These clinical guidelines apply to the implementation of health care for all patients with concomitant hypertension in the perioperative period in a hospital. The guidelines specify the method of stratifying the risk of perioperative cardiac complications. We described methods for the treatment of urgent conditions with hypertension and hypertensive crises and identified the main features of the preoperative evaluation and preparation of patients with concomitant hypertension. The clinical guidelines contain recommendations on the management of intra- and postoperative period

To study an expediency and efficacy of application of different reverses drugs (naloxone, flumazenil, neostigmine, galantamine, sugammadex) either their separate or combined using.We studied 119 patients underwent endoluminal endoscopic procedures and surgeries on trachea-bronchial tree and intestines under sedation or general anaesthesia.The article deals with conceptual approaches to the reversal of residual effects of opioids, benzodiazepine sedation and neuromuscular block (the so-called agonist-antagonist technique).A reversion of neuromuscular block without using of antagonists' combination does not provide complete recovery of psychomotor and cognitive functions for rapid socialization of patients after anaesthesia.

This article presents a clinical case of colon disease surgical treatment in a 34-year old patient with. generalized myasthenia. Perioperative management peculiarities in these patients are clarified. Different approaches to anaesthesia choice were discussed on a case study. The importance of tactics individualization, rational drugs selection, including neuromuscular block reversal agents as well as intraoperative neuromuscular transmission monitoring.

Neuroprotection could be the aim to use Xenon for general anesthesia. However the experience of Xenon anesthesia in neurosurgery is quite limited. The appraisal of Xenon based anesthesia was accomplished in 12 patients during various brain surgery. Xe in concentration 65% was used to maintenance of anesthesia, other medication was avoided. As a result there were 8 cases of arterial hypertension and 2 cases of superficial hypnotic state. Excitation (n=3), hyperdynamic reaction (n=8), PONV (n=8) were detected in early postoperative period. An analysis of this study suggests a conclusion that studied method of Xenon-based anesthesia is inexpedient for neurosurgery.

UNLABELLED:Postoperative delirium (PD) relates to increased morbidity -associated with prolonged hospital stay, institutionalization and persistent functional and cognitive decline- poor long term outcome and higher perioperative mortality. Aim of this literature review is to identify established risk factors for PD and to categorize them according timing of occurrence (pre, intra and post operative), and clinical impact (Odds ratio [OR], % increase in incidence of PD).SOURCE OF INFORMATION:medical literature databases (medline and embase) were searched for published manuscripts on "postoperative delirium". Predictors and preoperative risk factors for PD were categorized into 4 groups: demographics; co morbidities; surgery and anesthesia-related (age, education, laboratory anomalies, smoking habits, benzodiazepines premedication, cardiac and thoracic surgery, etc). Intra operative risk factors for PD were categorized into 2 groups: surgery and anesthesia-related (anemia, duration and type of surgery, selected opioid, intraoperative hypotension, etc). Post operative risk factors and precipitating factors include various pathophysiological and environmental conditions, (i.e., ICU admission, low cardiac output requiring inotropes infusion; new onset atrial fibrillation; persistent hypoxia or hypercarbia; use of narcotic analgesics, delayed ambulation, inadequate nutritional status; sensory deprivation, etc). In conclusion, the effective identification, prevention and treatment of pre, intra and postoperative risk factors are the cornerstones for the prevention of PD. A dedicated perioperative care path that encompasses a tailored selection of drugs used perioperatively, the appropriate anesthesia strategy, qualified nursing surveillance, systematic use of diagnostic tools and accurate staff communication reduces the incidence and clinical impact of PD.

This article presents a clinical case of colon disease surgical treatment in a 34-year old patient with generalized myasthenia. Perioperative management peculiarities in these patients are clarified. Different approaches to anaesthesia choice were discussed on a case study. The importance of of tactics individualization, rational drugs selection, including neuromuscular block reversal agents as well as intraoperative neuromuscular transmission monitoring.

