Panovska petrusheva, Aleksandra
Preferred name
Panovska petrusheva, Aleksandra
Official Name
Panovska petrusheva, Aleksandra
Translated Name
Пановска Петрушева Александра
Alternative Name
Пановска Петрушева Александра
Пановска Александра
Петрушева Александра
Александра Пановска Петрушева
Александра Пановска
Александра Петрушева
А. Петрушева
A. Пановска
Aleksandra Panovska - Petrusheva
Aleksandra Panovska Petrusheva
Aleksandra P. Petrusheva
Aleksandra Panovska Petrusheva
Panovska Petrusheva Aleksandra
Aleksandra Petrusheva
Aleksandra Panovska
A. Petrusheva
A. Panovska
Petrusheva A
Panovska A
A. Panovska Petrusheva
Main Affiliation
Email
panovska.petrusheva@gmail.com
30 results
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Item type:Publication, Preoperative magnesium sulphate usage as a medical challenge in postoperative pain management.(Department of Anesthesia and reanimation, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Macedonia, 2018-12); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, 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); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, MANAGING DUAL PATHOLOGIES: NEPHRECTOMY FOR RENAL CELL CARCINOMA IN A PATIENT WITH SEVERE TRICUSPID VALVE REGURGITATION(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025); ; ; Chavkoska, MarinaRenal cell carcinoma (RCC) is the most prevalent form of kidney cancer.Tricuspid regurgitation is a condition marked by the reverse flow of blood from the right ventricle into the right atrium and necessitates thorough assessment to ascertain its severity and effect on heart function. In this case, we present a 57-years-old male patient with symptomatic renal cell carcinoma and a severe tricuspid valve regurgitation. The performed open nephrectomy went uneventfully. While the patient was successfully and safely managed from an anesthesiology standpoint despite his comorbidities, performing the procedure in a resource-limited setting posed significant challenges. In such environments, the lack of immediate access to advanced hemodynamic monitoring, cardiothoracic surgical support and perioperative cardiac interventions increases the complexity of managing patients with dual pathologies. Ideally, conducting nephrectomy in an operating theater equipped for simultaneous surgical interventions, addressing both the renal pathology and potential worsening of tricuspid valve regurgitation, with a cardiothoracic team on standby, would have provided a safer approach. However, in settings with constrained resources, optimizing intraoperative management, ensuring rigorous hemodynamic monitoring, and coordinating multidisciplinary teams within the available infrastructure become critical for achieving favorable outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ULTRASOUND GUIDED SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERY IN CARDIOVASCULAR COMPROMISED PATIENT(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2025); ; Introduction: We can use the supraclavicular block as a postoperative pain management approach, as an addition to general anesthesia, or as the sole form of anesthesia for upper limb surgery. For upper limb surgery, this block is a fantastic substitute for general anesthesia in patients with pulmonary and cardiac comorbidities. Case Presentation: In order to undergo surgery for a fracture of the proximal portion of his upper arm, a 66-years-old male AA was brought to the Clinic for Orthopedic Diseases in Skopje. The anesthesiologic examination revealed that the patient had diabetes mellitus type II, cardiomyopathy, untreated ischemic heart disease and wheezing and crepitations in the distal portions of his lungs. We planned the open fixation of the fracture for the patient. A supraclavicular brachial plexus block was performed as the most non-invasive procedure for perioperative treatment, taking into consideration the patient’s health. The patient’s vital indicators were normal and stable during the procedure. After receiving therapy for two days, the postoperative course was uneventful, leading to the patient’s discharge. Conclusion: If not addressed earlier, preoperative pulmonary and cardiac comorbidity increases the risk of perioperative and postoperative problems. With no postoperative problems, peripheral nerve block – in our case, supraclavicular brachial plexus block – proved to be a safe option for anesthesia management used for upper limb surgery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Effect of Adding Dexamethasone as a Ropivacaine Adjuvant in Ultrasound-Guided Transversus Abdominis Plane Block for Inguinal Hernia Repair(Macedonian Academy of Sciences and Arts / Walter de Gruyter GmbH, 2015); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, IS THERE AN IDEAL IRRIGATION FLUID FOR PERCUTANEOUS NEPHROLITHOTOMY?(Department of Anesthesia and reanimation, Faculty of Medicine, Ss.Cyril and Methodius University, Skopje, Macedonia, 2019-05); ; ; ; Zafirova D - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The impact of intraoperative targeting of the central venous pressure on the onset of diuresis in living donor kidney transplantation(Macedonian Association of Anatomists and Morphologists, 2016); ; ; Introduction: Early graft function is very important and can be achieved with an adequate intraoperative perfusion characteristics of the graft and urine output. The goal of this study was to examine the influence of targeting CVP on the onset of diuresis in kidney transplantation. Material and methods: The patients were divided in 2 groups of thirty patients: group A receiving normal saline intraoperatively, targeting for CVP 15 mmHg until vascular clamps were off and group B receiving normal saline 10ml/kg/h. The hemodynamic changes were recorded as systolic, diastolic and mean arterial pressure in 4 times: T0 before