[Total intravenous anaesthesia without medical gases during economic blockade of the country].

Srp Arh Celok Lek

Ward of Anaesthesiology, Reanimation and Intensive Care, Sveti Sava Hospital, Knin.

Published: March 2006

In June and July 1992, when the corridor--through which we received the necessary medical supply--was closed, 61 patients (mostly wounded persons, 62%) underwent an urgent surgery. Because of the lack of oxygen and nitric oxydul, the patients were administered the intravenous total anaesthesia without medical gases. The control group was composed of 30 patients operated on in June and July 1991. The patients received Mydasolam (0.3 mg/kg) for general anaesthesia. Anaesthesia was maintained with Phentanil (15 mg/kg) and Alcurone (0.3 mg/kg). The control group was subjected to standard balanced anaesthesia (Thiopenton + nitric oxydul/oxygen + Halotin + Pancuron). The results of the two groups were compared. The observed, analysed and compared parameters were: the introduction period to anaesthesia, systolic blood pressure, diastolic blood pressure and time elapsed from the end of surgery to extubation. The introduction to anaesthesia was markedly unfavourable (p), the systolic and diastolic blood pressures, measured in five-minute intervals during anaesthesia, were significantly lower (p). The difference was especially great in the period from the end of surgery to the time of extubation: 73 +/- 12 minutes in the studied group, and 7 +/- 5 minutes in the control group. The method of total intravenous anaesthesia without medical gases satisfied our needs and expectations during the shortage of medical supplies. However, the standard balanced anaesthesia is a better method because it provokes a faster introduction to general anaesthesia, haemodynamic effects are less compromized, revival from anaesthesia is faster, the use of anaesthetics and equipment and engagement of the personnel are not great.

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