The article presents the results of preoperative preparation, anesthesia and surgical treatment of patients operated on for non-toxic nodular goiter. A new approach to preoperative preparation for thyroid surgery is described. The effectiveness in the preoperative period of using the modified method of preoperative preparation using sibazon and droperidol and anesthesia with the use of ketamine and the advantages of this method compared with other methods of general anesthesia are shown.
The purpose of the study was to improve the quality of anesthesia during orthopedic operations in children using the opioid-sparing anesthesia technique.
Materials and methods. The course of anesthesia was analyzed in 48 patients aged 3 to 14 years, during orthopedic operations in children. The distribution of patients into groups was carried out depending on the technique of anesthesia. Group 1 (main) consisted of 25 children who underwent general anesthesia using low doses of fentanyl, sevoflurane and propofol. group 2 (control) - 23 children who underwent general anesthesia with fentanyl and propofol. Echocardiography was used to determine hemodynamic parameters. The dynamics of changes in the level of cortisol in the blood and the concentration of catecholamines (adrenaline, norepinephrine, dopamine) in daily urine was studied. Results. In children of the first group, during the introductory period of anesthesia, there was a decrease in CI, an increase in heart rate and UPS. Stroke index (SI), mean arterial pressure (MAP), cardiac index (CI) changed insignificantly compared to the previous stage of the study. In the children of the second group in the most traumatic stages of the operation, there was an increase in SI, HR, and AI. In the most traumatic stages of the operation and after the operation in children of the first group, there was a tendency to increase cortisol, in the second group of patients, an increase in cortisol was noted.
The purpose of the study. Optimization of anesthesia by using the low-opioid anesthesia technique for thoracoplasty in children.
Materials and methods. Analyzed the course of anesthesia in 48 patients aged 3 to 14 years, operations for pectus excavatum in children. The distribution of patients into groups was carried out depending on the technique of anesthesia. Group 1 (main) consisted of 25 children who underwent general anesthesia using low doses of fentanyl, sevoflurane and propofol. group 2 (control) - 23 children who underwent general anesthesia with fentanyl and propofol. Echocardiography was used to determine hemodynamic parameters. The dynamics of changes in the level of cortisol in the blood and the concentration of catecholamines (adrenaline, norepinephrine, dopamine) in the blood was studied.
Results. In children of the first group, during the introductory period of anesthesia, there was a decrease in CI, an increase in heart rate and UPS. Stroke index (SI), mean arterial pressure (MAP),
cardiac index (CI) changed insignificantly compared to the previous stage of the study. In the children of the second group in the most traumatic stages of the operation, there was an increase in SI, HR, and AI. In the most traumatic stages of the operation and after the operation in children of the first group, there was a tendency to increase cortisol, in the second group of patients, an increase in cortisol was noted.
The aim of the study was to assess the level and depth of various types of anesthesia by studying the BIS-index in intraocular operations in children.
The data of the study of the dynamics of the BIS-index and, accordingly, the depth of sedation indicated the effectiveness of the anesthesia options used, including the use of inhaled anesthetics sevoflurane and isoflurane in the anesthetic support of intraocular operations. The following combinations were used to provide anesthetic protection in 46 children with intraocular surgery: fentanyl with sevoflurane (group 1), fentanyl with isoflurane (group 2). At the stage of basic anesthesia in patients of group 1, the BIS index was in the range of 45,8-57,4, in group 2, the BISindex was in the range of 37,61- 53,6.
All the proposed options of anesthesia provide a sufficient level of sedation of patients during intraocular operations and can be used in practice. Thus, conducting anesthesia using BIS-monitoring allows you to reduce the doses of drugs used, reduce the amount of excessively deep and superficial anesthesia, and reduce the time of recovery of consciousness after the end of the operation
The aim of the study was to assess the level and depth of various types of anesthesia by studying the BIS-index in intraocular operations in children. The data of the study of the dynamics of the BIS-index and, accordingly, the depth of sedation indicated the effectiveness of the anesthesia options used, including the use of inhaled anesthetics sevoflurane and isoflurane in the anesthetic support of intraocular operations. The following combinations were used to provide anesthetic protection in 46 children with intraocular surgery: fentanyl with sevoflurane (group 1), fentanyl with isoflurane (group 2). At the stage of basic anesthesia in patients of group 1, the BIS-index was in the range of 45,8-57,4, in group 2, the BISindex was in the range of 37,61- 53,6. All the proposed options of anesthesia provide a sufficient level of sedation of patients during intraocular operations and can be used in practice. Thus, conducting anesthesia using BIS-monitoring allows you to reduce the doses of drugs used, reduce the amount of excessively deep and superficial anesthesia, and reduce the time of recovery of consciousness after the end of the operation.
