4 research outputs found
Π‘Π½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ°ΡΡ ΠΎΠ΄Π° ΡΠ΅Π²ΠΎΡΠ»ΡΡΠ°Π½Π° ΠΈ ΡΠ΅Π½ΡΠ°Π½ΠΈΠ»Π° ΠΏΡΠΈ ΠΎΠ½ΠΊΠΎΠ³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡΡ ΠΏΡΡΠ΅ΠΌ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ Π΄Π΅ΠΊΡΠΌΠ΅Π΄Π΅ΡΠΎΠΌΠΈΠ΄ΠΈΠ½Π° Π² ΡΠΎΡΡΠ°Π²Π΅ ΠΎΠ±ΡΠ΅ΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ (ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΡΠ»Π΅ΠΏΠΎΠ΅ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅)
The objective: to compare hemodynamic parameters, expiratory concentration of sevoflurane, fentanyl consumption during the surgery, the intensity of the pain syndrome during general combined anesthesia with and without dexmedetomidine.Subjects and methods: a prospective, blind, randomized study was performed in patients with oncogynecological disorders divided into two groups, where dexmedetomidine was used and not.Results. In the studied groups, changes in hemodynamics, expiratory concentration of sevoflurane, and fentanyl consumption were observed. There was no difference in the pain intensity between the groups.Conclusions. The expiratory concentration of sevoflurane, as well as the consumption of fentanyl, were lower in the group where dexmedetomidine was used. The intensity of the pain syndrome did not differ between two groups.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΡΡΠ°Π²Π½ΠΈΡΡ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ Π³Π΅ΠΌΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ, ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ ΡΠ΅Π²ΠΎΡΠ»ΡΡΠ°Π½Π° Π½Π° Π²ΡΠ΄ΠΎΡ
Π΅, ΡΠ°ΡΡ
ΠΎΠ΄ ΡΠ΅Π½ΡΠ°Π½ΠΈΠ»Π° Π·Π° Π²ΡΠ΅ΠΌΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΡΡΡ Π±ΠΎΠ»Π΅Π²ΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΏΡΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ ΠΎΠ±ΡΠ΅ΠΉ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π°Π½Π΅ΡΡΠ΅Π·ΠΈΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π΄Π΅ΠΊΡΠΌΠ΅Π΄Π΅ΡΠΎΠΌΠΈΠ΄ΠΈΠ½Π° ΠΈ Π±Π΅Π· Π½Π΅Π³ΠΎ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΎ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΡΠ»Π΅ΠΏΠΎΠ΅ ΡΠ°Π½Π΄ΠΎΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ ΠΎΠ½ΠΊΠΎΠ³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΈΠ»Ρ Ρ ΡΡΠ°ΡΡΠΈΠ΅ΠΌ Π΄Π²ΡΡ
Π³ΡΡΠΏΠΏ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ Π΄Π΅ΠΊΡΠΌΠ΅Π΄Π΅ΡΠΎΠΌΠΈΠ΄ΠΈΠ½Π° ΠΈ Π±Π΅Π· Π½Π΅Π³ΠΎ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
Π²ΡΡΠ²Π»Π΅Π½Ρ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π³Π΅ΠΌΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ, ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ ΡΠ΅Π²ΠΎΡΠ»ΡΡΠ°Π½Π° Π½Π° Π²ΡΠ΄ΠΎΡ
Π΅, ΡΠ°ΡΡ
ΠΎΠ΄Π° ΡΠ΅Π½ΡΠ°Π½ΠΈΠ»Π°. Π Π°Π·Π½ΠΈΡΡ Π² ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΡΡΠΈ Π±ΠΎΠ»Π΅Π²ΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° Π² ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
Π½Π΅ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ.ΠΡΠ²ΠΎΠ΄Ρ. ΠΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ ΡΠ΅Π²ΠΎΡΠ»ΡΡΠ°Π½Π° Π½Π° Π²ΡΠ΄ΠΎΡ
Π΅, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ°ΡΡ
ΠΎΠ΄ ΡΠ΅Π½ΡΠ°Π½ΠΈΠ»Π° ΠΌΠ΅Π½ΡΡΠ΅ Π² Π³ΡΡΠΏΠΏΠ΅ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π΄Π΅ΠΊΡΠΌΠ΅Π΄Π΅ΡΠΎΠΌΠΈΠ΄ΠΈΠ½Π°. ΠΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΡΡΡ Π±ΠΎΠ»Π΅Π²ΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° Π½Π΅ ΠΎΡΠ»ΠΈΡΠ°Π»Π°ΡΡ Π² Π΄Π²ΡΡ
ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
Π‘ΠΏΠ΅ΠΊΡΡ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ½ΡΡ Π²ΠΎΠΏΡΠΎΡΠΎΠ² ΡΡΠ΅ΡΠΊΠΎΠΆΠ½ΠΎΠΉ Π΄Π΅Π½Π΅ΡΠ²Π°ΡΠΈΠΈ ΠΊΠΎΠ»Π΅Π½Π½ΠΎΠ³ΠΎ ΡΡΡΡΠ°Π²Π°
Severe pain and, as a result, limitation of function are the main disabling factors in knee osteoarthritis. In such cases, percutaneous denervation (cryo- and chemoneurolysis, radiofrequency ablation) is used as one of the methods to reduce the intensity of pain and improve the patient's quality of life. Unfortunately, the relative 6-month effectiveness of this minimally invasive manipulation varies greatly and, according to the literature, ranges from 10 to 63%. The article discusses the scope of the most obvious interrelated factors that can negatively affect the effectiveness of denervation. Thanks to the fundamental works of recent years the anatomical location of the target sensory nerves of the knee joint in relation to bone and soft tissue landmarks have become more clear. This revised anatomy can significantly increase the effectiveness of percutaneous denervation of this joint and needs to be validated in clinical trials.ΠΡΡΠ°ΠΆΠ΅Π½Π½Π°Ρ Π±ΠΎΠ»Ρ ΠΈ, ΠΊΠ°ΠΊ ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅, ΠΎΠ³ΡΠ°Π½ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΡΠ½ΠΊΡΠΈΠΈ ΡΠ²Π»ΡΡΡΡΡ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΈΠ·ΠΈΡΡΡΡΠΈΠΌΠΈ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΠΏΡΠΈ ΠΎΡΡΠ΅ΠΎΠ°ΡΡΡΠΈΡΠ΅ ΠΊΠΎΠ»Π΅Π½Π½ΠΎΠ³ΠΎ ΡΡΡΡΠ°Π²Π°. Π ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΈΠ· ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΡΡΠΈ Π±ΠΎΠ»ΠΈ ΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΆΠΈΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° Π² ΡΠ°ΠΊΠΈΡ
ΡΠ»ΡΡΠ°ΡΡ
ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡ ΡΡΠ΅ΡΠΊΠΎΠΆΠ½ΡΡ Π΄Π΅Π½Π΅ΡΠ²Π°ΡΠΈΡ (ΠΊΡΠΈΠΎ- ΠΈ Ρ
ΠΈΠΌΠΈΠΎΠ½Π΅Π²ΡΠΎΠ»ΠΈΠ·, ΡΠ°Π΄ΠΈΠΎΡΠ°ΡΡΠΎΡΠ½Π°Ρ Π°Π±Π»ΡΡΠΈΡ). Π ΡΠΎΠΆΠ°Π»Π΅Π½ΠΈΡ, ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π΄Π°Π½Π½ΠΎΠΉ ΠΌΠ°Π»ΠΎΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΠΉ ΠΌΠ°Π½ΠΈΠΏΡΠ»ΡΡΠΈΠΈ ΡΠ΅ΡΠ΅Π· 6 ΠΌΠ΅Ρ. ΡΠΈΠ»ΡΠ½ΠΎ Π²Π°ΡΡΠΈΡΡΠ΅Ρ ΠΈ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ, ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ, ΠΎΡ 10 Π΄ΠΎ 63%. Π ΡΡΠ°ΡΡΠ΅ ΡΠ°ΡΡΠΌΠΎΡΡΠ΅Π½ ΡΠΏΠ΅ΠΊΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΎΡΠ΅Π²ΠΈΠ΄Π½ΡΡ
Π²Π·Π°ΠΈΠΌΠΎΡΠ²ΡΠ·Π°Π½Π½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ², ΡΠΏΠΎΡΠΎΠ±Π½ΡΡ
Π½Π΅Π³Π°ΡΠΈΠ²Π½ΠΎ ΠΏΠΎΠ²Π»ΠΈΡΡΡ Π½Π° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π΄Π΅Π½Π΅ΡΠ²Π°ΡΠΈΠΈ. ΠΠ»Π°Π³ΠΎΠ΄Π°ΡΡ ΡΡΠ½Π΄Π°ΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΠΌ ΡΠ°Π±ΠΎΡΠ°ΠΌ ΠΏΠΎΡΠ»Π΅Π΄Π½ΠΈΡ
Π»Π΅Ρ Π±ΠΎΠ»ΡΡΡΡ ΡΡΠ½ΠΎΡΡΡ ΠΏΡΠΈΠΎΠ±ΡΠ΅Π»ΠΈ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΈΡ ΠΎΠ± Π°Π½Π°ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΈ ΡΠ΅Π»Π΅Π²ΡΡ
ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΡΡ
Π½Π΅ΡΠ²ΠΎΠ² ΠΊΠΎΠ»Π΅Π½Π½ΠΎΠ³ΠΎ ΡΡΡΡΠ°Π²Π° ΠΏΠΎ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΠΊ ΠΊΠΎΡΡΠ½ΡΠΌ ΠΈ ΠΌΡΠ³ΠΊΠΎΡΠΊΠ°Π½Π½ΡΠΌ ΠΎΡΠΈΠ΅Π½ΡΠΈΡΠ°ΠΌ. Π’Π°ΠΊΠ°Ρ Β«ΠΏΠ΅ΡΠ΅ΡΠΌΠΎΡΡΠ΅Π½Π½Π°ΡΒ» Π°Π½Π°ΡΠΎΠΌΠΈΡ ΡΠΏΠΎΡΠΎΠ±Π½Π° Π² Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΠΏΠΎΠ²ΡΡΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΡΠ΅ΡΠΊΠΎΠΆΠ½ΠΎΠΉ Π΄Π΅Π½Π΅ΡΠ²Π°ΡΠΈΠΈ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΡΡΡΡΠ°Π²Π° ΠΈ Π½ΡΠΆΠ΄Π°Π΅ΡΡΡ Π² Π²Π°Π»ΠΈΠ΄Π°ΡΠΈΠΈ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΠΠ»ΠΈΡΠ½ΠΈΠ΅ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΡΡ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΊΠΈ Π½Π° ΡΠ°ΡΡΠΎΡΡ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ ΠΎΠ΄Π° Ρ Π²Π·ΡΠΎΡΠ»ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π΄ΡΡ Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡΡ, Π²ΡΠ·Π²Π°Π½Π½ΠΎΠΉ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ
The objective: to evaluate the effect of high-flow oxygen and non-invasive ventilation on the mortality rate in adults with severe respiratory failure caused by the new coronavirus infection in the intensive care unit (ICU).Subjects and methods. A one-center retrospective study was conducted. Electronic medical files of patients treated in the ICU from April 1 to MayΒ 25,Β 2020, were analyzed. Totally, 101 medical files were selected, further, they were divided into two groups. Group 1 (n = 49) included patients who received oxygen insufflation, and should it fail, they received traditional artificial ventilation. No non-invasive respiratory therapy was used in this group. Group 2 (n = 52) included patients who received high-flow oxygen therapy and non-invasive ventilation. The mortality rate in the groups made a primary endpoint for assessing the impact of high-flow oxygen therapy and non-invasive ventilation. The following parameters were also analyzed: drug therapy, the number of patients in whom non-invasive techniques were used taking into account the frequency of cases when these techniques failed, and the number of patients in whom artificial ventilation was initiated.Results. In Group 2, non-invasive methods of respiratory therapy were used in 31 (60%) cases. High-flow oxygen therapy was used in 19 (36%) ofΒ them; in 13 cases this method allowed weaning them from the high flow. Non-invasive ventilation was used in 18 cases, in 12 patients it was used due to progressing severe respiratory failure during humidified oxygen insufflation, in 6 patients β after the failed high-flow oxygen therapy. In Group 1, 25 (51%) patients were intubated and transferred to artificial ventilation, in Group 2, 10 (19.2%) underwent the same. The lethal outcome was registered in 23 (47%) cases in Group 1, and in 10 (19.2%) in Group 2 (p = 0.004). Analysis of drug therapy in the groups revealed the difference inΒ the prescription of pathogenetic therapy. Logistic regression demonstrated the effectiveness of the combination of tocilizumab + a glucocorticoid inΒ reducing the frequency of lethal cases (p = 0.001).Conclusion. The use of non-invasive respiratory support in adults with severe respiratory failure caused by the new coronavirus infection combined with therapy by tocilizumab + a glucocorticoid can reduce the incidence of lethal cases.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΎΡΠ΅Π½ΠΈΡΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π²ΡΡΠΎΠΊΠΎΠΏΠΎΡΠΎΡΠ½ΠΎΠΉ ΠΎΠΊΡΠΈΠ³Π΅Π½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΠΉ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
