The article presents the model of organization of oncologic care of population of the region exemplified by the Primorskiy Krai. The major principle of development of the model consists in medical, social and economic efficiency. The main structural unit of the model of oncologic service of the region is to be the oncologic center. These centers are organized with economically justified personnel and material technical staffing, on the basis of one place concentration of significant number of patients. The functioning of the oncologic center comes to three principles: 1) quality of oncologic care is to be provided for by a single standard of organizational and medical technologies: 2) the system of oncologic care is to be accessible for any patient; 3) institutions of oncologic care within the limits of geographic, economic and social zone of the krai (oblast, okrug) are to have efficient mechanisms of interaction permitting to implement transference of patients and coordination of activities of specialists of various profiles. The implementation of modern organizational technologies of oncologic care of population of the region includes elements of strategic planning, development of system of palliative care of patients, application of standardization and management of medical care quality.

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Biomedicine, 8 Sukhanova Str., Vladivostok, 690950, Russian Federation, 3 Vladivostok Clinical Hospital No.2, 57 Russkaya Str., Vladivostok, 690105, Russian Federation In the study using the questionnaire EORTC-

В последние десятилетия сочетанная анестезия при выполнении травматичных хирургических вмеша тельств получила большое распространение, и одним из ее популярных вариантов является сочетание эпи дуральной блокады и общей анестезии [1]. Влияние нейроаксиальной блокады и современных общих анес тетиков на систему кровообращения хорошо известно и часто сопровождается значимым снижением артери ального давления, требующим назначения симпатоми Objective: to make a comparative assessment of hemodynamic parameters when correcting combined anesthesia induced arterial hypotension with dopamine, adrenaline, mesatone, or noradrenaline. Subjects and methods. A prospective study enrolled patients who had undergone prosthetic hip replacement under combined lumbar epidural (ropivacaine)/general (sevoflurane) anesthesia. Intravenous sympathomimetic infusion was initiated when the mean blood pressure decreased below 55 Hg mm. Cardiac index (CI) and systemic vascular resistance index (SVRI) were calculated by impedance car diography. Fifty six subjects (14 in each group) were selected for analysis. Results. During the study, CI remained in the normal range for all sympathomimetics. When adrenaline was administered, there was an obvious tendency to maintain blood pressure due to heart rate (HR) with preserved low SVRI. The use of mesatone caused a considerable reduction in HR. No statistically significant differences were found between the dopamine and noradrenaline groups in any of the study stages. The start of infusion of these agents was attended by SVRI normalization and HR maintenance within 60-70 beats per minute. Conclusion. The infusion of dopamine, adrenaline, mesatone, or noradrenaline to correct arterial hypotension resulting from combined epidural block/general anesthesia with sevoflurane ensures maintenance of CI within the normal range. That of noradrenaline and dopamine was ascertained to have a more balanced impact on HR and systemic vascular resistance.