[Reduced gas-flow inhalation anesthesia in traumatology and orthopedics]. 2008

A A Smorodnikov, and V A Iudytskiĭ

Whether reduced gas-flow inhalational anesthesia using sevorane might be used in traumatological and orthopedic care was studied. A hundred and thirty-six reduced gas-flow anesthetic aids were applied. These included 41 aids during high risk surgical interventions (ventral spondylodesis under artificial pneumothorax; two-stage surgical interventions in thoracic and thoracolumbar injuries; total knee joint endoprosthesis, corrective osteotomy and synthesis in limb fractures), 66 aids during moderate-risk ones (transpedicular fixation, total hip joint endoprosthesis, intervertebral herniotomy), and 30 aids during low-risk ones (interbody spondylodesis in cervical spinal injuries, hardware removal, arthroscopy, etc.). Under low-flow anesthesia, the parameters of oxygenation, gas exchange, respiratory function, and hemodynamics were beyond the normal physiological values. The developed procedure makes it possible to employ reduced gas-flow inhalational anesthesia using sevorane at the maximum allowable concentration of 0.8 for traumatological and orthopedic operations. The use of sevorane for anesthetic maintenance reduces a pharmacological load on the patient's homeostasis and the synergism with a central analgesic (fentanyl) and a myorelaxant diminishes both a stress-induced response to surgical aggression and an anesthetic agent. Reduced gas-flow anesthesia promotes the exclusion of intraoperative cold gas cooling that is typical of high-flow anesthesia. It is necessary to continue studies to comparatively analyze the consumables in compliance with the requirements for the quality of high-technology surgical interventions since the application of high-grade disposable consumables reduces airway microbial contamination, the time of disinfection of anesthesia-monitoring apparatuses and the consumption of disinfectant agents.

UI MeSH Term Description Entries
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000769 Anesthesia, Inhalation Anesthesia caused by the breathing of anesthetic gases or vapors or by insufflating anesthetic gases or vapors into the respiratory tract. Insufflation Anesthesia,Anesthesia, Insufflation,Inhalation Anesthesia
D014947 Wounds and Injuries Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity. Injuries,Physical Trauma,Trauma,Injuries and Wounds,Injuries, Wounds,Research-Related Injuries,Wounds,Wounds and Injury,Wounds, Injury,Injury,Injury and Wounds,Injury, Research-Related,Physical Traumas,Research Related Injuries,Research-Related Injury,Trauma, Physical,Traumas,Wound
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D016903 Drug Monitoring The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically. Monitoring, Drug,Therapeutic Drug Monitoring,Drug Monitoring, Therapeutic,Monitoring, Therapeutic Drug
D018685 Anesthetics, Inhalation Gases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173) Inhalation Anesthetic,Inhalation Anesthetics,Anesthetic Gases,Anesthetic, Inhalation,Gases, Anesthetic
D019637 Orthopedic Procedures Procedures used to treat and correct deformities, diseases, and injuries to the MUSCULOSKELETAL SYSTEM, its articulations, and associated structures. Orthopedic Surgery,Surgery, Orthopedic,Orthopedic Rehabilitation Surgery,Orthopedic Surgical Procedures,Orthopedic Procedure,Orthopedic Rehabilitation Surgeries,Orthopedic Surgeries,Orthopedic Surgical Procedure,Procedure, Orthopedic,Procedure, Orthopedic Surgical,Procedures, Orthopedic,Procedures, Orthopedic Surgical,Rehabilitation Surgeries, Orthopedic,Rehabilitation Surgery, Orthopedic,Surgeries, Orthopedic,Surgeries, Orthopedic Rehabilitation,Surgery, Orthopedic Rehabilitation,Surgical Procedure, Orthopedic,Surgical Procedures, Orthopedic

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