[Correction of temperature homeostasis and microcirculation under the stress-protection anesthesia in hip replacement].
Prolonged epidural anesthesia belongs to the most effective anesthetic management schemes in total hip replacement. However, its use is related with compensatory stress-induced vasoconstriction resulting in an impaired vasoconstriction registered above the block level. It entails, in its turn, an impaired thermoregulation (hypothermia, postoperative muscle trembling), a reduced renal blood flow with diminished diuresis and metabolic lactate-acidosis. The preoperative preparation with daralgin (15 microg/kg, 3 intramuscular injections per day for 2-3 days) with its subsequent intraoperative infusion (30 microg/h) made concurrently with premedication by clofelin (1.5 microg/kg) arrest the above hemostasis impairments. Finally, the ability of stress-protection drugs to diminish the rate of postoperative fever and muscle trembling was registered.
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Mitsukov
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Nazarov
D000138:Acidosis / Q000378:metabolism; D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D019644:Arthroplasty, Replacement, Hip; D001833:Body Temperature Regulation / Q000187:drug effects*; D003000:Clonidine / Q000494:pharmacology / Q000627:therapeutic use*; D004743:Enkephalin, Leucine / Q000494:pharmacology / Q000627:therapeutic use; D016308:Enkephalin, Leucine-2-Alanine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000517:prevention & control; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008833:Microcirculation / Q000187:drug effects / Q000503:physiopathology; D008875:Middle Aged; D011292:Premedication; D012079:Renal Circulation / Q000187:drug effects*; D013312:Stress, Physiological / Q000517:prevention & control; D014202:Tremor / Q000517:prevention & control; D014661:Vasoconstriction / Q000187:drug effects
D019344:Lactic Acid; D004743:Enkephalin, Leucine; D016308:Enkephalin, Leucine-2-Alanine; D003000:Clonidine; C040996:enkephalin-Leu, Ala(2)-Arg(6)-