The purpose of the study. To compare the effects of the traditional inhalation method and VIMA (Volatile Induction and Maintenance Anesthesia) anesthesia and the new VIMA technique in two-bolus induction with sevoflurane on the frequency of development of agitation, bradycardia and agitation in children. Materials and styles. Studies were conducted at the clinic of the Tashkent Pediatric Medical Institute. The studies are retrospective and prospective. A clinical analysis of 245 anesthesiological practices with sevoflurane (traditional VIMA technique) in children with neurological symptoms of various urological, surgical and ophthalmosurgical pathologies was conducted. Results. The VIMA technique of double-bolus sevoflurane induction of anesthesia provides a preconditioned result and minimizes the frequency of bradycardia development, as well as excitability and agitation in children. In our opinion, this inhalation anesthesia application of the method is promising, it is necessary to continue its research.
Prevention and elimination of increased intraocular pressure is one of the most important tasks of an anesthesiologist during ophthalmic operations, therefore, the search for optimal anesthesia schemes is an urgent problem of modern anesthesiology. The aim of the work was to evaluate the effectiveness of combined methods of anesthesia in intraocular surgery in children by analyzing hemodynamic parameters. We examined 46 children who needed ophthalmological operations. The following anesthesia schemes were used: sevoflurane + fentanyl (group 1), propofol + fentanyl (group 2). Anesthesia effectiveness was assessed on the basis of clinical data with monitoring of the main hemodynamic and respiratory parameters. The results showed that the anesthesia regimens used were characterized by a smooth clinical course, while maintaining the stability of the main hemodynamic parameters.
To Evaluate the effectiveness and safety of neuroaxial anesthesia for lower limb joint replacement in elderly and senile patients with a high comorbidity index and ASA class III and IV physical status.
Materials and Methods: The studies were carried out in a multidisciplinary TMA clinic in 40 geriatric patients with a comorbid background who were operated on under conditions of combined spinal-epidural anesthesia. 29 patients underwent total hip arthroplasty (THA), 11 - total knee arthroplasty (TKA). Inclusion criteria: elderly (65 to 75 years) and senile (76-90 years) age, and over 90 - long-livers, pain syndrome for more than one year, no contraindications for regional methods of anesthesia. For continuous monitoring of the vital functions of the patient, we used the "resuscitation-surgical" monitor YUM 300 (LLC "Company UTAS" Ukraine).
Conclusion: For elderly and senile patients with a high risk of comorbidity, the technique of unilateral spinal and epidural anesthesia with low doses of intrathecal local anesthetic (5 mg 0.5% hyperbaric solution of bupivacaine with 20 μg fentanyl) and additional administration of low doses of bupivacaine into the epidural space 7, 5 mg is a safe method of anesthesia and allows you to achieve the proper sensory - motor block, which is necessary for the replacement of the joints of the lower extremities.
Fast track surgery (FTS), or rapid recovery surgery, is a fundamentally new approach to surgery. FTS was developed by Kehlet F.I. (1993) and assumed the following aspects to minimize stress reactions and significantly reduce the recovery period of patients: regional anesthesia, minimally invasive operations, aggressive postoperative rehabilitation (early enteral nutrition and activation of patients). Wind J. (2006) specified FTS as follows: informing the patient, avoiding bowel preparation and premedication, using probiotics, avoiding preoperative dry fasting, oral glucose (5%, 150 ml 2 hours before surgery), regional anesthesia or anesthetics short-acting, adequate perioperative infusion, surgical mini-invasiveness, prevention of hyposermia, non-opioid analgesia, avoidance of routine nasogastric tubes and drains, early removal of the urinary catheter, prokinetics, early enteral nutrition and patient activation.
Aim of the study was assess both the effectiveness and safety of anesthetic management and optimizing postoperative anesthesia under conditions of multimodal anesthesia and analgesia during abdominal operations in children.
