scholarly journals Analysis of vital indicators for different types of anesthesia in newborns and infants with surgical pathology

2020 ◽  
Vol 24 (4) ◽  
pp. 595-599
Author(s):  
O. O. Vlasov
Keyword(s):  
Regional Anesthesia ◽  
Surgical Pathology ◽  
Organ Function ◽  
Intravenous Anesthesia ◽  
Surgical Interventions ◽  
Group Iii ◽  
Vital Functions ◽  
Group I ◽  
Different Types ◽  
Combined Anesthesia

Annotation. In newborns and infants, surgical interventions against the background of severe concomitant and background perinatal pathologies and malformations lead to catabolic stress, circulatory and respiratory disorders, which are reflected in the indicators of vital functions. Given the high risk of severe complications of organ function in the perioperative and postoperative periods, it is advisable to continuously monitor key clinical parameters. Aim of the study – to establish the absolute values of indicators of vital functions in newborns and infants with congenital surgical pathology with various types of combined anesthesia and compare them with clinical data. A retrospective study included 150 newborns and infants with congenital malformations of the surgical profile, depending on the anesthesia (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous). The parameters of peripheral oximetry, blood pressure, heart rate and respiration were analyzed. It was found that peripheral saturation did not critically decrease at all stages of observation. With the exception of the resulting decrease in the indicator in children of group I compared with group III at the stage of induction into anesthesia (97.79±2.45 versus 98.79±1.63, at p=0.0194, respectively) and at the most painful moment of surgical intervention (96.29±3.47 versus 98.10±2.47, with p=0.0368). In children who received combined intravenous anesthesia with two drugs, there was an increase in mean arterial pressure from the beginning of surgical treatment to the child's recovery after surgery (49.49±10.71, 56.18±8.05, respectively, at p˂0.01). Thus, among the surveyed groups, the most vulnerable were children for whom anesthesia was provided by Sevoflurane inhalation with regional anesthesia. The performed correlation analysis established the effect of anesthesia on the general hemodynamics in children during all stages of observation.

scholarly journals Clinical analysis of vital indicators in newborns and infants with surgical pathology with different types of anesthesiological support

2020 ◽  
pp. 18-25
Author(s):  
A.A. Vlasov ◽  
Keyword(s):  
Regional Anesthesia ◽  
Congenital Malformations ◽  
Clinical Analysis ◽  
Surgical Pathology ◽  
Cerebral Oximetry ◽  
Intravenous Anesthesia ◽  
Group Iii ◽  
Vital Functions ◽  
Anesthesia Group ◽  
Combined Anesthesia

Congenital defects are more common in newborns and children of the first year of life and require surgical correction in the first hours, days of life. Surgical interventions against the background of serious diseases and malformations can lead to catabolic stress, circulatory and respiratory disorders, metabolism, water-electrolyte, protein and acid-base states, which are reflected in the indicators of vital functions. Purpose — to conduct a clinical analysis of indicators of vital functions in newborns and infants with congenital surgical pathology with various types of combined anesthesia. Materials and methods. A retrospective study included 150 newborns and infants with congenital malformations of the surgical profile, depending on the anesthesia (inhalation + regional anesthesia — group І (50 newborns); inhalation + intravenous anesthesia — group ІІ (50 newborns); total intravenous — group III (50 newborns)). The parameters of peripheral and cerebral oximetry, blood pressure, heart rate and respiration were analyzed. Results. The minimum indicator of cerebral oximetry was noted in the left brain hemisphere of children of the ІІ group — 50.57±16.66, which may be an unfavorable prognostic factor in further recovery and influence on the cognitive functions of the child's brain. Peripheral saturation did not critically decrease at all stages of observation. With the exception of the resulting decrease in the indicator in children of group I compared with group III at the stage of induction into anesthesia (97.79±2.45 versus 98.79±1.63, at p=0.0194, respectively) and at the most painful moment of surgical intervention (96.29±3.47 versus 98.10±2.47, with p=0.0368). In children who received combined intravenous anesthesia with two drugs, there was an increase in mean arterial pressure from the beginning of surgical treatment to the child's recovery after surgery (49.49±10.71; 56.18±8.05, respectively, at p<0.01). Conclusions. Among the surveyed groups, the most vulnerable to pathological changes in vital function indicators were children for whom anesthetic support was provided by inhalation anesthesia with sevoran with regional anesthesia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: newborns, infants, congenital malformations, combined anesthesia, vital indicators.

scholarly journals CLINICAL ASSESSMENT OF THE ACID-BASIC STATE AND INDIVIDUAL INDICATORS IN CHILDREN WITH CONGENITAL SURGICAL PATHOLOGY UNDER DIFFERENT TYPES OF ANESTHESIA

2021 ◽  
Vol 11 (1(39)) ◽  
pp. 13-21
Author(s):  
Aleksey Vlasov
Keyword(s):  
Regional Anesthesia ◽  
Congenital Malformations ◽  
Metabolic Disorders ◽  
Acid Base ◽  
Intravenous Anesthesia ◽  
Clinical Indicators ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Different Types

