Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2004
Comparative Study[Changes in hemodynamics during regional anesthesia and medicinal sedation in children traumatology].
Thirty-nine patients, aged 8 to 15, who were operated for damaged bones in the upper lower limbs were examined. The parameters of central hemodynamics, heart rate and arterial pressure were studied (monitor HP "Viridia m3", USA). Strike volume was determined automatically (rheography monitor NCCOM-3"Boomed Co.", USA). ⋯ The changes of hemodynamics detected in the children of group 1 revealed an insufficient analgetic and antistress efficiency of halothane. The data obtained for group 2 are indicative of insignificant hemodynamic changes observed at all examination stages and related with the impact exerted by drugs, used for sedation and regional anesthesia, on the vascular tonus of the original undetected hypovolemia. A lack of complications, a fast awakening and recovery of an adequate consciousness after combined regional anesthesia as well as comfort and a lack of need in extra analgetics that are normally used in the immediate postoperative period make it possible to refer to the discussed anesthesia variation as to the preferential one in cases of surgeries for damaged bones in children.
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Anesteziol Reanimatol · Jan 2004
[Preventive analgesia and early postoperative period in ambulatory orthopedic surgeries in children].
The purpose of the case study was to compare the adequacy of anesthetic management and the specificity of the early postoperative course with preventive analgesia (group 1) and without it (group 2). Preventive analgesia comprised diclofenac, 50-75 mg/kg in intramuscular injections made 1 h before surgery, and microdoses of ketamine, 1.0 mg/kg in intramuscular injections 0.3 mg/kg in intravenous injections as a component of premedication. ⋯ An earlier awakening was observed in group 1, which we attributed to a more valuable antinociceptive protection and to lower doses of ketamine (group 1--3.2 mg/kg; group 2--4.3 mg/kg). According to the results the preventive analgesia method reduces significantly the postoperative pain and anxiety, which makes the administration of additional analgetics advisable and cuts the child's stay in one-day hospital.