Patients and methods. The authors examined 58 children aged 1 to 17 years with abdominal operations (malformations, diseases, and abdominal organ injuries). To ensure anesthetic protection, patients underwent combined general anesthesia with propofol and fentanil (induction) with inhalation of sevoflurane + propofol intra venous (maintenance) in combination with epidural blockade with bupivacaine.
Results. According to surgical intervention, the arrangement of perioperative analgesic protection provided a favorable correction of the hemodynamic status of patients, a decrease in inhalation anesthetic, promoted a smooth course of the postoperative period, a long painless period, an excellent psychoemotional background, and rapid postoperative recovery.
The purpose of the study. Traditional inhalation method and VIMA (Volatile Induction and Maintenance Anesthesia) method of applying anesthesia and using the new VIMA technique in double-bolus induction with sevoflurane to compare the effect on the frequency of development of agitation, bradycardia and agitation in children. Materials and styles. Studies were conducted at the clinic of the Tashkent Pediatric Medical Institute. The studies are retrospective and prospective. A clinical analysis of 245 anesthesiological practices with sevoflurane (traditional VIMA technique) in children with neurological symptoms of various urological, surgical and ophthalmosurgical pathologies was conducted. Results. The VIMA method is a technique of double-bolus sevoflurane induction of anesthesia provides a preconditioned result and minimizes the frequency of development of bradycardia, as well as excitability and agitation in children. In our opinion, the use of this method of inhalation anesthesia is promising, it is necessary to continue its research.
One of the prior directions in inhalation anesthesia is low flow anesthesia (LFA 1,0 l/min), which has several advantages over the traditional anesthesia with high gasflow. The work is based on the foilowing, oblained in imprementation of the combined general
anesthesia with row flow on the basis Jf enflurana on r47 children aged from 3 to 18 years (average age 7.5+2.2 years). The studied
reading of hemodynamic in anesthesia with sevoflurana was charac terizedwith minor changes in ttre stages of the research: HRR in period of induction increased to 8,2Yo,in comparison with the amount before the surgery
Purpose: to determine the effect of unilateral spinal anesthesia on systemic and central hemodynamics, to identify its side effects in the elderly and senile, with total hip replacement.
Materials and methods: 60 patients of geriatric age operated on under unilateral spinal anesthesia were examined. 44 patients underwent total hip arthroplasty (THA), 16 - total knee arthroplasty (TKA). Inclusion criteria: elderly (from 60 to 75 years). For continuous monitoring of the vital functions of the patient, they used the "resuscitation and surgical" monitor UM 300 (LLC UTAS Company Ukraine).
Conclusion: Unilateral spinal anesthesia is a safe and highly effective technique that can provide full intraoperative pain management for patients with total hip replacement in a high-risk group of patients.
Was assessing both the effectiveness and safety of anesthetic management and optimizing postoperative anesthesia under conditions of multimodal anesthesia abdominal operations in children. The authors examined 61 children aged 1 to 14 years with abdominal operations (malformations, diseases, and abdominal organ injuries). To ensure anesthetic protection, patients underwent combined general anesthesia with propofol and fentanyl (induction) with inhalation of sevoflurane + propofol intra venous (maintenance) in combination with epidural blockade with bupivacaine. According to surgical intervention, the arrangement of perioperative analgesic protection provided a favorable correction of the hemodynamic status of patients, a decrease in inhalation anesthetic, promoted a smooth course of the postoperative period, a long painless period, an excellent psychoemotional background, and rapid postoperative recovery
The study of ancient manual sources provides invaluable insights into the history and culture of past civilizations. One crucial aspect of these sources is the material on which they were prepared, particularly the types of paper used. This paper aims to explore the various types of paper employed in the preparation of ancient manual sources, focusing on their composition and the preparation processes involved.
This study draws on a comprehensive review of existing literature, historical records, and archaeological findings to identify and categorize the types of paper used in different historical periods and regions. Furthermore, the composition of these papers, including the raw materials and manufacturing techniques, will be examined to understand the physical and chemical properties that contribute to their durability and preservation over time.
In addition, the preparation process of ancient paper will be investigated, shedding light on the methods and tools used by ancient scribes and artisans to create writing surfaces. The influence of cultural, geographical, and technological factors on paper preparation will be analyzed to provide a comprehensive understanding of the diverse practices employed by various civilizations.
