SYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES

The operation of total endoprosthesis replacement of large joints is associated with several anesthetic problems. Solving these problems ensures the safety of these highly traumatic operations and requires the solution of the following anesthetic tasks in the perioperative period: high degree of ant...

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Autores principales:	S. N. Bocharov, M. L. Lebed', V. S. Popova, I. N. Sandakova, M. G. Kirpichenko, M. M. Karmanova, M. A. Fesenko, A. S. Shamburova, Y. S. Bocharova
Formato:	article
Lenguaje:	RU
Publicado:	Scientific Сentre for Family Health and Human Reproduction Problems 2017
Materias:	large joint replacement system of anaesthetic support spinal anesthesia fat globulinemia thrombogenic complications Science Q
Acceso en línea:	https://doaj.org/article/6f9040144895401ab9287379e4ea7bfc
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spelling	oai:doaj.org-article:6f9040144895401ab9287379e4ea7bfc2021-11-23T06:14:39ZSYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES2541-94202587-959610.12737/article_5a0a85e453e1a3.15439393https://doaj.org/article/6f9040144895401ab9287379e4ea7bfc2017-11-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/469https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596The operation of total endoprosthesis replacement of large joints is associated with several anesthetic problems. Solving these problems ensures the safety of these highly traumatic operations and requires the solution of the following anesthetic tasks in the perioperative period: high degree of antinociceptive protection of patients with effective relaxation of the surgical intervention area; prevention of fatty hyperglobulinemia; decrease in the volume of perioperative hemorrhage and prophylaxis of thrombogenic complications. We developed our own program of anesthetic maintenance at major joints replacement. The components of the program are: the type of anesthesia - spinal anesthesia preservation of spontaneous respiration; our method of fat globulinemia prevention, based on maintaining the functional stability of the hepatocyte; our own method of replacement of peri-operative blood loss, based on the additional principle of "normalization of the oncotic blood pressure". Before the operation, patients receive a solution of tranexamic acid at a dose of 10 mg/kg of body mass to inhibit proteolysis (blood preservation technology). This method provides a "dry" operating field, reducing intraoperative hemorrhage. In the early postoperative period (5 hours after the surgery), under the control of whole blood clotting time, patients receive low molecular weight heparin Clexane at a therapeutic dosage of 1 mg/kg of body weight. This provides effective prevention of thrombogenic complications. The application of the developed technique shows its high clinical effectiveness. Over the past 5 years, 5,800 operations for large joint prosthetics have been performed, including 3,200 total hip replacement operations, 2,600 total knee replacement operations. There were no complications with a fatal outcome, in 5 cases fatty hyperglobulinemia was noted, which was stopped by the own method of treatment. There are no thrombogenic complications.S. N. BocharovM. L. Lebed'V. S. PopovaI. N. SandakovaM. G. KirpichenkoM. M. KarmanovaM. A. FesenkoA. S. ShamburovaY. S. BocharovaScientific Сentre for Family Health and Human Reproduction Problemsarticlelarge joint replacementsystem of anaesthetic supportspinal anesthesiafat globulinemiathrombogenic complicationsScienceQRUActa Biomedica Scientifica, Vol 2, Iss 6, Pp 59-63 (2017)
institution	DOAJ
collection	DOAJ
language	RU
topic	large joint replacement system of anaesthetic support spinal anesthesia fat globulinemia thrombogenic complications Science Q
spellingShingle	large joint replacement system of anaesthetic support spinal anesthesia fat globulinemia thrombogenic complications Science Q S. N. Bocharov M. L. Lebed' V. S. Popova I. N. Sandakova M. G. Kirpichenko M. M. Karmanova M. A. Fesenko A. S. Shamburova Y. S. Bocharova SYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES
description	The operation of total endoprosthesis replacement of large joints is associated with several anesthetic problems. Solving these problems ensures the safety of these highly traumatic operations and requires the solution of the following anesthetic tasks in the perioperative period: high degree of antinociceptive protection of patients with effective relaxation of the surgical intervention area; prevention of fatty hyperglobulinemia; decrease in the volume of perioperative hemorrhage and prophylaxis of thrombogenic complications. We developed our own program of anesthetic maintenance at major joints replacement. The components of the program are: the type of anesthesia - spinal anesthesia preservation of spontaneous respiration; our method of fat globulinemia prevention, based on maintaining the functional stability of the hepatocyte; our own method of replacement of peri-operative blood loss, based on the additional principle of "normalization of the oncotic blood pressure". Before the operation, patients receive a solution of tranexamic acid at a dose of 10 mg/kg of body mass to inhibit proteolysis (blood preservation technology). This method provides a "dry" operating field, reducing intraoperative hemorrhage. In the early postoperative period (5 hours after the surgery), under the control of whole blood clotting time, patients receive low molecular weight heparin Clexane at a therapeutic dosage of 1 mg/kg of body weight. This provides effective prevention of thrombogenic complications. The application of the developed technique shows its high clinical effectiveness. Over the past 5 years, 5,800 operations for large joint prosthetics have been performed, including 3,200 total hip replacement operations, 2,600 total knee replacement operations. There were no complications with a fatal outcome, in 5 cases fatty hyperglobulinemia was noted, which was stopped by the own method of treatment. There are no thrombogenic complications.
format	article
author	S. N. Bocharov M. L. Lebed' V. S. Popova I. N. Sandakova M. G. Kirpichenko M. M. Karmanova M. A. Fesenko A. S. Shamburova Y. S. Bocharova
author_facet	S. N. Bocharov M. L. Lebed' V. S. Popova I. N. Sandakova M. G. Kirpichenko M. M. Karmanova M. A. Fesenko A. S. Shamburova Y. S. Bocharova
author_sort	S. N. Bocharov
title	SYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES
title_short	SYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES
title_full	SYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES
title_fullStr	SYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES
title_full_unstemmed	SYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES
title_sort	system of anaesthetic support at large joint replacement surgeries
publisher	Scientific Сentre for Family Health and Human Reproduction Problems
publishDate	2017
url	https://doaj.org/article/6f9040144895401ab9287379e4ea7bfc
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SYSTEM OF ANAESTHETIC SUPPORT AT LARGE JOINT REPLACEMENT SURGERIES

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