Shosholcheva, Mirjana

Preferred name

Official Name

Shosholcheva, Mirjana

Translated Name

Andreevska Mirjana

Alternative Name

Shosholceva M

Mirjana D Shosholcheva

Sosolceva M

Mirjana Sosolceva

Sosolceva Mirjana

Mirjana Shosholcheva

M Sosolceva

Main Affiliation

mirjana.shosholcheva@medf.ukim.edu.mk

sosolceva@hotmail.com

macedoniananaesthesilogy@gmail.com

Now showing 1 - 10 of 40

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Rhabdomyolysis in Critically Ill Surgical Patients
(Academy of Medical Sciences of Bosnia and Herzegovina, 2016-07-27)
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Cvetkovska, E.
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Kuzmanovski, I.
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Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication.
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The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair
(Walter de Gruyter GmbH, 2017-12-01)
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Zdravkovska, Milka
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Ultrasound guided rectus sheath block can block the ventral rami of the 7th to 12th thoracolumbar nerves by injection of local anesthetic into the space between the rectus muscle and posterior rectus sheath. The aim of this randomized double-blind study was to evaluate the analgesic effect of the bilateral ultrasound guided rectus sheath block as supplement of general anesthesia on patents undergoing elective umbilical hernia repair.
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THE ANALGESIC EFFECT OF ULTRASOUND-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK FOR LAPAROSCOPIC BILATERAL INGUINAL HERNIA REPAIR
(Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University, Skopje, Macedonia, 2017-04)
Toleska M
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Background: Transversus abdominis plane (TAP) block is a (new) regional anesthetic technique that provides analgesia to the parietal peritoneum, as well as the skin and muscles of the anterior abdominal wall, by introducing local anesthetic into the neuro-fascial plane between the internal oblique and the transversus abdominis muscles. Pain after laparoscopic bilateral inguinal hernia surgery can be moderate to severe and can result in prolonged hospital stay, unanticipated hospital admission and delayed return to normal daily activities. We evaluated the efficacy of TAP block in patients undergoing laparoscopic bilateral inguinal hernia repair in a randomized controlled clinical trial. Material and methods: Sixty patients undergoing laparoscopic bilateral inguinal hernia repair were randomized to undergo standard care (n=30) or to undergo a bilateral TAP block with bupivacaine (n=30). All patients received standard anesthetic, and after induction of anesthesia, the TAP group received an ultrasound-guided bilateral TAP block. Each patient was assessed after operation at 2, 6, 12 and 24 hours after surgery. Results: Bilateral ultrasound-guided TAP block significantly reduced postoperative visual analogue scale (VAS) pain scores at rest and on moving, reduced ketonal and tramadol postoperative consumption and reduced incidence of PONV in the TAP block group after surgery compared to control group. Conclusion: Bilateral ultrasound-guided TAP block provides effective postoperative analgesia during the 24 postoperative hours after laparoscopic bilateral inguinal hernia repair.
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Evaluation of effects of repetitive recruitment maneuvers
(Academy of Medical Sciences of Bosnia and Herzegovina, 2012)
Tatjana Trojik
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Jasmina Radulovska-Chabukovska
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Margita Lovach-Chepujnoska
Introduction: acute respiratory failure is manifested clinically as patient with variable degrees of respiratory distress, but characteristically an abnormal arterial blood partial pressure of oxygen or carbon dioxide. The application of mechanical ventilation in this setting can be life saving. Goals: The aim of this study is to evaluate the effects of two recruitment maneuvers not only on oxygenation, but on aeration of the lung as well. For that purpose chest x ray and thoracic computed tomography scan (CT) of the lung were used as safe and objective methods for evaluation the impact of recruitment maneuvers on aeration of the lung. CT scan and chest x ray were performed before recruitment maneuvers as confirmation of diagnose and one day after the last recruitment maneuvers. Material and methods: Sixty patients who met ar DS criteria of the american european consensus conference were included in this study. This study was conducted in iCU in our hospital between november 2009 and December 2011. Patients were orally intubated, sedated with 0, 2-0, 4 μg/kg /min and midazolam 4 mg/h, and ventilated with evita 2 Dura ventilator (Dragger germany). According to the recom-mendation of the Consensus Conference of the american College of Chest