By examining the types of paper, their composition, and the preparation processes, this research aims to contribute to the broader understanding of ancient manual sources and the historical contexts in which they were produced. Understanding the materiality of these sources is crucial for their preservation, conservation, and interpretation, and this study seeks to provide a valuable resource for scholars, historians, and conservationists engaged in the study and safeguarding of ancient cultural heritage.
Topicality and demand of the theme of dissertation. One of the actual problems of modern physical chemistry and macromolecular chemistry is the study on the development of the fundamentals of synthesis of functional polymers with ion-exchange and complexing properties.
Anion exchange and complexing compounds based fibrous materials have a high specific surface area, which provides a high possibility of sorption and desorption processes. They arc especially effective in removing toxic substances, even at very low content of the latter from the air and water pollution. Of particular interest is the acrylic fiber "Nitron", which is produced by JSC "Navoiazot" (Uzbekistan).
In the Academy of Sciences of the Republic of Uzbekistan, Tashkent Institute of Textile and Light Industry conducted research on the development of fibrous ion exchange materials based on acrylic fiber "Nitron" but they have not been brought to its logical end. In addition, when these studies neglected the study of the physicochemical aspects of the preparation of these materials.
In developing the fundamentals of ion exchange materials obtaining a lot of attention paid to the study of physical and chemical aspects of the synthesis and properties of these high-molecular compounds. These studies due to the fact that they allow you to adjust the processes of synthesis and, therefore, necessary to obtain polymers with required composition and with complex specific properties.
As noted above, to date, no attention was paid to the study of the physicochemical foundations of anion exchangers and polycomplcxons, due to applied research conducted to date in this field of research. In this regard, the study of physical and chemical principles of bases of creation, and the properties of anion exchangers and polycomplcxons based on acrylic fiber "Nitron" arc actual both from a theoretical and practical point of view.
Demand perform of the dissertation is characterized by the fact that modern worldwide technology for extraction of non-ferrous and precious metals can not be realized without the use of ion-exchange materials. These techniques use mostly granular sorbents, while fibrous sorbents comprise just 2-3 % of the ion exchange materials used . Using technology employing ion exchange material from algae and natural brine deposits of oil and gas recovered to 90% of iodine and bromine, lodinc-containing sorbents arc used for disinfection of drinking water from microorganisms and extraction of mercury from wastewater and gas emissions. They can be used for concentrating the processing solutions and biologically active substances in the preparation of catalyst systems nanoparticles metals. It should also be noted that Uzbekistan hitherto not been established as industrial manufacture granular and fibrous sorbents, although such polymers arc widely used in industry.
The purpose of this study is to identify the physico- chemical characteristics of the formation and properties of anion exchangers polycomplcxons based on acrylic fiber " Nitron ".
Scientific novelty of disscrtational research consists in the following:
in the first time studied the kinetics of the interaction of acrylic fiber "Nitron" with nitrogen-containing bases in aqueous and organic media;
shown that due to the high surface area fibers arc modifiable , the reaction rate depends on the concentration of the nitrile groups of the polymer being in the solid surface;
proved previously identified mechanism of the catalytic action of small amounts of hydroxylaminc on the process of modifying of fiber " Nitron " with nitrogen-containing bases;
in the first lime developed a method for producing anion exchangers branched structure by sequential treatment of acrylic fiber " Nitron " with cthylcncdiaminc and dichlorocthanc;
found that the interaction of PAN - fibers with hcxamcthylcnc- and ethylene diamines formed anion exchange fibrous materials having in its composition as a weakly basic and strongly basic functional groups ;
in the first time obtained new polycomplcxons with ampholytic properties by reacting maleic anhydride with amine -modified polyacrylonitrile fiber " Nitron " or by hydrolysis of residual of the nitrile groups modified with diamines of acrylic fiber "Nitron";
established values of the thermodynamic equilibrium constants of adsorption of ions Cr (VI), Си (II), halogens, Arsenazo (III) by synthesized anion exchangers and polycomplcxons and alteration in thermodynamic functions of the process testify to high sorption capacity of these ion-exchange materials with respect to the sorption ions;
Conclusion
1. Values degree reaction of the nitrile group and a nitrogenous base, the activation energy of the process shows that the process of modifying fiber " Nitron " nitrogen-containing bases subject to the usual regularities observed in homogeneous reactions. This effect is due to a high fiber surface area to be modified, allowing the reactants to facilitate access to the nitrile groups of the polymer. (Physical chemistry, High molecular compounds).
