АНЕСТЕТИК, АНАЛЬГЕТИК, ГИПНОТИК – ВАЖНЫ ЛИ ТЕРМИНЫ?

The review is devoted to pharmacology of the general anesthesia in the light of current understanding of this event and as a medical technique. The discussion covers the classification of medications used for general anesthesia basing on action mechanisms of these substances including specific and nonspecific actions on the central nervous system functions and evolution of their presentation. Обзор посвящён фармакологии общей анестезии в свете современных представлений об этом явлении и медицинском методе. Обсуждаются классификация препаратов, применяемых для общей анестезии, на основе механизмов действия этих веществ, из которых вытекают их специфические и неспецифические влияния на функции центральной нервной системы, а также эволюция представлений о них

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

PHARMACOECONOMIC ANALYSIS OF THE IMPACT ON THE BUDGET COSTS OF ADDING DEXMEDETOMIDINE (DEXDOR) INTO THE LIST OF VITAL AND ESSENTIAL DRUGS

Analysis of  four pharmacoeconomic replacement models for  midazolam, propofol and  phentanyl with dexmedetomidine for sedation in resuscitation and intensive care unit (RICU) shows increase of the annual costs (at current prices) by 14-28 million rubles (at prices of the reference country – by 9-23 million rubles). The calculation of the RICU stay cost in the rates of the health care providers rather than in that of the Compulsory Health Insurance (CHI) effects a saving of up to 1 billion rubles at current prices and up to 3.5 billion rubles at prices of the reference country

ANESTHETIC, ANALGETIC, HYPNOTIC – ARE THE TERMS IMPORTANT?

The review is devoted to pharmacology of the general anesthesia in the light of current understanding of this event and as a medical technique. The discussion covers the classification of medications used for general anesthesia basing on action mechanisms of these substances including specific and nonspecific actions on the central nervous system functions and evolution of their presentation

ФАРМАКОЭКОНОМИЧЕСКИЙ АНАЛИЗ ВЛИЯНИЯ НА БЮДЖЕТНЫЕ РАСХОДЫ ВКЛЮЧЕНИЯ ДЕКСМЕДЕТОМИДИНА (ДЕКСДОР) В СПИСОК ЖИЗНЕННО НЕОБХОДИМЫХ И ВАЖНЕЙШИХ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ

Analysis of  four pharmacoeconomic replacement models for  midazolam, propofol and  phentanyl with dexmedetomidine for sedation in resuscitation and intensive care unit (RICU) shows increase of the annual costs (at current prices) by 14-28 million rubles (at prices of the reference country – by 9-23 million rubles). The calculation of the RICU stay cost in the rates of the health care providers rather than in that of the Compulsory Health Insurance (CHI) effects a saving of up to 1 billion rubles at current prices and up to 3.5 billion rubles at prices of the reference country. Анализ четырёх фармакоэкономических моделей замены дексмедетомидином мидазолама, пропофола и фентанила для седации в отделении реанимации и интенсивной терапии (ОРИТ) показывает увеличение годовых расходов (при нынешних ценах) на 14-28 млн руб. (при ценах референтной страны - на 9-23 млн руб.). Расчёт стоимости пребывания в ОРИТ по тарифам не ОМС, а медучреждений даёт экономию до 1 млрд руб. при нынешних ценах и до 3,5 млрд руб. - при ценах референтной страны