Ensuring the effectiveness and safety of peripheral blockades

Adequate analgesia determines the success of the performed surgical intervention. In modern surgery, most of postoperative complications are directly related to ineffective therapy of pain syndrome in the perioperative period. The main principle of modern analgesia is its multicomponence, when analgesia, neurovegetative blockade and relaxation are achieved and potentiated by different drugs and methods. The blockade of nociceptive impulses with a local anesthetic at the transmission stage provides effective, targeted analgesia, hyporefl exia and muscle relaxation, prevents the sensitization of neuroaxial structures, hyperalgesia and the development of postoperative chronic pain syndrome. At the same time, providing analgesia with drugs of central action leads to the ineffectiveness of therapy in 80 % of cases, which has serious consequences.The aim. According to the literature review, to evaluate the effectiveness and safety of peripheral blockades on the example of performing a blockade of the pterygopalatine ganglion.Conclusion. The pterygopalatine blockade has broad indications for use in ophthalmology, which is explained by the complex structure of the pterygopalatine ganglion and the possibility of simultaneous infl uence on sympathetic, parasympathetic and nociceptive innervation. All the presented methods of pterygopalatine blockade performance have their advantages and disadvantages. Ultrasound navigation eliminates technical difficulties and the possibility of damage of the pterygopalatine fossa anatomical structures, ensuring the effectiveness and safety of the pterygopalatine blockade

Turbulent particle transport in magnetized fusion plasma

The understanding of the mechanisms responsible for particle transport is of the utmost importance for magnetized fusion plasmas. A peaked density profile is attractive to improve the fusion rate, which is proportional to the square of the density, and to self-generate a large fraction of non-inductive current required for continuous operation. Experiments in various tokamak devices (AUG, DIII-D, JET, TCV, TEXT, TFTR) have indicated the existence of an anomalous inward particle pinch. Recently, such an anomalous pinch has been unambiguously identified in Tore Supra very long discharges, in absence of toroidal electric field and of central particle source, for more than 4 minutes [1]. This anomalous particle pinch is predicted by a quasilinear theory of particle transport [2], and confirmed by non-linear turbulence simulations [3] and general considerations based on the conservation of motion invariants [4]. Experimentally, the particle pinch is found to be sensitive to the magnetic field gradient in many cases [5, 6, 7, 8], to the temperature profile [5, 9] and also to the collisionality that changes the nature of the microturbulence [10, 11, 12]. The consistency of some of the observed dependences with the theoretical predictions gives us a clearer understanding of the particle pinch in tokamaks, allowing us to predict more accurately the density profile in ITER.Comment: 12th International Congress on Plasma Physics, 25-29 October 2004, Nice (France

Ultrasoft x-ray spectroscopy using multilayer mirrors on TCV

The TCV tokamak is equipped with a four-channel ultrasoft x-ray monochromator allowing low resolution (lambda/Deltalambda similar to 30) measurements in the energy range 200-800eV. Its main purpose is to simultaneously monitor emission from four of the main Kalpha resonance lines of highly ionized light impurities such as boron, carbon, nitrogen and oxygen. Wavelength selectivity is achieved using synthetic multilayer mirrors having 30-40 alternate layers with layer periods in the range 3-7 nm, depending on the design wavelength range. Recently the instrument was modified for measuring the radial profiles of Kalpha and Lyman-alpha lines from He-like and H-like intrinsic carbon impurities to allow estimates of impurity diffusivities by comparisons with simulations using the impurity transport code STRAHL

ANESTHESIA FOR MICROSURGICAL AUTOTRANSPLANTATION OF TOES ON THE WRIST IN CHILDREN WITH CONGENITAL AND POSTTRAUMATIC PATHOLOGY

Intraoperative combination of monolateral spinal anesthesia and prolonged brachial plexus block is evaluated in 65 children with autotransplantation of fingers from foot to hand. Variability of heart rhythm demonstrated autonomous stability in the main group. Dynamical study of skin temperature and dopplerographic evaluation demonstrated local sympatholysis in the blocked extremity. Significant improvement of circulation and quality of analgesia is revealed in case of prolonged perineural use of local anesthetics in the postoperative period. Described combination of intra- and postoperative treatment of such patients makes complex treatment more effective

