Efficiency and safety of use of the extemporal inhalation anesthetic “Sevoflurane Chemoteka” for anesthetic management in abdominal surgery

Sevoflurane is the most widely used modern inhalational anesthetic in the world. Sevoflurane is the “gold standard” for anesthetic management now. The article discusses the modern possibilities of using inhalation anesthesia, and the experience of using the domestic inhalational anesthetic “Sevoflurane Chemoteka” by the authors from the point of view of its effectiveness and safety.

Neuroprotective Properties of Xenon According to Experimental Studies

ABSTRACT. An increase in the number of patients with severe brain damage of various etiologies determines the need to improve neuroprotection technologies. The review is devoted to modern views on the mechanisms of brain protection, as well as the basic processes underlying damage to neurons. The article discusses the results of the most important experimental studies in this area using inert xenon gas. The authors analyzed a number of works highlighting neurotective properties of the xenon inhalation anesthetic in studies performed in vitro and in vivo. The main mechanisms of neuronal death depending on the type of damage are shown, the points of application of the protective effect of xenon on the brain and the prospects for further research in this area are demonstrated in the article.

Comparison of the effects of inhalation anesthetics in the intraand postoperative periods during kidney transplantation

Background. Every year the number of patients with chronic renal failure is steadily increasing. Allogeneic kidney transplantation from a post-mortem donor is a radical method to cope with chronic renal failure, improving the quality and life expectancy of patients. Currently available inhalation anesthetics make it easy to control the depth of anesthesia; they are excreted by the lungs unchanged, providing a quick emergence from anesthesia and easy waking up of the patient. An “ideal” inhalation anesthetic used for kidney transplantation should have a minimal amount of adverse effects.The aim was to compare the efficacy of inhaled anesthetics used for allogeneic kidney transplantation from a posthumous donor.Material and methods. A randomized, prospective, single-center study included 62 patients with end-stage chronic renal failure. The subjects were divided into three groups depending on the type of the inhalation anesthetic used. The first group included patients who underwent low-flow inhalation anesthesia with desflurane, the second and third groups were comparator groups where patients received sevoflurane or isoflurane, respectively, as an inhalation anesthetic. When assessing hemodynamic parameters, most episodes of hemodynamic instability were seen in the isoflurane group; the most stable statistically significant values were observed in the sevoflurane group, and desflurane took an intermediate position.Results. The use of desflurane as an inhalation anesthetic in a kidney transplant provided a quicker recovery of consciousness and early extubation of the patient after anesthesia compared to the sevoflurane or isoflurane use. So desflurane proved to be the most efficient of the three studied inhalation anesthetics. Conclusion. Desflurane is the optimal inhalation anesthetic used in kidney transplantation.

Propofol Based Tiva Vs. Sevoflurane Inhalation Anesthetic for Breast Cancer Surgery: A Systematic Review

Metastasis from breast cancer leads to a higher chance of death from that cancer. According to the National Cancer Institute (2018) breast cancer survival rates among all three SEER stages (localized, regional, and distant) was approximately 90% between the years 2008 and 2014. Among these patients, those with distant metastasis had a survival rate of 27% and those with regional metastasis had an 85% survival rate (American Cancer Society, 2019). When creating an individualized anesthetic plan for a patient presenting for tumor excision of breast cancer, the anesthesia provider should create a plan that l owers the risk of metastasis and increases the patient’s chance of survival. The purpose of this systematic review was to analyze which anesthetic technique, Propofol based total Intravenous Anesthesia (TIVA) or Sevoflurane based inhalation anesthetic, will elicit less immune response. A comprehensive literature review was completed using CINAHL, Medline Plus, and Pubmed Health focusing on propofol based TIVA and Sevoflurane for anesthesia maintenance for the removal of cancerous breast tumors. The PRISMA model was used to identify eligible studies. Study analysis was completed by creating study specific and data outcome tables. Critical appraisal of individual randomized control trials was performed using the Critical Appraisal Skills Programme (CASP) checklist. A cross study analysis table was also created to compare the results of all eligible studies. The findings of this systematic review determined that Propofol based TIVA increases recurrence free survival, however there is negligible differences in the immune response between Propofol based TIVA and Sevoflurane inhalation anesthetic for women undergoing surgery for breast cancer tumor excision.

Inhalation anesthetics in a comprehensive enhanced recovery after surgery program

Over the recent years, an increasing attention has been paid in the Russian healthcare to the concept of a‘fast-track surgery’ also known as ‘enhanced recovery after surgery (ERAS)’. This article presents the advantage of inhalation anesthetic agents from the perspective of the ERAS concept. A special attention is paid to drugs belonging to halogen-containing inhalation anesthetic class (Sevoflurane and Desflurane). It is emphasized that, despite a number of differences in the clinical effect of these anesthetics, they are drugs of choice in the fast-track surgery.