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Two nondepolarizing myorelaxants: tracrium, with medium-long duration of action, and a new short-acting drug mivacron were used in combined anesthesia of 50 patients with gastrointestinal diseases subjected to laparoscopic cholecystectomy. Both drugs can be used for anesthesia of laparoscopic operations; mivacron should be preferred due to its shorter action.

The authors analyze the efficacy of midazolam (dormicum, Egys, Hungary) used for induction anesthesia in 35 patients subjected to planned surgery for varicose disease of the lower limbs and on the abdominal organs and in 17 critical patients in intensive care units. To assess the hemodynamics, catheterization of the peripheral and pulmonary arteries was carried out, cardiac output, pressure in cardiac cavities, pulmonary capillary wedging pressure assessed, total peripheral and total pulmonary resistance, cardiac and stroke indexes estimated, gaseous composition of arterial and mixed venous blood analyzed. The drug had virtually no side effects on the function of vital systems of the body. Midazolam fully meets the requirements to drugs used for induction anesthesia and is compatible to such drugs as barbiturates, diazepam, ketamine. The drug can meet pharmacodynamic and pharmacokinetic requirements to sedative agents used in intensive care units, excepting analgesia. However, the need in analgesics and their doses are reduced during sedative therapy with midazolam. Midazolam effects on the lesser circulation hemodynamics permit its use as a sedative agent in patients with respiratory distress syndrome and pulmonary artery thromboembolism; it is also advisable for induction anesthesia in patients operated on for pulmonary artery thromboembolism and in other patients with lesser circulation hypertension.

The problems of infusion therapy during anesthesia and surgery, relevant for clinical practice, have been reviewed. The changes in circulating blood volume, plasma osmolality and colloid-osmotic pressure have been studied depending on quantitative and qualitative structure of the infusion therapy as well as on the duration of surgical intervention. The dependence observed indicates that infusion therapy during anesthesia and surgery must not be considered a routine procedure. The data obtained will help practicing anesthesiologists to choose the right technique.

Clinico-laboratory studies were conducted in 30 patients who underwent operations for heart diseases and thromboembolism of the pulmonary artery under extracorporeal circulation. Gentamicin and tobramycin were used for antibacterial prophylaxis. Study of the pharmacokinetics of the agents disclosed essential changes of the distribution volume and clearance of the antibiotics in the patients of the studied group, which made the routine regimen of their administration modified. Analysis of the results of administration of the agents according to a modulatory regimen showed its high prophylactic efficacy in the absence of side effects.

The use of glucose-insulin mixture (0.5 g/(kg.h) glucose and 1 U/(kg.h) insulin) during preperfusion period in 26 cardiosurgical patients subject to cardiopulmonary bypass surgery prevented the disturbances in carbohydrate metabolism, reduced hemoglobin glycosylation, and normalized thromboxane-prostacyclin system functions, as compared to the data obtained in control groups.

The effect of Fentanyl upon the main haemodynamic parameters was studied in 10 patients free of any concomitant cardiac or pulmonary pathology. The drug was administered in a dosage of 0.001 mg/kg with a stable ventilational and circulatory level. A decrease of all indices of arterial pressure was observed (as a result of decreasing minute cardiac output and total peripheral resistance), as well as a slowing down of the cardiac rhythm, and reduction of the work of the heart. Fentanyl produces a multidirectional effect on the leading mechanisms of cardiac contractility.