Ognjanova Simjanovska, Violeta
Preferred name
Ognjanova Simjanovska, Violeta
Official Name
Ognjanova Simjanovska, Violeta
Main Affiliation
7 results
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Item type:Publication, Continuous Peripheral Block as a Pain Treatment for Redressment and Physical Therapy in a 7-Year-Old Child - A Case Report(Macedonian Academy of Sciences and Arts / Sciendo, 2022-04-22); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, USE OF DESFLURANE: CONSIDERATIONS AND CONTROVERSIES(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024); ; Desflurane stands as a pivotal volatile anesthetic in contemporary anesthesia practice and has been a cornerstone of modern anesthesia practice due to its rapid onset and offset of action. Despite its clinical advantages, the environmental footprint of desflurane, characterized by significant greenhouse gas emissions, has sparked a debate on its continued use and potential regulatory measures. This article evaluates desflurane’s clinical benefits, alongside its environmental implications, offering insights into possible regulation perspectives. Highlighting its favorable pharmacokinetic properties, rapid induction, hemodynamic stability and bronchodilator effects, against its contribution to climate change, the study aims to foster a balanced discourse on desflurane’s role in healthcare, advocating for a harmonization of clinical needs with ecological stewardship. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ADVANTAGES OF TARGET CONTROL INFUSION - TOTAL INTRAVENOUS ANESTHESIA VS SEVOFLURANE INHALATION ANESTHESIA IN CONTROLLING SURGERY - RELATED STRESS RESPONSE(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024); ; ; Trposka, AngelaIntroduction: The stress response to surgery, a sequence of pathological and physiological alterations brought on by the stimulation of surgery, can be divided into two main categories: the inflammatory-immune response and the neuroendocrine-metabolic response. It depends on the anesthesia technique and surgical approach. Material and Methods: The patients were divided into two groups: Sevoflurane inhalational anesthesia (SIA) and Target control infusion-Total intravenous anesthesia (TCI-TIVA). The TCI-TIVA group has used the Marsh model for the propofol and the Minto model for the remifentanil, using target plasma concentration. The SIA group has induction in general anesthesia with Propofol plus Fentanyl, and the maintenance of anesthesia has been achieved with Sevoflurane on MAC 0.7-1.0. We compared the effect of different anesthetic techniques on the surgical stress response through measuring the blood levels of proinflammatory cytokines Interleukin-6, Cortisol and blood glucose, as well as the hemodynamic response. Results: Interleukin-6 (IL-6) levels rise sharply from T0 (4.78εg/mL) to T2 (10.06εg/mL) and then again at T3 (36.34εg/mL), showing a strong inflammatory response after surgery in the SIA group. IL-6 levels in the TCI-TIVA Group exhibit a comparable pattern, however with a significantly smaller increase at T3 (14.56). When comparing the cortisol levels at T0, both groups show a comparable range of variability. There is a highly significant difference in cortisol levels between TIVA and SIA after extubating and 24 hours postoperatively, as indicated by the T2 p-value of less than 0.001. Glucose levels in the SIA group are comparatively constant from T0 (5.29) to T1 (5.25), then they significantly rise at T2 (6.56) and stay high at T3 (5.71). Glucose levels in the TCI-TIVA Group exhibit less variability, increasing slightly from T0 (5.17) to T2 (5.21) and then staying constant at T3 (5.28). Hemodynamic stability was better with TCI-TIVA than with SIA. Conclusion: Our findings indicate that TCI-TIVA consistently demonstrates advantages regarding controlling the stress response, inflammation, and metabolic response both during and after surgery as compared to the SIA group. These results provide credence to the prospective advantages of TCI-TIVA over SIA in surgical settings where patient’s outcomes depend critically on reducing stress, inflammation, and metabolic disturbances - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COMPARISON OF THE EFFECTS OF DESFLURANE AND SEVOFLURANE IN AWAKENING AND COGNITIVE FUNCTION AFTER A GENERAL ANESTHESIA(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, AIRWAY MANAGEMENT IN 7-WEEKS-OLD INFANT WITH PIERRE ROBIN SYNDROME AND CONGENITAL PYLORIC STENOSIS(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024-05); ; Angjusev, DarkoPierre Robin Syndrome (PRS) is characterized by a sequence of events including mandibular hypotrophy (micrognathia), abnormal posterior placement of tongue (glossoptosis), and airway obstruction. Pyloric Stenosis on the other hand is the most common infant surgical condition which presents with episodes of projectile vomiting leading to dehydration and weight loss. Airway management in these patients is a true challenge for every anesthesiologist. The patient was 7 weeks old infant, weighted 3,1 kg, admitted in Intensive Care Department for surgical repair of pyloric stenosis, previously diagnosed with Pierre Robin Syndrome at birth. Preoperative preparation, intravenous rehydration and electrolyte substitution was obtained. Video laryngoscope was used for management of difficult airway. We had many attempts in visualization of the vocal cords, eventually we performed awake intubation with stylet uncuffed endotracheal tube size 3. Pyloromyotomy was performed. Maintenance of anesthesia was with Sevoflurane and bolus doses of Fentanyl as adjunct. Perioperative vital signs were within normal ranges. Awake extubation was performed. The facial malformation that appears in patients with Pierre Robin Syndrome makes visualization of the glottis extremely difficult to impossible. In cases where tracheal intubation is needed, awake fiberoptic intubation is recommended, but it can have many limitations. These two conjoined conditions present the quandary of safely managing an expected difficult airway in an uncooperative patient. With this case we can conclude that for children with Pierre Robin syndrome, video laryngoscopy should be considered as a first attempt intubation device both in the operating room and for emergent situations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Anesthetic Challenges for Major Hepatectomy(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2022-03); ; Rushiti, KjemalHepatic resection is the treatment of choice for many liver diseases. However, it is a large and complex operation with a high risk of side effects in the patients, and it is a challenge for both surgeons and anesthesiologists. This paper presents a case of successfully performed right hepatectomy in a 45-years-old woman with the finding of a giant liver hemangioma, larger than 10cm, placed near the inferior vena cava and the challenges faced by the anesthesiologists when guiding such a patient during the entire perioperative period. The main concern was the risk of massive blood loss, which might significantly increase the rate of morbidity and mortality. During liver resection, central venous pressure (CVP) was optimally maintained below 5cmH2O to reduce blood loss. The cell salvage technique was used to minimize heterologous blood transfusion. Epidural anesthesia can be safely applied in patients undergoing major hepatic resection, provided that they have corrected perioperative hemostasis. The surgical approach after Belghiti “liver hanging maneuver” performed by the surgeons in our case may involve transient compression of the inferior vena cava that cause profound hypotension. Therefore, a successful outcome requires close collaboration between the anesthesiology and surgical team by sharing decisions throughout the operation and following and implementing the latest evidence-based recommendations. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Occurrance of perioperative hypoxemia during one lung ventilation(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2022-03); ;