RESUMEN
Reconstructive operations on the facial skeleton and on the skull have been widely introduced in surgery. Increment of indications and augmentation of traumaticity from surgical interventions pose to anesthesiologist a set of such problems, as tracheal intubation, antinociceptive protection, prevention of hepatocerebral encephalopathy. The peculiarities of cerebral and hepatic circulation and metabolism as well as approaches in anesthesia and craniofacial surgery are discussed.
Asunto(s)
Anestesia General/métodos , Huesos Faciales/cirugía , Procedimientos de Cirugía Plástica , Cráneo/cirugía , Anestesia General/efectos adversos , Encefalopatía Hepática/prevención & control , Humanos , Intubación Intratraqueal , Monitoreo Intraoperatorio , Cuidados Posoperatorios , Complicaciones Posoperatorias/prevención & control , Respiración ArtificialRESUMEN
A total of 106 patients with surgical infection in maxillofacial region were studied. Clinical and laboratory diagnostic data on surgical infection and sepsis in maxillofacial surgery are presented. Integral indices of blood circulation, respiration, brain and liver metabolism, regarding severity of surgical infection were determined. Pathogenetically substantiated therapy of sepsis is proposed.
Asunto(s)
Procedimientos Quirúrgicos Orales , Servicio de Cirugía en Hospital/estadística & datos numéricos , Infección de la Herida Quirúrgica/complicaciones , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Adolescente , Adulto , Humanos , Incidencia , Persona de Mediana Edad , Moscú/epidemiología , Sepsis/diagnóstico , Sepsis/epidemiología , Sepsis/etiología , Infección de la Herida Quirúrgica/epidemiología , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/epidemiologíaAsunto(s)
Procedimientos Quirúrgicos Ambulatorios , Anestesia Dental/métodos , Anestesia Intravenosa/métodos , Anestésicos Intravenosos , Operatoria Dental , Propofol , Anestésicos Intravenosos/administración & dosificación , Humanos , Medicación Preanestésica , Propofol/administración & dosificaciónRESUMEN
Anesthesia including high- or low-frequency transtracheal jet ventilation of the lungs was used in 52 patients with maxillofacial abnormalities subjected to repair surgery. The number of respiratory cycles was 20 per min in 1 group and 120 per min in the other. Intubation of the trachea was started 20 min after ventilation was started. Transtracheal jet ventilation of the lungs prevented hypoxia during intubation of the trachea in such patients. High-frequency jet ventilation of the lungs may be a method of choice in such cases.
Asunto(s)
Cara/anomalías , Ventilación con Chorro de Alta Frecuencia/métodos , Hipoxia/prevención & control , Cuidados Intraoperatorios/métodos , Complicaciones Intraoperatorias/prevención & control , Anomalías Maxilomandibulares/cirugía , Cara/cirugía , Hemodinámica , Ventilación con Chorro de Alta Frecuencia/instrumentación , Humanos , Cuidados Intraoperatorios/instrumentación , Intubación Intratraqueal , Anomalías Maxilomandibulares/fisiopatología , Medicación Preanestésica , Factores de TiempoAsunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Cirugía Bucal , Tolmetina/análogos & derivados , Trometamina/análogos & derivados , Antiinflamatorios no Esteroideos/efectos adversos , Evaluación de Medicamentos , Femenino , Humanos , Ketorolaco Trometamina , Masculino , Dolor Postoperatorio/tratamiento farmacológico , Tolmetina/efectos adversos , Tolmetina/uso terapéutico , Trometamina/efectos adversos , Trometamina/uso terapéuticoRESUMEN
Brain and liver metabolism has been studied by selective probing of vessels collecting blood from the brain and liver, in 95 patients with various surgical craniofacial pathology. Prolonged general anesthesia in craniofacial traumas has a negative effect on brain metabolism. Changes in indispensible amino acid formulas and hypoxia may cause the loss of brain circulation autoregulation and damages in central mechanisms regulating metabolic processes. A complex scheme of metabolism correction during prolonged anesthesia in craniofacial surgery is suggested.
Asunto(s)
Anestesia General/efectos adversos , Encéfalo/metabolismo , Huesos Faciales/cirugía , Hígado/metabolismo , Cráneo/cirugía , Humanos , Factores de TiempoAsunto(s)
Analgesia , Anestesia Dental , Anestésicos Locales , Antiinflamatorios no Esteroideos , Adulto , Procedimientos Quirúrgicos Ambulatorios , Benzofuranos , Operatoria Dental , Evaluación de Medicamentos , Femenino , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Factores de TiempoAsunto(s)
Anestesia Intravenosa , Ansiolíticos , Benzodiazepinas , Benzodiazepinonas/administración & dosificación , Fentanilo/administración & dosificación , Flunitrazepam/administración & dosificación , Hemodinámica/efectos de los fármacos , Enfermedades Maxilomandibulares/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
In 178 patients treated for the lower jaw fractures the respiration and gas exchange were studied. Respiratory insufficiency was caused by obstructive events due to bone fragments and maxillofacial soft tissues dislocation with arterial blood levels of oxygen decreased and hemoglobin oxygen saturation lowered. Traumatic stress resulted in hyperdynamic circulatory response correlating with the severity of lesion.
Asunto(s)
Sistema Cardiovascular/fisiopatología , Fracturas Mandibulares/fisiopatología , Sistema Respiratorio/fisiopatología , Adolescente , Adulto , Femenino , Fijación de Fractura/métodos , Hemodinámica , Humanos , Masculino , Fracturas Mandibulares/terapia , Persona de Mediana Edad , Intercambio Gaseoso Pulmonar , RespiraciónRESUMEN
Mathematical analysis of the heart rhythm and central hemodynamic tests have been performed in patients after surgery for congenital palatal defects and posttraumatic defects of soft facial tissues performed under combined electroanalgesia. Stability of the heart rhythm and hemodynamic patterns has been revealed, which is indicative of an adequate anesthesiological protection.