Π½Π° ΡΠ°ΡΡΠΎΡΡ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° Ρ Π²Π·ΡΠΎΡΠ»ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡΡ, Π²ΡΠ·Π²Π°Π½Π½ΠΎΠΉ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ, Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΈΠΈ ΠΈ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠ ΠΠ’).ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΎΠ΄Π½ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ΅ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅. ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ ΡΠ»Π΅ΠΊΡΡΠΎΠ½Π½ΡΠ΅ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠ΅ ΠΊΠ°ΡΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π½Π°Ρ
ΠΎΠ΄ΠΈΠ²ΡΠΈΡ
ΡΡ Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π² ΠΠ ΠΠ’ Ρ 1 Π°ΠΏΡΠ΅Π»Ρ ΠΏΠΎ 25 ΠΌΠ°Ρ 2020 Π³. ΠΠ±ΡΠ΅Π΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΎΡΠΎΠ±ΡΠ°Π½Π½ΡΡ
ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
ΠΊΠ°ΡΡ ΡΠΎΡΡΠ°Π²Π»ΡΠ»ΠΎ 101, Π΄Π°Π»Π΅Π΅ ΠΎΠ½ΠΈ Π±ΡΠ»ΠΈ ΡΠ°Π·Π΄Π΅Π»Π΅Π½Ρ Π½Π° Π΄Π²Π΅ Π³ΡΡΠΏΠΏΡ. Π Π³ΡΡΠΏΠΏΡ β 1 (n = 49) Π²ΠΊΠ»ΡΡΠ΅Π½Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ, ΠΊΠΎΡΠΎΡΡΠΌ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΈΠ½ΡΡΡΡΠ»ΡΡΠΈΡ ΠΊΠΈΡΠ»ΠΎΡΠΎΠ΄Π°, Π° Π² ΡΠ»ΡΡΠ°Π΅ Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ β ΡΡΠ°Π΄ΠΈΡΠΈΠΎΠ½Π½ΡΡ ΠΈΡΠΊΡΡΡΡΠ²Π΅Π½Π½ΡΡ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΡ Π»Π΅Π³ΠΊΠΈΡ
. Π Π΄Π°Π½Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ Π½Π΅ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΠΈ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠΈ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΡΡΠΏΠΏΡ β 2 (n = 52) ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ, Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ Π²ΡΡΠΎΠΊΠΎΠΏΠΎΡΠΎΡΠ½ΡΡ ΠΎΠΊΡΠΈΠ³Π΅Π½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΈ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΡΡ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΡ Π»Π΅Π³ΠΊΠΈΡ
. ΠΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠΉ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΠΉ ΡΠΎΡΠΊΠΎΠΉ ΠΎΡΠ΅Π½ΠΊΠΈ Π²Π»ΠΈΡΠ½ΠΈΡ Π²ΡΡΠΎΠΊΠΎΠΏΠΎΡΠΎΡΠ½ΠΎΠΉ ΠΎΠΊΡΠΈΠ³Π΅Π½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΈ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΠΉ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ
ΡΡΠΈΡΠ°Π»ΠΈ ΡΠ°ΡΡΠΎΡΡ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° Π² ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
. ΠΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈ ΡΠ°ΠΊΠΆΠ΅ ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΡΡ ΡΠ΅ΡΠ°ΠΏΠΈΡ, ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΠΈ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠΈ, ΡΡΠΈΡΡΠ²Π°Π»ΠΈ ΡΠ°ΡΡΠΎΡΡ ΠΈΡ
Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ, ΡΠΈΡΠ»ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠΌ ΠΈΠ½ΠΈΡΠΈΠΈΡΠΎΠ²Π°Π»ΠΈ ΠΈΡΠΊΡΡΡΡΠ²Π΅Π½Π½ΡΡ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΡ Π»Π΅Π³ΠΊΠΈΡ
.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠ΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠΈ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π² Π³ΡΡΠΏΠΏΠ΅ β 2 ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½Ρ Π² 31 (60%) ΡΠ»ΡΡΠ°Π΅. ΠΡΡΠΎΠΊΠΎΠΏΠΎΡΠΎΡΠ½ΡΡ ΠΎΠΊΡΠΈΠ³Π΅Π½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ»ΠΈ Ρ 19 (36%) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΈΠ· Π½ΠΈΡ
; Π² 13 ΡΠ»ΡΡΠ°ΡΡ
ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π° ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ»ΠΎ ΠΎΡΠ»ΡΡΠΈΡΡ ΠΎΡ Π²ΡΡΠΎΠΊΠΎΠ³ΠΎ ΠΏΠΎΡΠΎΠΊΠ°. ΠΠ΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½Π°Ρ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΡ Π»Π΅Π³ΠΊΠΈΡ
ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½Π° Π² 18 ΡΠ»ΡΡΠ°ΡΡ
, Ρ 12 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π΅Π΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ ΠΏΡΠΈ Π½Π°ΡΠ°ΡΡΠ°Π½ΠΈΠΈ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ Π½Π° ΡΠΎΠ½Π΅ ΠΈΠ½ΡΡΡΡΠ»ΡΡΠΈΠΈ ΡΠ²Π»Π°ΠΆΠ½Π΅Π½Π½ΠΎΠ³ΠΎ ΠΊΠΈΡΠ»ΠΎΡΠΎΠ΄Π°, Ρ 6 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² β ΠΏΠΎΡΠ»Π΅ Π½Π΅ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π²ΡΡΠΎΠΊΠΎΠΏΠΎΡΠΎΡΠ½ΠΎΠΉ ΠΎΠΊΡΠΈΠ³Π΅Π½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΠ½ΡΡΠ±Π°ΡΠΈΡ ΡΡΠ°Ρ
Π΅ΠΈ ΠΈ ΠΏΠ΅ΡΠ΅Π²ΠΎΠ΄ Π½Π° ΠΈΡΠΊΡΡΡΡΠ²Π΅Π½Π½ΡΡ Π²Π΅Π½ΡΠΈΠ»ΡΡΠΈΡ Π»Π΅Π³ΠΊΠΈΡ
Π²ΡΠΏΠΎΠ»Π½Π΅Π½Ρ Ρ 25 (51%) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π³ΡΡΠΏΠΏΡ β 1, 10 (19,2%) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π³ΡΡΠΏΠΏΡ β 2. ΠΠ΅ΡΠ°Π»ΡΠ½ΡΠΉ ΠΈΡΡ
ΠΎΠ΄ Π² Π³ΡΡΠΏΠΏΠ΅ β 1 Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½ Π² 23 (47%) ΡΠ»ΡΡΠ°ΡΡ
, Π² Π³ΡΡΠΏΠΏΠ΅ β 2 β Π² 10 (19,2%) (p = 0,004). ΠΠ½Π°Π»ΠΈΠ· ΠΌΠ΅Π΄ΠΈΠΊΠ°ΠΌΠ΅Π½ΡΠΎΠ·Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π² ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
ΠΏΠΎΠΊΠ°Π·Π°Π» ΡΠ°Π·Π»ΠΈΡΠΈΠ΅ Π² Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΠΈ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΠΎΠ³ΠΈΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΡ ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»Π° ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ ΡΠΎΡΠΈΠ»ΠΈΠ·ΡΠΌΠ°Π± + Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄ Π² ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ ΡΠ°ΡΡΠΎΡΡ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° (p = 0,001).ΠΡΠ²ΠΎΠ΄. ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊ ΡΠ΅ΡΠΏΠΈΡΠ°ΡΠΎΡΠ½ΠΎΠΉ ΠΏΠΎΠ΄Π΄Π΅ΡΠΆΠΊΠΈ Ρ Π²Π·ΡΠΎΡΠ»ΡΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΉ Π΄ΡΡ
Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΡΡ, Π²ΡΠ·Π²Π°Π½Π½ΠΎΠΉ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΡΠΎΠ½Π°Π²ΠΈΡΡΡΠ½ΠΎΠΉ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠ΅ΠΉ, Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΡΠ΅ΡΠ°ΠΏΠΈΠ΅ΠΉ Π² ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΠΈ ΡΠΎΡΠΈΠ»ΠΈΠ·ΡΠΌΠ°Π± + Π³Π»ΡΠΊΠΎΠΊΠΎΡΡΠΈΠΊΠΎΠΈΠ΄ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠ½ΠΈΠ·ΠΈΡΡ ΡΠ°ΡΡΠΎΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π°
Reduction of sevoflurane and fentanyl consumption through dexmedetomidine use as a part of general anesthesia in oncogynecological surgery (a prospective blind randomized study)
The objective: to compare hemodynamic parameters, expiratory concentration of sevoflurane, fentanyl consumption during the surgery, the intensity of the pain syndrome during general combined anesthesia with and without dexmedetomidine.Subjects and methods: a prospective, blind, randomized study was performed in patients with oncogynecological disorders divided into two groups, where dexmedetomidine was used and not.Results. In the studied groups, changes in hemodynamics, expiratory concentration of sevoflurane, and fentanyl consumption were observed. There was no difference in the pain intensity between the groups.Conclusions. The expiratory concentration of sevoflurane, as well as the consumption of fentanyl, were lower in the group where dexmedetomidine was used. The intensity of the pain syndrome did not differ between two groups