2. Kinetic studies of the reaction of acrylic fiber " Nitron " with diamine (hexamethylene and ethylenediamine) showed that the change of physical and chemical parameters of the modification process can be controlled sorption properties, chemical resistance and the strength of the anion exchangers due to network structure of the polymer. It has been established that this modification "Nitron" produces strongly basic anion character especially in organic media. Strongly basic anion exchangers possibility of obtaining a high sorption capacity with graft polycthylcnpolyaminc chain reactions revealed in fiber modification "Nitron " ethylenediamine in the presence of dichloroethane. (High molecular compounds, Physical chemistry ).
3. IR - spectroscopic and analytical determination of the formation of intermediate amidoxime groups in the polymer chains and free hydroxylaminc after substitution reaction proved previously proposed mechanism of the catalytic action of hydroxylaminc on the process of chemical modification of acrylic fiber " Nitron " nitrogen-containing bases . ( Physical Chemistry).
4. Developed conditions of synthesis polycomplcxons reacting maleic anhydride with modified by hcxamcthylcncdiaminc acrylic fiber "Nitron" and with of hydrolysis of residual nitrile groups modified by hcxamcthylcnc- and cthylcncdiamin of acrylic fibers . (High molecular compounds, Physical Chemistry).
5. Alkalinity obtained anion exchange resins depends on the nature of their functional groups. Strongly basic anion exchangers have in their composition cyclic amidine groups and they arc formed by the reaction of polyacrylonitrile fiber with a diamine. The specific surface area obtained fibrous sorbents exceeds by two orders of known surface area granular ion exchange resins, and their crosslinking rate is up to 100 nodes per macromolecule polymer. ( Physical Chemistry )
6. Kinetics and thermodynamics of the sorption of various inorganic and organic ions obtained polycomplcxons sorbents showed that ions of Cr (VI), Arsenazo (111) can be sorbed strongly basic anion exchangers only, and the process of sorption of copper (II) with polycomplcxons occurs not only due to the ion exchange, but also due to chelation. ( Physical Chemistry ).
7. Developed the conditions obtaining bromide complexes of polymers and kinetics, thermodynamics of the sorption halogen anion in synthesized materials was studied. It is shown that the lower the stability of the ion [Bn]’ for ion [J3]'than the ability to form such molecular chlorine ions leads to the fact that almost no molecular chlorine is adsorption, and molecular bromine is absorbed to a lesser extent than the molecular iodine. (Physical Chemistry ).
8. Combined developed iodinated anion exchange materials based on acrylic fiber " Nitron " and chitosan. Insertion of the iodinc-containing chitosan materials, leads to an increase of absorbent capacity. Combined antibacterial dressings have a pronounced anti-inflammatory and antibacterial effect, arc effective for the treatment of necrotic soft tissue diseases. (High molecular compounds, Physical Chemistry).
Anesthesiology as a new specialty has a little more than 160 years, if we date its occurrence from the moment of the first use of ether anesthesia (1846). However, these 160 years were a revolutionary revolution in the development of surgery and many other areas of medicine. Thanks to endotracheal anesthesia, access to the chest cavity became possible, and operations on the lungs and heart became a daily practice. The pinnacle of surgical perfection was the transplantation of the heart and other organs. All this has set before anesthesiology the task of developing new methods and means of controlling the vital functions of the operated organism. Over time, the range of anesthetic techniques has expanded significantly, modern anesthesia and respiratory equipment, monitors for intraoperative control, disposable consumables, etc. have appeared, which became the basis for the development of domestic anesthesiology and intensive care.
The data from the study of the state of central hemodynamics testified to the effectiveness of the used variants of anesthesia with fentanyl in combination with sevoflurane and the variant of anesthesia with fentanyl in combination with propofol in the anesthetic management of congenital hip dislocation. The paper assesses the state of the circulatory system in children with congenital hip dislocation. The development of rational options for pain relief has identified the advantages of combined anesthesia with fentanyl and sevoflurane. The study of indicators of daily monitoring of blood pressure, heart rate, study of indicators of central hemodynamics made it possible to determine the nature and type of regulation of the circulatory system under the conditions of the recommended methods of combined anesthesia for surgical correction of congenital hip dislocation in children.