterial lesions

2018 ◽  
Vol 22 (3) ◽  
pp. 474-478
Author(s):  
V. Shaprynskyi ◽  
Y. Gupalo ◽  
O. Shved ◽  
O. Nabolotnyi ◽  
D. Shapovalov
Keyword(s):  
Atherosclerotic Lesion ◽  
Lower Extremities ◽  
Main Group ◽  
Lower Limbs ◽  
Control Group ◽  
Critical Ischemia ◽  
Optimal Method ◽  
Surgical Interventions ◽  
Limb Preservation ◽  
Arterial Lesions

The extreme manifestation of atherosclerotic lesion of the arteries of the lower extremities is the critical ischemia of the lower extremities. The number of high amputations in such patients ranges from 120 to 500 per 1 million population in the general population annually. In order to achieve the best results in the patency of the arterial bed in the near and distant periods, revascularization of the arteries of the proximal and distal blood flow is necessary. The aim of the work was to evaluate the possibilities and effectiveness of endovascular, open and hybrid arterial interventions on the lower extremities, particularly in patients with multilevel arterial disease, by conducting a retrospective analysis of treatment of critical ischemia. The results of the preoperative ultrasound duplex scan (UDS) of the arteries of 212 patients with critical ischemia of the lower limbs (CILL) shoved, that in 78 (36.8%) were multilevel arterial lesions (MLAL). Patients were divided into two groups. The first (main group) consisted of 50 patients (64%), who have been restored to the open-end and endovascular methods of MLAL, or only endovascular. The second (control) group included 28 patients (36%) — with restoration of permeability of the proximal segment without intervention on the arteries of the distal. Installed, during the period of 16 months, postoperative observation of 78 patients with MLAL, the primary frontal area of the femoral reconstruction in the main group was 92%, and limb preservation - 96%. In the control group, the permeability of the reconstruction zone was 75%, limb preservation — 82%. Thus, it has been established that the most optimal method of recovery of inflow and outflow pathways is one-time hybrid surgical interventions performed in 88% of these patients, which allow to achieve more effectively the recurrence of ischemia and maintain limb.

Various Types of Anesthesia for Cesarean Section (Literature Review)

10.12737/9085 ◽  
2015 ◽  
Vol 22 (1) ◽  
pp. 87-93
Author(s):  
Багомедов ◽  
R. Bagomedov ◽  
Омарова ◽  
Kh. Omarova
Keyword(s):  
Blood Flow ◽  
Cesarean Section ◽  
Regional Anesthesia ◽  
Surgical Stress ◽  
Infusion Therapy ◽  
Peripheral Blood Flow ◽  
Protective Effects ◽  
Sympathetic Blockade ◽  
Optimal Method ◽  
Vital Functions

The choice of anesthesia for Cesarean section is relevant in modern obstetrics, because an anesthesia should promote adequate protection of pregnant from operational stress and to create optimal conditions for the adaptation of the fetus in the perioperative and the neonatal period. In modern obstetrics, the anesthesiologist plays a significant role not only in the introduction of anesthesia for Caesarean section and to assist in the immediate postpartum period. A number of authors have noted the positive effect of segmental blocks on the vital functions at the comparison the general and regional anesthesia. In particular, hemo-rheological and stress-protective effects of regional anesthesia were identified in comparison with general anesthesia. Fewer thromboembolic complications were noted. The article discusses the various mechanisms that underlie these changes, namely, the activation of blood flow in the area of sympathetic blockade and activation of fibrinolysis, the decrease of the viscosity and aggregation properties of platelets prior to infusion therapy. The changes of hemostasis are associated with sympathetic blockade, peripheral vasodilatation, improvement of peripheral blood flow and microcirculation. According to some authors, the optimal method of modulation surgical stress is regional anesthesia, which allows to provide extensive sympathetic block during surgery and prolonged epidural analgesia.

scholarly journals Possibilities of rehabilitation in atherosclerosis of arteries of the lower limbs in combination with diabetes

2021 ◽  
Vol 24 (2) ◽  
pp. 29-32
Author(s):  
Vera S. Spiridonova ◽  
Rimma T. Sklyarenko ◽  
Oleg A. Churzin ◽  
Dmitry V. Antonov ◽  
Magomed S. Omarov
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Interdisciplinary Approach ◽  
The Body ◽  
Lower Limbs ◽  
World Health ◽  
Industrialized Countries ◽  
Surgical Interventions ◽  
The World ◽  
Health Organization

