Abstract
The aimof this study was to identify the distinctive features of the course of anesthesia and the structure of critical incidents (CI) in patients with various functional states (FS) during surgical interventions aimed at eliminating acute colonic obstruction.Materials and methods. 146 patients having undergone emergency surgical interventions aimed at eliminating acute colonic obstruction were examined. On the basis of the constant potential (CP) value, 3 groups were identified. Group 1 (n=66) was characterized by the CP value of -30 mV and below (FS subcompensation). Group 2 (n=44) included patients with the average negative CP values from -15 to -29.9 mV (FS compensation). Group 3 (n=36) comprised patients with the low negative and positive CP values of -14.9 mV and above (FS decompensation). The connection of FS with the frequency of the CI development was studied. The recorded CI included hemodynamic: hypotension — hypertension — bradycardia — arrhythmia — tachycardia; respiratory: hypoxemia — hypercapnia — the need for a prolonged mechanical ventilation of lungs in the postoperative period; metabolic: hypothermia — retarded recovery of the neuromuscular conductivity — delayed postoperative awakening.Results. CI occurrence is found to be different in patients with different FS. Hemodynamic CIs were noted in all the studied groups; however, their proportion in patients with high and low negative and positive CP values was significantly higher. Their formation was accompanied by violations of the adequate course of anesthesia, namely, the hypokinetic state of the blood circulation and aerobic metabolism. In addition, this group showed an increase in the frequency of a slow recovery of the neuromuscular conduction and delayed postoperative awakening.Conclusion.The most adequate course of anesthesia has been observed in patients with moderate negative CP values.Conflict of interest: the authors declare no conflict of interest
Highlights
critical incidents (CI) occurrence is found to be different in patients with different functional states (FS)
Hemodynamic CIs were noted in all the studied groups; their proportion in patients with high and low negative and positive constant potential (CP) values was significantly higher. Their formation was accompanied by violations of the adequate course of anesthesia, namely, the hypokinetic state of the blood circulation and aerobic metabolism. This group showed an increase in the frequency of a slow recovery of the neuromuscular conduction and delayed postoperative awakening
The most adequate course of anesthesia has been observed in patients with moderate negative CP values
Summary
Метаболические: гипотермия (снижение центральной температуры тела ниже 36 °С); замедленное восстановление нейромышечной проводимости; замедленное послеоперационное пробуждение (восстановление сознания более чем через час после анестезии). После индукции анестезии и интубации трахеи в целом данная динамика изменений СИ сохранялась у большинства представителей 1-й и 3-й групп, а более чем у половины исследованных лиц 2-й группы формировался гиперкинетический тип кровообращения. Стабильное течение анестезии, оцениваемое на основе величин параметров гемодинамики, газового состава крови, кислотно-основного состояния и метаболизма
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
