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Utilizarea analgeticelor neopioizi în supravegherea anestezică monitorizată în chirurgia ORL


Author: Virgiliu Guţan
Degree:doctor of medicine
Speciality: 14.00.37 - Anaesthesiology and Reanimathology
Year:2005
Scientific adviser: Boris (decedat) Pîrgari
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Ion Ababii
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 15 December, 2004
Approved by NCAA on the 27 January, 2005

Abstract

Adobe PDF document0.20 Mb / in romanian

Thesis

CZU 616.21+616-089.5-032:611.14+615.783

Adobe PDF document 0.61 Mb / in romanian
114 pages


Keywords

Ketanov, Midazolam, polimodal anesthesia, preemptive anesthesia, non-opioid analgetics, monitored anesthesia care, ENT surgery

Summary

Dissertational work of the doctor Gutan Virgiliu on competition of a scientific degree of the doctor of medicine with a theme: «The usage of non-opioid analgesics in the monitored anesthesia care in the ENT surgery»

The work is based on the comparison of three techniques of monitored anesthesia care: 1) first group (21 patients), to which was done monitored anesthesia care based on the intravenous administration of Dormicum for sedation in the context of local-infiltrative anesthesia; 2) second group (41 patients), to which, in the context of local-infiltrative anesthesia, was done the monitored anesthesia care by intravenous administration of Dormicum and the opioid analgesic Phentanyl - 1,45±0,03µg/kg; 3) third group (43pacients), to which, in the context of local-infiltrative anesthesia, was done the monitored anesthesia care by intravenous administration of Dormicum and the nonopioid analgesic Ketanov 0,45±0,03mg/kg; For touching the wished level of sedation into the first group was administrated dormicum 0,07±0,02 mg/kg, into the second group – 0,06±0,002 mg/kg and into the third group – 0,06±0,003 mg/kg This study was randomized, the groups being practically homogeneous concordant the age, sex.

The risk of anesthesia according to ASA at all the patients was from I to II degree. The manifestation degree of surgical stress was estimated by using the state of the central hemodynamics, the mathematics analysis of cardiac rhythm, catecholamine – adrenaline and noradrenalin, the verbal scales of pain, and the scales of estimation of sedation depth at four stages of the ENT surgery: septoplasty, polipotomy, stapedoplasty, myringoplasty, antromastoidoplasty and others.

Conclusion: The effectuation of surgeries was possible in the all groups, but the most favorable protection at a convenient surgical level was possible into the third group by using an non-opioide analgesic, from non-steroides analgesics class – Ketanov.