We evaluated the Intubating Laryngeal MAsk (ILMA Fastrach tm) efficacy for airway management, ventilation and blind intubation in obese and overweight patients. Methods. 50 adult patients (22 men and 28 women) with predicted difficult trachea intubation (PDTI), undergoing general anaesthesia with ILMA were included in this study. ILMA was selected according to gender: ILMA №5 for men and №4 for women. Premedication: diazepam and H 2-blockers. Anaesthesia induction: midazolam 0,1 0,15 mg/kg, propofol 1,6-2,5 mg/kg, fentanyl 0,1-0,15 jig/kg, rocuronii bromide or atracurii besilate 0,6 mg/kg. Results: 21/2/3 patients had morbid obesity with BMI over 40/45/55 kg/m 2. 5 and more difficult trachea intubation (TI) predictors were found in 48 patients. The ILMA was placed successfully at the first try for 7,2±2,9 sec in all patients. Ventilation was successful in 100% of cases; TI via ILMA in 94% of cases (90% at the first try). Total TI time was 7,5±4,8 sec, ILMA removal time 9,2±1,5 sec. 2 patients had 2 or 3 DTI predictors, but conventional TI was unsuccessful; TI via ILMA was performed at the first try. There was one intubate, can’t ventilate case, TI via ILMA was made at the first try. TI via ILMA was unsuccessful in 3 patients, ILMA was replaced by Proseal LM or Supreme LM, TI was performed conventionally. There were no complications observed. Conclusion. ILMA Fastrach tm was used successfully in obese patients with PDTI for both ventilation and TI. Technique is simple in training, but a preliminary experience is essential for ILMA use in difficult cases.

Neuroprotection could be the aim to use Xenon for general anesthesia. However the experience of Xenon anesthesia in neurosurgery is quite limited. The appraisal of Xenon based anesthesia was accomplished in 12 patients during various brain surgery. Xe in concentration 65% was used to maintenance of anesthesia, other medication was avoided. As a resuIt there were 8 cases of arterial hypertension and 2 cases of superficial hypnotic state. Excitation (n = 3), hyperdynamic reaction (n = 8), PONV (n = 8) were detected in early postoperative period. An analysis of this study suggests a conclusion that studied method of Xenon-based anesthesia is inexpedient for neurosurgery.

The article deals with the first comparative study of haemodynamics, gas exchange, and metabolic lung function in patients with underlying respiratory and cardiovascular diseases. Different anaesthesia and ventilation (conventional AVL, ОLV, differentiated ALV) techniques were used. Respiratory support methodology with the use of HFV or CPAP during the main phase of thoracic surgery in patients with severe associated cardio-respiratory diseases was developed. Indications for differentiated ALV in thoracic surgery were developed.

The article deals with the first comparative study of haemodynamics, gas exchange, and metabolic lung finction in patients with underlying respiratory and cardiovascular diseases. Different anaesthesia and ventilation (conventional AVL, OLV differentiated ALV) techniques were used. Respiratory support methodology with the use of HFV or CPAP during the main phase of thoracic surgery in patients with severe associated cardio-respiratory diseases was developed. Indications for differentiated AL V in thoracic surgery were developed.

Cholinesterase blockers are widely used in various fields of clinical medicine. In anesthesiology they are used for the means of decurarisation, as well as for performance of central segmental blockades. In recent years, along with the most frequently used neostigmine again an opportunity arose to use the well-known galantamine. A brief overview of the pharmacological properties of galantamine is completed by the study of its efficacy and safety in 30 patients (first group) who underwent general anesthesia with total myoplegia at a range of abdominal surgeries. The comparison group (second group) included 30 patients who were applied neostigmine. The method of clinical functional evaluation, the accelerometry and frontal electromyography confirmed that galantamine although inferior to neostigmine in efficiency, has a higher safety threshold.

The material of the research were 63 patients operated on benign strictures and esophageal cancer in the RSCS after B.V. Petrovsky. We studied the occurrence and the character of postoperative complications, dependence on initial nutritive (alimentary) status and anesthesia techniques. The main postoperative complications were of respiratory system and cardiovascular insufficiency and mainly depended on the initial degree of nutritive and used anesthesia techniques. No significant difference in the structure of postoperative complications for the patients with benign and malignant diseases of esophagus has been identified.

This article reviews the possibility of the use of paracetamol (perfalgane) as an analgesic component of medical sedation. The actuality of the problem is the choice effective pharmacological means of protection from peri-operative pain. The theoretical advantages of paracetamol in the scheme of sedoanalgesia are exquisite. We describe a personal experience of efficacy assessment and safety of paracetamol as an analgesic component of the methodology of drug sedation for bronchoscopy in the early postoperative period. We compare analgesia by the means of paracetamol 1000 mg (IV) and tramadol 100 mg (IV). The sedative agent in both groups was midazolam. It turned out, that despite the high efficacy of tramadol as a component of sedoanalgesia, the quality of anialgesia when using perfalagane is almost 5 times higher, both due to the significant number of good results, and to reduced number of adverse events. Use of paracetamol (Perfalgane) instead of tramadol for medical sedation during fibrotracheoscopy in patients in the early postoperative period leads to better quality of analgesia, thus avoiding such undesirable phenomena as hypersedation, respiratory depression, dizziness, and nausea.