Preview

Messenger of ANESTHESIOLOGY AND RESUSCITATION

Advanced search

Trends in changing the structure of anesthesia at the advanced stages of medical care in modern armed conflict

https://doi.org/10.24884/2078-5658-2024-21-5-83-90

Abstract

The objective was to analyze the structure of anesthesia provided to the wounded at the advanced stages of medical care in the active phase of hostilities.

Materials and methods. A retrospective analysis of the medical data of anesthesia was performed. The data on the structure of anesthesia in military medical organizations of 1–3 levels in the zone of a special military operation for the period from 01.2023 to 07.2024 were analyzed.

Results. In the structure of combat trauma, with the need for surgical intervention, gunshot wounds amounted to 85.2%, there was a predominance of combined (71.5%) and multiple (19.8%) wounds.

The low proportion of combined general anesthesia and the lack of use of inhalation anesthesia at some stages is explained by the special conditions of care. Regional anesthesia (RA), including as part of combined anesthesia, in the structure of anesthesia at the stages of emergency specialized surgical care amounted to 34.5%, and at the stages of qualified surgical care – 25.4%. The lowest rates of RA use were at the stages of level 1, as well as at the stages of level 2 with a 100% flow of primary wounded.

Conclusion. RA occupies a significant share in the structure of anesthesia at the military stages of medical evacuation; an increase in the frequency of its use is possible due to the introduction of ultrasonic navigation.

About the Authors

A. E. Tsygankov
442 Military Clinical Hospital
Russian Federation

Tsygankov Alexander Е. - Head of the Group of Anesthesiology and Intensive Care (mobile) of the Medical Detachment (special purpose)

63a, Suvorovsky Ave., Saint Petersburg, 191124

AuthorID: 1156230



M. E. Semenov
Central Military Clinical Hospital named after A. A. Vishnevsky
Russian Federation

Semenov Mikhail Е. - Cand. of Sci. (Med.), Head of the Department of Anesthesiology and Intensive Care of the Cardiac Surgery Center

1, Novy settlement, Krasnogorsk,143420



V. E. Petrov
1586 Military Clinical Hospital
Russian Federation

Petrov Vitaly E. - Head of the Center for Anesthesiology and Intensive Care

4, Mashtakova str., Podolsk, 142110



E. А. Usoltsev
442 Military Clinical Hospital
Russian Federation

Usoltsev Evgeny A. - Head of the Center for Anesthesiology and Intensive Care

63a, Suvorovsky Ave., Saint Petersburg, 191124



S. V. Sidelkin
1409 Naval Clinical Hospital
Russian Federation

Sidelkin Sergey V. - Head of the Department of Anesthesiology and Intensive Care

1, Botkin str., Baltiysk, 238520



E. N. Ershov
Kirov Military Medical Academy
Russian Federation

Ershov Evgeny N. - Cand. of Sci. (Med.), Teacher of the Department of Anesthesiology and Intensive Care

6, Akademika Lebedeva str., Saint Petersburg, 194044



References

1. Agafonov D. E., Kraynyukov P. E., Yakovlev M. Yu., Valtseva E. A. Expression of inflammatory process and wound healing rate after regional conduction anesthesia in surgical treatment of the lower extremities: a prospective study. Moscow Surgical Journal, 2023, no. 4, pp. 15–21. (In Russ.) DOI: 10.17238/2072-3180-2023-4-15-21.

2. Agafonov D. E., Yakovlev M. Yu., Kraynyukov P. E., Valtseva E. A. Evaluation of the effectiveness of regional conduction anesthesia according to hemodynamic parameters in the surgical treatment of patients with shrapnel wounds of the lower extremities. Military Medical Journal, 2023, vol. 344, pp. 21–27. (In Russ.)

3. Anaesthesiologic and critical care for the wounded during the war / eds by Yu. S. Polushin. St. Peterburg, ELBI-SPb Publ., 2003, 288 p. ISBN 5-93979-075-5. (In Russ.)

4. Bogomolov B. N., Levshankov A. I., Polushin Yu. S., Shchegolev A. V. Anesthesiological and resuscitatory care in local armed conflicts. Bulletin of the Russian Military Medical Academy, 2011, no. 4 (36), pp. 163–167. (In Russ.)

5. Military field surgery. National Manual (2nd edition, revised and supplemented). Moscow, 2024. (In Russ.).

6. Esipov A. V., Sukhorukov A. L., Musailov V. A. et al. The magnitude and structure of isolated limb injuries in modern local conflicts (literature review). Military Medical Journal, 2023, no. 3, pp. 33–39. (In Russ.). DOI: 10.52424/00269050_2023_344_3_33.

7. Kasimov R. R., Prosvetov V. A., Samokhvalov I. M. et al. Structure of combat surgical trauma and features of surgical care in advanced groups in the active phase of hostilities. Military Medical Journal, 2024, no. 7, pp. 4–12. (In Russ.)

