The article provides the main statements of the guidelines for the anesthesia and intensive care of patients with the coronavirus disease (COVID-19), developed by the Federation of Anesthesiologists and Reanimatologists of Russia. In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was February 01, 2021. To develop the recommendations for the Guidelines, were used documents directly describing the features of the management of patients with NCI COVID-19 (guidelines - 34; randomized clinical trials and Cochrane Reviews - 13; observational and comparative studies - 107; other documents, notes and comments - 64), and documents describing anesthesia and intensive care in the general population of patients. Compared to the previous 4th version of the guidelines, the recommendations in 8 sections have been corrected; new subsections “Chronic kidney disease”, “Rehabilitation treatment of patients with COVID-19 in the intensive care unit”, “Routing of patients with COVID-19 to the stages of rehabilitation” were created; revised 1 Appendix, additionally developed 7 Appendices; the section “Quality criteria” has been supplemented. The provisions of the current version of the guidelines highlight the specifics of anesthesia, intensive care, rehabilitation, resuscitation measures, manipulation, transportation, prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis, drug interactions are described. The features of management of pregnant women, children of different age groups, patients with concomitant diseases, the principles of the formation of stocks of drugs and consumables are considered.

The article provides the main statements of the guidelines for the anesthesia and intensive care of patients with the coronavirus disease (COVID-19), developed by the Federation of Anesthesiologists and Reanimatologists of Russia. In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was June 29, 2020. To develop the Guidelines for the recommendations, were used documents that directly describing the features of the management of patients with coronavirus disease COVID-19 (guidelines and guidelines - 16; randomized clinical trials and Cochrane Reviews - 8; observational and comparative studies - 77; other documents, notes and comments - 54) and describing anesthetic and resuscitation support in the general population of patients. The provisions of the recommendations highlight the specifics of anesthesia, intensive care, resuscitation, manipulation, and prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis are described. The features of the management of pregnant women, children of different age, patients with concomitant diseases, issues of transportation of patients are considered.

“Difficult airways” situations continue to be one of the main causes of anesthetic mortality and morbidity. Current requirements of patient safety during anesthesia determine the need for the necessary equipment and compliance with existing clinical guidelines. The situation with the equipment of hospitals in the Russian Federation with different airway devices and medical equipment, as well as the approaches used by anesthesiologists are regularly reviewed by the FAR Committee of Difficult Airways by distributing a questionnaire. During the last 10 years there has been a positive trend in the level of hospital equipment with supraglottic airways, there has been an increase in the awareness of specialists about the existing clinical guidelines. An updated version of the survey was developed to examine the current situation in the Russian Federation, to analyze the effectiveness of the approaches used to solve the problem of “difficult airways” and to evaluate the role of the existing recommendations of the FAR. The role of the human factor is decisive in the development of a significant part of critical situations during anesthesia. A modern training program for clinical residents in anesthesiology should include training in upper airways assessment, performing basic maneuvers of airways management, working out techniques for using various devices, as well as using existing algorithms of actions during “difficult airways” situations. The ability to apply theoretical knowledge and act requires training in a high-fidelity simulation and subsequent analysis of residents performance. The newly developed survey is devoted to the analysis of the situation with airways management training in the clinical residency. Based on the results of the survey, it is planned to develop a draft national airways management training program for anesthesia residents.

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Цель исследования: сравнить параметры гемодинамики, концентрацию севофлурана на выдохе, расход фентанила за время операции, интенсивность болевого синдрома при проведении общей комбинированной анестезии с использованием дексмедетомидина и без него� Материалы и методы: выполнено проспективное слепое рандомизированное исследование у пациенток онкогинекологического профиля с участием двух групп с применением дексмедетомидина и без него� Результаты. В исследуемых группах выявлены изменения гемодинамики, концентрации севофлурана на выдохе, расхода фентанила� Разницы в интенсивности болевого синдрома в исследуемых группах не обнаружено� Выводы. Концентрация севофлурана на выдохе, а также расход фентанила меньше в группе с использованием дексмедетомидина� Интенсивность болевого синдрома не отличалась в двух исследуемых группах� Ключевые слова: общая комбинированная анестезия, дексмедетомидин, агонисты α 2-адренорецепторов, анестезия у онкологических пациентов