BACKGROUND: According to the World Health Organization, more than 17 million people die from cardiovascular diseases every year in the world. Coronary heart disease is the leading cause of death in industrialized countries. AIMS: To evaluate the immediate result of treatment by revascularization of the limb and organ-preserving surgical interventions for purulent-necrotic lesions of the feet, neuropathic form of diabetic foot with osteoarthropathy in chronic arterial insufficiency of the IV degree. MATERIAL AND METHODS: In the paper, the authors investigated possible treatments with different limb lesions in patients diagnosed with diabetes mellitus. Since in this disease there are complications on the cardiovascular system, most people are diagnosed with obliterating atherosclerosis, which leads to slow necrosis of the limbs. This causes diabetes patients, not only severe pain and an aesthetically unsightly state of the body, but also noticeably worsens the quality of life. RESULTS: With a consolidated approach to this problem, endocrinologists and cardiovascular surgeons developed and tested the method of endascular surgery. Patients diagnosed with obliterating lower extremity vascular atherosclerosis against the background of diabetes mellitus with trophic and necrotic lesions of the peripheral lower extremities underwent enduscular surgery to revascularize the limb, which showed not just positive immediate treatment results, but gave opportunities to preserve patients limbs. CONCLUSION: Timely recognition and treatment of purulent-necrotic lesions of the feet, the neuropathic form of diabetic foot with osteoarthropathy requires an interdisciplinary approach and close cooperation of doctors of different specialties - endocrinologists, surgeons, podiatrists, orthopedists, general practitioners, etc. Only if these conditions are met, it is possible to achieve significant success and minimize the number of irreversible deformities and amputations of the feet, the weighting of disability groups.

scholarly journals HYBRID SURGERY IN MULTI-FLOOR ATHEROSCLEROTIC INFLAMMATION OF THE MAIN ARTERIES OF THE LOWER LIMBS

2021 ◽  
Vol 4 (18) ◽  
pp. 27-31
Author(s):  
V.Y. Smorzhevsky ◽  
I.S. Pizhovskyi ◽  
P.A. Gindich
Keyword(s):  
Lower Extremities ◽  
Early Postoperative Period ◽  
Lower Limbs ◽  
Hybrid Surgery ◽  
Medical Problems ◽  
Optimal Method ◽  
Surgical Interventions ◽  
Limited Mobility ◽  
Choice Of Treatment ◽  
New Research

Cardiovascular diseases occupy one of the main groups in the structure of morbidity in most countries. A significant part of this group is affected by the main arteries of the lower extremities. Atherosclerotic diseases of the terminal aorta are combined with stenotic-occlusive lesions of the iliac-femoral, femoral-popliteal and popliteal-tibial arterial segments. Timely diagnosis and choice of treatment to maintain a full life remains one of the most pressing medical problems today. Comprehensive drug therapy used in the treatment of this pathology is ineffective and leads to limb loss, which leads to limited mobility, ability to self-care, contributes to social maladaptation and requires the involvement of the working population to care for the patient. All of the above has led to an expansion of readings to restorative operations aimed at preserving the limbs. However, reconstructive surgery of stenotic-occlusive diseases of the arteries of the lower extremities today is a complex and far from unresolved problem, which contributes to the development of new research to select the optimal method of surgical treatment. The article presents data on hybrid surgical interventions (open surgery and stenting) in 59 patients with chronic ischemia of the lower extremities. The early postoperative period in 4 (6.8%) patients was complicated by hematoma and in 5 patients (8.5%) by postoperative wound lymphorrhea. Hybrid surgeries, in chronic lower extremity ischemia in patients with multilevel lesions of the main arteries, are effective and minimally invasive, especially in patients at high risk of complications. Such technologies allow to save the limb and life of the patient with the minimum trauma, to reduce duration of stay in a hospital.

scholarly journals Analysis of vital indicators for different types of anesthesia in newborns and infants with surgical pathology

2020 ◽  
Vol 24 (4) ◽  
pp. 595-599
Author(s):  
O. O. Vlasov
Keyword(s):  
Regional Anesthesia ◽  
Surgical Pathology ◽  
Organ Function ◽  
Intravenous Anesthesia ◽  
Surgical Interventions ◽  
Group Iii ◽  
Vital Functions ◽  
Group I ◽  
Different Types ◽  
Combined Anesthesia

