title: [Efficacious anesthesiological and resuscitation care--the cornerstone of modern oncosurgery].
abstract: A few modern concepts of anesthesiological and resuscitation care during complicated surgical interventions are considered with special reference to multimodal anesthesia as a principal tool for the protection of the patient from a surgical trauma based on the rational combination of three-component epidural analgesia (ropivacaine, fentanyl, and adrenalin) with sevoflurane inhalation narcosis and extention of the same epidural analgesia to the early postoperative period. The basic principles of infusion-transfusion therapy for the treatment of massive intraoperative blood loss ensuring its tolerability by the patient are discussed. Special attention is given to the problem of hospital-acquired infections and sepsis in oncosurgery. Methods are proposed for the improvement of the management of septic shock including immunomodulation, respiratory support, infusion and anti-infective therapies. It is concluded that the use of these conceptual approaches permits to perform extensive surgical interventions in patients with the initially low reserve capacity of vital functions.
authors.forename: E S
authors.initials: ES
authors.lastname: Gorobets
authors.forename: I V
authors.initials: IV
authors.lastname: Nekhaev
authors.forename: S V
authors.initials: SV
authors.lastname: Lomidze
mesh_terms: D000698:Analgesia / Q000379:methods; D000758:Anesthesia / Q000379:methods*; D006801:Humans; D009369:Neoplasms / Q000601:surgery*; D012151:Resuscitation / Q000379:methods*