To analyze the advantages of ultrasound-guided catheterization of the internal jugular vein in patients with scoliotic deformity. Material and Methods. Patients with scoliotic deformity (n = 366), aged 16 months to 18 years were divided into two groups. The study group included patients (n = 128) in whom ultrasound guided approach to the internal jugular vein was used. Out of them 79 patients underwent classical catheterization over the guidewire with aspiration sample, and 49-intravasal insertion of J-guidewire without aspiration sample. The control group included patients (n = 238) who underwent catheterization without ultrasound control with aspiration sample over the guidewire. Results. Ultrasound-guided puncture and catheterization of the internal jugular vein decreases complication rate and shortens the time of preoperative preparation. Conclusion. The study showed that puncture in Trendelenburg's position improves verification of the internal jugular vein. Ultrasound control allows performing catheterization over guidewire without aspiration sample with low rate of complications.
Intraoperative combination of monolateral spinal anesthesia and prolonged brachial plexus block is evaluated in 65 children with autotransplantation of fingers from foot to hand. Variability of heart rhythm demonstrated autonomous stability in the main group. Dynamical study of skin temperature and dopplerographic evaluation demonstrated local sympatholysis in the blocked extremity. Significant improvement of circulation and quality of analgesia is revealed in case of prolonged perineural use of local anesthetics in the postoperative period. Described combination of intra- and postoperative treatment of such patients makes complex treatment more effective.
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