the induction, T1 after induction, T2 before the clamping the vessels and T3 after unclamping. We also recorded the duration of surgery, the duration of cold and warm ischemia, and the amount of normal saline until the unclamping of the vessels, lactates at the end of the surgery and total urine output from unclamping the renal vessels to the end of the surgery in both groups. We were monitoring the administration of plasma expander, dopamine and furosemide (if higher than 40mg) and we were inspecting if any tissue edema occurred. Results: There were no statistically significant differences in intraoperative hemodynamic parameters between both groups. The onset of diuresis in seconds was insignificantly longer in group B p>0.05 (p=0.31). The average value of postoperative levels of the lactate showed that in group B the level of the lactate were significantly higher for Z=-5.79 and p<0.001 (p=0.000). Conclusion: CVP as a guide for volume substitution is still highly recommended in kidney transplantation. The fact that in group B (the constant infusion group) we had 5 (16.7%) patients in whom we didn’t achieved urine output at the end of the surgery and the level of lactate was higher in group B gives us the right to conclude that targeting higher CVP, promotes diuresis and better urine output at the end of the surgery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The impact of continuous epidural analgesia and continuous femoral nerve block on postoperative cardiac complications in elderly patients with hip fracture(Journal of the Macedonian Medical Association, 2015); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, REGIONAL ANESTHETIC MANAGEMENT OF A PATIENT WITH CHARCOT MARIE TOOTH DISEASE WITH HIP FRACTURE(Department of Anaesthesia and Reanimation, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, R.N. Macedonia, 2024); ; Todorova, TeodoraIntroduction: Charcot-Marie-Tooth disease (CMT) is a hereditary peripheral neuropathy characterized by progressive peripheral muscular atrophy and muscle-sensitive disorders, especially in extremities. The choice of anesthesia in these patients is a great challenge, as the neurological symptoms may worsen. Case presentation: Female S.G., 53 years old, with a previously diagnosed Charcot Marie Tooth disease, was admitted to the Clinic for Orthopedic Diseases in Skopje for the treatment of a basicervical fracture of the femur. Apart from the existing neurological disease, the patient had no other comorbidities. An indication for surgery was set, and regional, i.e. spinal anesthesia was the choice for the surgical management of the patient. In the postoperative period, the patient was treated with analgesic therapy. After 9 days of treatment at the Clinic for Orthopedic Diseases, the patient was discharged in good general condition, without worsening of the neurological symptoms. Conclusion: Regional anesthesia has been shown to be a safe type of anesthesia in surgical treatment of the lower limb. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, TACHYCARDIA - BRADYCARDIA SYNDROME IN A PATIENT UNDERGOING PERTROCHANTERIC FRACTURE REPAIR UNDER SPINAL ANESTHESIA(Department of Anesthesia and reanimation, Faculty of Medicine, "Ss.Cyril and Methodius", University Skopje Macedonia, 2018-12); ; ; ; Trposka ABackground: Sick sinus syndrome (SSS) is an abnormality of a cardiac impulse formation as a result of sinus node dysfunction that could be presented as a diverse heart rate and rhythm abnormalities. SSS is the most common in the elderly people. In most of the cases the etiology of the SSS remains unknown, but the majority of the patients are experiencing some stage of coronary artery disease (1). Case Report: We present an 89 years old female patient undergoing pertrochanteric fracture repair under spinal anesthesia. Her preoperative evaluation did not reveal any pathologic findings. All vital signs were stable prior to the surgery. The patient has received 2.4 ml of Bupivacaine 0.5% and 10 mcg of Fentanyl. Dural puncture was done in an aseptic technique at the L3-L4 level and clear liquor was seen prior to the anesthetic application. The first hour of the surgery went uneventful, after what abrupt onset of tachycardia of 109bpm was seen followed by bradycardia of 48bpm. The episodes of tachycardia followed with bradycardia were repeating till the patient entered a bigeminy rhythm with the lowest hearth rate of 45, after what 0.5 mg of atropine was given and restoration of normal sinus rhythm was seen. The patient was monitored postoperatively in PACU and followed up at the Traumatology ward while there were not seen any vital signs deterioration. Discussion: We’ve researched PubMed from 1994-2017 and we’ve found 8 case reports in patients undergoing general anesthesia, one undergoing general and epidural anesthesia and one under spinal anesthesia. Eight of 10 patients were previously healthy without known cardiac disease and one with peripheral artery disease. Different types of conduction and heart rate abnormalities, including asystole, were seen in all of the cases after induction of the patients under anesthesia. In our case during the surgery the patient developed multiple episodes of tachycardia followed with bradycardia without subjective discomfort. The resolution of the tachycardia-bradycardia syndrome after giving the 0.5 mg of atropine shows a possible relationship between the local anesthetic application and the onset of the SSS manifestation. References: 1. Brignole M1.; Sick sinus syndrome; Clin Geriatr Med. 2002 May;18(2):211-27. Learning points: SSS can be precipitated perioperatively because of increased vagal tone caused by anesthesia or surgical intervention. As general anesthetics, local anesthetics could also trigger intraoperative manifestation of SSS.
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