physician all patients had an arterial catheter and cen-tral venous catheter. Hemodynamic data were collected from Data Ohmeda monitors. Gas analyses were mesured from blood samples taken from arteria radialis. Partial pressure of oxygen of mixed blood was messured from blood sample taken from v jugularis interior. We used arterial blood colection syringe Bd preset, and blood samples were analyzed with aVl 995HB blood gas analiser. Results: HEMODYNAMIC CHANGES: there wasn't any differences in heart rate, and mean arterial blood pressure before the recruitment five minutes and sixty minutes after the recruitment in both groups. respiratory mechanics: Highest values of the compliance are achived during the recruitment manouver in both groups. There was better improvment in compliance during the e sigh recruitment maneouver, then in Cpap recruitment maneouver. There was improvement in chest X ray in both groups. 93,4% of patients in the Cpap group and 96,7% in e sigh group. CT scan: in Cpap group there were 8 patients with focal changes and 22 patients with diffusse changes. in e sigh group 29 patients had diffuse changes of the lung and one patient had focal changes. We noticed that there was better improvment in aeration in patients with diffuse changes of the lung 96.7% in e sigh group and 73,3% in Cpapgroup. In patient with focal changes there was improvment in 26,7% in e sigh group and 3,3% in Cpap group. We noticed that there was better improvmnet in aeration in patients with diffuse changes than in patients with focal changes. E sigh maneuver had better impact on aeration of the lung then Cpap recruitment maneuver. Conclusion: In our study we proved that e sigh recruitment maneuvers better improved oxygenation in arterial blood than Cpap recruitment maneuver. Repetative e sigh manouvers proved to be essential for arDS patients. They reopened collapsed alveolli and improved aeration of the lung which was confirmed by X ray and CT scan as an objective methods for verification of lung condition.
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The effects of two thermal insulation methods on the postoperative lactate levels, shivering and patient’s thermal comfort.
(Department of Anesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2019-05)
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Tolevska M
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Do hypertensive patients chronically treated with Renin-Angiotensin system antagonist have risk of hypotension during induction in general anesthesia?
(MIT Univerzitet Skopje, 2021)
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Toleska, M.
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Patient-Controlled Analgesia (PCA) with Remifentanil Versus Intermittent Epidural Boluses for Labor Analgesia
(Македонско лекарско друштво / Walter de Gruyter GmbH, 2017-06-01)
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Ivanov, Emilija
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Introduction.Remifentanil is becoming more and more popular for labor analgesia as an alternative for neuro-axial anesthesia. In this study we compared the severity of pain, patient satisfaction and side effects between two different types of labor analgesia. Methods. Eightyprimiparous patients ASA I or II, atterm pregnancy, were included in the study and divided in two groups. The first group (35 patients) received intravenous remifentanil on patient control pump in bolus doses. The second group (45 patients) received intermittent epidural boluses with highly diluted local anesthetic and opioid (Bupivacain and Fentanil). We analyzed oxygen saturation (SpO<jats:sub>2</jats:sub>), respiration rate, heart rate, blood pressure, sedation, nausea and vomiting as well as patient pain scores and satisfaction scores through 2 different VAS. Results. Mean SpO<jats:sub>2</jats:sub> was significantly lower in the PCA remifentanil group 96.2%±1.6 versus 98.2±1.2 in the epidural group. Respiratory depression (RR<9 or SpO2 <90%) was not found in both groups. Sedation scores were significantly higher in the PCA remifentanil group, P<0.05. Incidence of nausea and vomiting was similar between the two groups, without significant difference. PCA remifentanil was inferior to epidural analgesia with respect to pain scores at all time points, but without significant difference in patient satisfaction between the two groups. Conclusion. Intravenous patient-controlled analgesia with remifentanil provides satisfactory level of labor analgesia, with lower SpO<jats:sub>2</jats:sub> and more sedation. It could be an excellent alternative to epidural analgesia but continuous monitoring and oxygen supply is mandatory.
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Efficacy of Intraperitoneal Bupivacaine on Pain Relief After Laparoscopic Cholecystectomy
(Macedonian Academy of Sciences and Arts /Walter de Gruyter GmbH, 2018-07-01)
Toleska, Marija
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Panovski, Milcho