8. Kunitskiy Yu. L., Grintsov A. G., Kharkovskiy V. A. et al. Features of battle trauma during the local armed conflict in Donbass. Vestnik neotlozhnoj i vosstanovitel’noj khirurgii, 2019, no. 3, pp. 47–50. (In Russ.)

9. Lakhin R. E., Kusai A. S., Usoltsev E. A. et al. Regional anesthesia for shock. Russian Journal of Anaesthesiology and Reanimatology, 2024, no. 1, pp. 6–13. (In Russ.) DOI: 10.17116/anaesthesiology20240116.

10. Molchanov I. V., Gridchik I. E. Analysis of the work of the anesthesiology – intensive care service for 2021. Pedagogy of professional medical education, 2022, no. 2. URL: https://www.profmedobr.ru/articles/analiz-raboty-sluzhby-anesteziologii-reanimatologii-za-2021-g/ (accessed: 20.08.24). (In Russ.)

11. Tsygankov A. E., Starostin D. O., Polyakov P. A. et al. Predictors of death in seriously injured patients. Emergency medical care, 2023, no. 4, pp. 47–54. (In Russ.) DOI: 10.24884/2072-6716-2023-24-4-47-54.

12. Shapkin Yu. G., Seliverstov P. A., Stekolnikov N. Yu., Ashevsky V. V. Prehospital care according to the principles of Damage Control Resuscitation in conditions of modern warfare (literature review). Medico-biological and socio-psychological problems of safety in emergency situations, 2022, no. 4, pp. 55–65. (In Russ.) DOI: 10.25016/2541-7487-2022-0-4-55-65.

13. Shchegolev A. V., Bogomolov B. N., Levshankov A. I. The experience of providing anesthesiological and resuscitation care to military personnel in the local war in Afghanistan. Biomedical and socio-psychological problems of security in emergency situations, 2015, no. 1, pp. 15–21. (In Russ.) DOI: 10.25016/2541-7487-2015-0-1-15-21.

14. Shchegolev A. V., Kuzin A. A., Lakhin R. E. et al. Changing approaches to anesthesiological care in the context of a special military operation. Military Medical Journal, 2023, no. 9, pp. 19–24. (In Russ.)

15. April M. D., Stednick P. J., Christian N. B. A descriptive analysis of notional casualties sustained at the joint readiness training center: implications for health service support during large-scale combat operations. Med. J. (Ft Sam Houst Tex), 2021, PB 8–21.

16. Chandler H., MacLeod K., Penn-Barwell J. G. Extremity injuries sustained by the UK military in the Iraq and Afghanistan conflicts: 2003–2014. Injury, 2017, no. 7, pp. 1439–1443. DOI: 10.1016/j.injury.2017.05.022.

17. Falovic R., Graves M., Hendel S. Anaesthesia safety in war zone. Update in Anaesthesia, 2024, vol. 38, pp. 21–25. URL: https://resources.wfsahq.org/update-in-anaesthesia (accessed: 20.08.24).

18. Fisher A. D., Washburn G., Powell D. et al. Damage control resuscitation (DCR) in prolonged field care (PFC). Joint Trauma System. Clinical Practice Guideline, 2018, 25 p. URL: https://deployedmedicine.com/market/29/content/1002 (accessed: 20.08.24).

19. Graves M. Total Intravenous Anesthesia in Disaster Medicine. Essentials of Disaster Anesthesia, 2020, pp. 32–41. DOI: 10.1017/97813161814454.005.

20. Mazuchowski E. L., Kotwal R. S., Janak J. C. et al. Mortality review of US Special Operations Command battle-injured fatalities. J. Trauma Acute Care Surg, 2020, no. 5, pp. 686–695. DOI: 10.1097/TA.0000000000002610.

21. Perkins Z. B., Kersey A. J., White J. M. et al. Impact of Ischemia Duration on Lower Limb Salvage in Combat Casualties. Ann. Surg, 2022, no. 3, pp. 532–538. DOI: 10.1097/SLA.0000000000005560.

22. Webster S., Barnard E. B. G., Smith J. E. et al. Killed in action (KIA): an analysis of military personnel who died of their injuries before reaching a definitive medical treatment facility in Afghanistan (2004–2014). BMJ Mil. Health, 2021, no. 2, pp. 84–88. DOI: 10.1136/bmjmilitary-2020-001490.


Review

For citations:


Tsygankov A.E., Semenov M.E., Petrov V.E., Usoltsev E.А., Sidelkin S.V., Ershov E.N. Trends in changing the structure of anesthesia at the advanced stages of medical care in modern armed conflict. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2024;21(5):83-90. (In Russ.) https://doi.org/10.24884/2078-5658-2024-21-5-83-90



Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2078-5658 (Print)
ISSN 2541-8653 (Online)