43 — 9 (47) 2022 — Ismailova M.U., Yusupov A.S., ANESTHETIC  PROTECTION OF CHILDREN DURING  SURGICAL CORRECTION OF PENETRAL CHEST DEFORMATION

ANESTHETIC  PROTECTION OF CHILDREN DURING  SURGICAL CORRECTION OF PENETRAL CHEST DEFORMATION

Ismailova M.U., Tashkent Pediatric Medical Institute

Yusupov A.S., Tashkent Pediatric Medical Institute

Resume

The purpose of the study. Optimization of anesthesia by using the low-opioid anesthesia technique for thoracoplasty in children.

Materials and methods. Analyzed the course of anesthesia in 48 patients aged 3 to 14 years, operations for pectus excavatum in children. The distribution of patients into groups was carried out depending on the technique of anesthesia. Group 1 (main) consisted of 25 children who underwent general anesthesia using low doses of fentanyl, sevoflurane and propofol. group 2 (control) – 23 children who underwent general anesthesia with fentanyl and propofol. Echocardiography was used to determine hemodynamic parameters. The dynamics of changes in the level of cortisol in the blood and the concentration of catecholamines (adrenaline, norepinephrine, dopamine) in the blood was studied.

Results. In children of the first group, during the introductory period of anesthesia, there was a decrease in CI, an increase in heart rate and UPS. Stroke index (SI), mean arterial pressure (MAP), cardiac index (CI) changed insignificantly compared to the previous stage of the study. In the children of the second group in the most traumatic stages of the operation, there was an increase in SI, HR, and AI. In the most traumatic stages of the operation and after the operation in children of the first group, there was a tendency to increase cortisol, in the second group of patients, an increase in cortisol was noted.

Key words: Opioids, general anesthesia, fentanyl, sevoflurane, propofol, thoracoplastic.

First page

269

Last page

275

For citation: Ismailova M.U., Yusupov A.S., ANESTHETIC  PROTECTION OF CHILDREN DURING  SURGICAL CORRECTION OF PENETRAL CHEST DEFORMATION //New Day in Medicine 9 (47)2022 269-275 https://l.clck.bar/c4593

LIST OF REFERENCES:

1. Диордиев А.В., Яковлева Е.С., Адкина Е.А., Батышева Т.Т., Климов Ю.А., Лазарев В.В. // Анестезиология и реаниматология 2021 №3.С.60-68). http://doi.org/10.17116/anaesthesiology202103160
2. Евреинов В.В., Жирова Т.А., Лечение боли у детей с детским церебральным параличом при реконструктивных или паллиативных операциях на тазобедренном суставе. // Анестезиология и реаниматология, 2019, 5: с. 88-95. DOI: https://doi.org/10.17116/anaesthesiology201905175
3. Лекманов А. У. Достижения и проблемы педиатрической анестезиологии и интенсивной терапии // Вестник анестезиологии и реаниматологии 2019. – Т. 16, № 2. – С. 34-43. DOI: 10.21292/2078-5658-2019-16-2-34-43
4. Мишина Т.П., Исалабдуллаева П.А., Магомедов А.Д., Махачев С.М. Особенности послеоперационного периода у детей с воронкообразной деформацией грудной клетки после торакопластики // Анестезиология и реаниматология 2010 №1 С 50-54
5. Овечкин А.М., Сокологорский С.В., Политов М.Е. Безопиоидная анестезия и анальгезия- дань моде или веление времени? // Новости хирургии Том 27.(6) 2019. С.700-715 //doi:10.18484/2305-0047.2019.6.700).
6. Рузикулов У.Ш. Хирургическое лечение врожденной воронкообразной деформации грудной клетки по методике D. Nuss. Научная дискуссия: вопросы медицины. 2017;(1):62-68.
7. Тарасова Н.Ю., Шмигельский А.В, Лубнин А.Ю., Куликов А.С. //Анестезиология и реаниматология 2020№3-С.27-36). DOI: https://doi.org/10.17116/anaesthesiology202003127
8. Angsi M.S., Clark J.D. Opioid-induced hyperalgesia: a qualitative systematic review. Anesthesiology.2006; 104(3):570-587.
9. Ancora G., Lago P., Garetti E. et al. Evidence-based clinical guidelines on analgesia and sedation in newborn infants undergoing assisted.ventilation and endotracheal intubation // ActaPaediatr. ‒ 2018. ‒ Oct 5. Doi:10.1111/apa.14606.
10. Batistaki C., Kaminiotis E., Papadimos T., Kostopanagiotou G. A Narrative Review of the Evidence on Kostopanagiotou G.A Narrative Review of the Evidence onthe Efficacy of Dexamethasone on Postoperative Analgesic Consumption // Clin J Pain.2017 Nov;33(11):1037-46. doi: 10.1097/AJP.0000000000000486)