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Patients undergoing laparoscopic cholecystectomy do experience postoperative pain, especially in the abdomen. Postoperative pain management remains a major challenge after laparoscopic procedures. Administration of intraperitoneal local anesthetic (IPLA) after surgery is used as a method of reducing postoperative pain. In this study, we evaluated the effect of intraperitoneal infiltration of local anesthetic (bupivacaine) for pain relief after laparoscopic cholecystectomy.</jats:p> <jats:p><jats:bold>Material and methods:</jats:bold> In this prospective, controlled, and randomized study were included 50 patients aged 25-60 years (35 female and 15 male), scheduled to laparoscopic cholecystectomy with ASA classification 1 and 2. Patients were classified randomly into two groups: group A, which included 25 patients who received intraperitoneal instillation of bupivacaine 0.5% 20 ml; and group B, which included 25 patients who didn’t receive any intraperitoneal instillation. Postoperative pain was recorded using the visual analogue scale (VAS) for 24 hours after laparoscopic cholecystectomy.</jats:p> <jats:p><jats:bold>Results:</jats:bold> There was no significant difference with respect to age, weight, and sex; duration of surgery; and anesthesia time. VAS scores at different time intervals were statistically significantly lower at all times in group A compared to group B. There were statistically significant differences in VAS scores between group A and group B at all postoperative time points - 1hr,4 hr,8 hr,12hr and 24hr (p < 0.00001).</jats:p> <jats:p><jats:bold>Conclusion:</jats:bold> Intraperitoneal instillation of bupivacaine provides good analgesia in the postoperative period after laparoscopic cholecystectomy.</jats:p>
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Side Effects of Intravenous Patient-Controlled Analgesia with Remifentanil Compared with Intermittent Epidural Bolus for Labour Analgesia - A Randomized Controlled Trial
(Walter de Gruyter GmbH, 2019-12-01)
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Ivanov, Еmilija
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Epidural analgesia is considered a gold standard in obstetric anaesthesia and analgesia. However, in situation when it is contraindicated, unwanted by the patient or simply unavailable, remifentanil can be an excellent alternative. The goal of our study is to analyse the side effects of intravenous patient-controlled analgesia (IV PCA) with remifentanil compared with epidural analgesia during delivery.
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Opioid Free Anesthesia for Laparotomic Hemicolectomy: A Case Report
(Macedonian Academy of Sciences and Arts /Walter de Gruyter GmbH, 2018-12-01)
Toleska, Marija
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Opioid free anesthesia (OFA) is deffined as anaesthesiological technique where opioids are not used in the intraoperative period (systemic, neuroaxial or intracavitary). Anaphylaxis caused by opioids (fentanyl) is very rare, and the reaction is presented with hypotension and urticaria. When we have proven allergy to fentanyl, patients' refusal of placing epidural catheter and refusal of receiving bilateral ultrasound guided transversus abdominis plane block (USG TAPB), we must think of using multimodal nonopioide analgesia. The concept of multimodal balanced analgesia is consisted of giving different analgesic drugs in purpose to change the pathophysiological process which is included in nociception, in way to receive more effective intraoperative analgesia with less adverse effects. This is a case report of a 60-year-old male patient scheduled for laparotomic hemicolectomy, who previously had proven allergy to fentanyl. We have decided to give him an opioid free anaesthesia. Before the induction to anaesthesia, the patient would receive dexamethasone (dexasone) 0.1 mg/kg and paracetamol 1 gr intravenously. The patient was induced into general endotracheal anesthesia according to a standardized protocol, with midazolam 0.04 mg/kg, lidocaine hydrochloride 1 mg/kg, propofol 2 mg/kg and rocuronium bromide 0.6 mg/kg. Anaesthesia was maintained by using sevoflurane MAC 1 in order to maintain mean arterial pressure (MAP) with a value of +/- 20% of the original value. After tracheal intubation, the patient had received ketamine hydrochloride 0.5 mg/kg (or 50 mg ketamine) in bolus intravenously and a continuous intravenous infusion with lidocaine hydrochloride (lidocaine) 2 mg/kg/hr and magnesium sulfate (MgSO4) 1,5 gr/hr. At the end of surgery the continuous intravenous infusion with lidocaine and magnesium sulfate was stopped while the abdominal wall was closed and 2.5 g of metamizole (novalgetol) was given intravenously. VAS score 2 hours after surgery was 6/10 and 1 gr of paracetamol was given and the patient was transferred to the Department. Over the next 3 days, the patient had a VAS score of 4-6/10 and only received paracetamol 3x1g and novalgetol 3x1 gr daily, every four hours.

Shosholcheva, Mirjana

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