Prolonged blockade of the brachial plexus for the early rehabilitation of children with posttraumatic elbow contractures

Objective. Improvement of surgical treatment outcomes in children with post-traumatic elbow contractures. Materials and methods. The study is based on the diagnostic findings of 48 children with post-traumatic elbow contractures who were treated at the Turner Scientific and Research Institute for Children’s Orthopedics. All children underwent complex rehabilitation after reconstructive intra-articular surgery to work out passive motions in the elbow using ARTROMOT-E2 device. The patients of the study group started rehabilitation in the first days after reconstructive intra-articular surgery in the background of prolonged blockade of the brachial plexus. In the control group, the rehabilitation was carried out traditionally on the 6th day after surgery without regional anesthesia. The patients of the study group were supplied with Contiplex SU perinural catheters for prolonged blockade of the brachial plexus using ultrasound (Edge SonoSite) and neurostimulation (Stimuplex® HNS12) before surgery. For perioperative blockade of the brachial plexus we used intermittent injection of 0.5% ropivacaine (2 mg / kg). The severity of pain at the stages of rehabilitation was assessed using 10-point grading scale (FPS-R). The range of active and passive motions in the joints was evaluated by measuring the range of motions with a fleximeter. Results. Intermittent injection of ropivacaine before rehabilitation allowed to correct post-traumatic elbow contractures in children in the first days after surgery associated with the minimum subjective pain level and stable hemodynamic parameteres, accompanied with a significant increase of the elbow motion range in comparison with the group of the patients who were not performed regional anesthesia . Conclusion. Prolonged blockade of the brachial plexus in rehabilitation treatment of children with post-traumatic contractures provides appropriate analgesic and myoneural block components from the 1st day after intra-articular reconstructive surgery. Early rehabilitation provides good results of the treatment and reduces rehabilitation period terms

Using <i>N</i>-Norms for Analyzing Symmetric Protective Electrical Circuits with Triple Modal Reservation

The redundancy of functional blocks and critical assemblies in radio-electronic equipment is among the most widely used techniques for increasing reliability. Complex redundant systems raise the problem of electromagnetic compatibility (EMC). Ignoring EMC requirements can lead to partial or complete REE failures. In this paper, the authors analyze a noise-protective electrical circuit with triple modal reservation (a promising type of cold redundancy). A multilayer stripline is investigated, the conductors of which are symmetrically arranged relative to two planes. On account of the strong electromagnetic coupling, this protective circuit can decompose dangerous ultra-wideband (UWB) interference received at the input of the primary or redundant circuits into unipolar pulses of lower amplitude. Using this approach, due to the symmetry of the conductors, equal decomposition efficiency could be achieved. However, the effect of UWB interference at the input of one of the conductors produces bipolar pulses at the output of the other conductors. In this paper, the authors evaluate the dangers of unipolar and bipolar decomposed pulses and use modal analysis to mathematically determine the polarities and amplitudes of the decomposed pulses at all output nodes for a pseudo-matched structure. By using the quasistatic approach with and without losses, the time responses to a trapezoidal pulse with a total duration of 60 ps, which simulates UWB interference, are obtained. To confirm the results of modal analysis and quasistatic simulation, an experimental study is performed. Using a stroboscopic oscilloscope DSA 8300, the authors obtained a transient response to a step excitation. Then, taking the derivative, the response to a trapezoidal pulse with a total duration of 140 ps was obtained. To analyze the criticality of the decomposed pulses, N-norms are used. In the general case, it is shown that the UWB interference is decomposed into four pulses of lower amplitude. At the same time, the value of each N-norm indicates its significant attenuation. For example, the amplitude of the UWB pulse acting on the input of the reserved conductor decreases by 10.31–8.93 times. Such results numerically demonstrate the high efficiency of the suggested approach when it comes to protecting equipment against UWB interference. It is also shown that the probability of dielectric breakdown and damage to electronic components in redundant circuits is lower than in a primary circuit. This is due to the fact that the value of N3 in the redundant circuit is 2.38 times less than in the primary circuit. However, the results demonstrate that arcing is highly probable both in primary and redundant circuits. Finally, aspects of symmetry/asymmetry in the problem under investigation are emphasized