Annotation. In newborns and infants, surgical interventions against the background of severe concomitant and background perinatal pathologies and malformations lead to catabolic stress, circulatory and respiratory disorders, which are reflected in the indicators of vital functions. Given the high risk of severe complications of organ function in the perioperative and postoperative periods, it is advisable to continuously monitor key clinical parameters. Aim of the study – to establish the absolute values of indicators of vital functions in newborns and infants with congenital surgical pathology with various types of combined anesthesia and compare them with clinical data. A retrospective study included 150 newborns and infants with congenital malformations of the surgical profile, depending on the anesthesia (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous). The parameters of peripheral oximetry, blood pressure, heart rate and respiration were analyzed. It was found that peripheral saturation did not critically decrease at all stages of observation. With the exception of the resulting decrease in the indicator in children of group I compared with group III at the stage of induction into anesthesia (97.79±2.45 versus 98.79±1.63, at p=0.0194, respectively) and at the most painful moment of surgical intervention (96.29±3.47 versus 98.10±2.47, with p=0.0368). In children who received combined intravenous anesthesia with two drugs, there was an increase in mean arterial pressure from the beginning of surgical treatment to the child's recovery after surgery (49.49±10.71, 56.18±8.05, respectively, at p˂0.01). Thus, among the surveyed groups, the most vulnerable were children for whom anesthesia was provided by Sevoflurane inhalation with regional anesthesia. The performed correlation analysis established the effect of anesthesia on the general hemodynamics in children during all stages of observation.

A Comparison of General Anesthesia and Regional Anesthesia as a Risk Factor for Deep Vein Thrombosis Following Hip Surgery: A Critical Review

1990 ◽  
Vol 64 (04) ◽  
pp. 497-500 ◽  
Author(s):  
Martin H Prins ◽  
Jack Hirsh
Keyword(s):  
Deep Vein Thrombosis ◽  
General Anesthesia ◽  
Regional Anesthesia ◽  
Lower Incidence ◽  
Hip Surgery ◽  
Level Of Evidence ◽  
Vein Thrombosis ◽  
Postoperative Thrombosis ◽  
High Level ◽  
Deep Vein

SummaryWe evaluated the evidence in support of the suggestion that the risk of deep vein thrombosis after hip surgery is lower with regional than with general anesthesia. A literature search was performed to retrieve all articles which reported on the incidence of postoperative thrombosis in both fractured and elective hip surgery. Articles were included if the method of anesthesia used was reported and if they used mandatory venography. Based upon the quality of study design the level of evidence provided by a study was graded.In patients who did not receive prophylaxis there were high level studies in elective and fractured hip surgery. All studies showed a statistically significantly lower incidence of postoperative deep vein thrombosis with regional anesthesia (relative risk reductions of 46-55%). There were no direct comparative studies in patients who received prophylaxis. However, between study comparisons did not show even a trend towards to lower incidence of postoperative thrombosis with regional anesthesia.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

Neutral Lipids of Oats Fruit (Avena Sativa L.)

2020 ◽  
Vol 9 (4) ◽  
pp. 40-43
Author(s):  
N. K. Yuldasheva ◽  
S. D. Gusakova ◽  
D. Kh. Nurullaeva ◽  
N. T. Farmanova ◽  
R. P. Zakirova ◽  
...  
Keyword(s):  
Avena Sativa ◽  
Neutral Lipids ◽  
The Body ◽  
Biologically Active ◽  
Absorption Bands ◽  
Vital Functions ◽  
The Republic ◽  
Living Organisms ◽  
Main Components ◽  
Active Substances

Introduction. Lipids are a widespread group of biologically active substances in nature, making up the bulk of the organic substances of all living organisms. They accumulate in plants in seeds, as well as in fruits and perform a number of vital functions: they are the main components of cell membranes and the energy reserve for the body.Aim. Study of neutral lipids of sown oats (Avena sativa L.).Materials and methods. The objects of the study were fruits (grains) of oats of the sown variety "Tashkent 1," harvested in the Republic of Uzbekistan. Results and discussions. Neutral lipids of oat grains have been found to contain 13 fatty acids with a predominance of the sum of oleic, linolenic and linoleic acids. The total degree of unsaturation was almost 78%. Absorption bands characteristic of these substances were observed in the IR spectrum of MEGC.Conclusion. According to the results of the NL analysis, oat grains consisted of triacylglycerides and free LCDs, which were accompanied by hydrocarbons, phytosterols, triterpenoids and tocopherols.

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