Introduction. Congenital malformations are morecommon in newborns and require surgical correction againstthe background of severe perinatal diseases, which leadsto catabolic stress, circulatory and respiratory disorders,metabolic disorders, disorders of water-electrolyte, proteinand acid-base states.Aim of the study. To establish the dynamics of acidbase status and some clinical indicators in newborns andinfants with congenital pathology under different types ofanesthesia during surgical treatment.Material and research methods. A retrospective studyincluded 150 newborns and infants with congenital malformationsof the surgical profile, depending on the anesthesia (inhalation +regional anesthesia; inhalation + intravenous anesthesia andtotal intravenous). The indicators of the acid-base state,peripheral oximetry, and the need for the oxygen mixtureinhaled by an infant were analyzed.Results. When assessing the indicators of PvCO2, pH,it was found that in group I with anesthesia accompaniedby inhalation and regional anesthesia, the partial tensionof CO2was reduced and the pH was increased at all stages.Peripheral saturation was not critically reduced during theobservation, except for the obtained decrease in children ofgroup I compared with group III at the stage of inductionof anesthesia (97.79 ± 2.45 vs. 98.79 ± 1.63, at p = 0.0194,respectively). ) and at the most painful moment of surgery(96.29 ± 3.47 vs. 98.10 ± 2.47, at p = 0.0368). Newbornsand infants required higher concentrations of oxygen inthe inhalation mixture during inhalation and regionalanesthesia. There was a significant difference between theI and III groups during the most painful stage - 0.47 ± 0.29and 0.33 ± 0.2, at p = 0.0071, respectively, and immediatelyafter surgery - 0.34 ± 0, 19 and 0.26 ± 0.13, at p = 0.0246,respectively.Conclusion. Among the examined groups, the mostvulnerable to pathological changes were children whowere provided with anesthesia by inhalation sevoran withregional anesthesia.

scholarly journals Comparative Analysis of Acid-base Status Parameters in Newborn with Congenital Surgical Malformations During Perioperative Care Based on Types of Anesthesia

2021 ◽  
Vol 2 ◽  
pp. 14-22
Author(s):  
Oleksii Vlasov
Keyword(s):  
Regional Anesthesia ◽  
Oxygen Mixture ◽  
Acid Base ◽  
Group Iii ◽  
Group I ◽  
Anesthesia Group ◽  
Significant Difference ◽  
Combined Anesthesia ◽  
Acid Base Status ◽  
Group Ii

Introduction: Congenital malformations (CM) are most common in newborns and infants in the first year of life and require surgical correction in the first hours, days, months of life. Surgical interventions in severely ill babies with malformations can lead to catabolic stress, circulatory and respiratory disorders, metabolism shifts, water-electrolyte, protein, and acid-base status disorders. This study aimed to compare acid-base status in newborns and infants with congenital surgical pathology under different types of combined anesthesia.  Materials and methods: This retrospective study included 150 newborns and infants with CM who required surgery. The patients were divided into three groups based on types of provided anesthesia: inhalation by Sevoran (sevoflurane) and regional anesthesia (group I); inhalation of Sevoran and intravenous anesthesia by Fentanyl (group II); and intravenous combination of Fentanyl and 20% Sodium Oxybutyrate (group III). The analysis included: acid-base status, peripheral oximetry, and the need for an oxygen mixture inhaled by the patient. Results In group I, there was a significant reduction in partial tension of CO2 and increased pH from the pre-surgical status, at the time of induction of anesthesia, during the most painful, traumatic stage, and after surgery compared to group II and III. Peripheral O2 saturation was not critically reduced at all stages of observation except in babies of group I compared to group III at the stage of induction of anesthesia (97.79 ± 2.45 vs. 98.79 ± 1.63, p = 0.0194) and at the most painful period of surgery (96.29 ± 3.47 vs. 98.10 ± 2.47, p = 0.0368). In group I, newborns and infants required higher oxygen concentrations in the inhalation mixture. There was a significant difference in FiO2 between groups I and III during the most painful stage of surgery (0.47 ± 0.29 and 0.33 ± 0.2, p = 0.0071), and immediately after surgery (0.34 ± 0, 19 and 0.26 ± 0.13, p = 0.0246). Conclusion: Among the newborns and infants with CM requiring surgical intervention and combined anesthesia, the most substantial acid-base status changes were observed in the group where anesthesia was provided by Sevoran (sevoflurane) and regional anesthesia (Group I).

scholarly journals Peculiarities of the state of peripheral oxygenation of tissues in different kinds of combined anesthesia in children with congenital surgical pathology

2021 ◽  
pp. 49-52
Author(s):  
Aleksey Vlasov
Keyword(s):  
Heart Rate ◽  
Pulse Oximetry ◽  
Regional Anesthesia ◽  
Congenital Malformations ◽  
Oxygen Deficiency ◽  
The State ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Combined Anesthesia

In the presented work, we have assessed the features of peripheral oxygenation in children with congenital malformations of the surgical profile under various types of combined anesthesia. The aim of the study. To assess the state of peripheral oxygenation in newborns and infants with congenital malformations with various types of anesthetic support. Materials and research methods. A retrospective study included 150 newborns and infants with congenital malformations of the surgical profile, depending on the anesthesia (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous). The parameters of pulse oximetry were analyzed: peripheral oxygenation, heart rate. Additionally, the concentration of oxygen in the respiratory mixture of children was taken into account. Research results. Peripheral saturation did not critically decrease at all stages of observation, with the exception of a decrease in the indicator in children of group I compared with group III at the stage of induction into anesthesia (97.79±2.45 versus 98.79±1.63, at p˂0.05, respectively) and at the most painful moment of the operation (96.29±3.47 versus 98.10±2.47, with p˂0.05). At the painful moment of the operation, it was in children of group I that a drop in heart rate was noted compared to group III (127.98±13.77 and 136.10±15.37, respectively, with p˂0.05) and group II (134.02±18.43, at p>0.05) against the background of a decrease in SpO2. Newborns and group I infants required higher oxygen concentrations in the breathing mixture. A significant difference in the indicator is noted between groups I and III at the traumatic stage – 0.47±0.29 and 0.33±0.2, with p˂0.05, respectively, and immediately after the operation – 0.34±0,19 and 0.26±0.13, with p˂0.05, respectively. Conclusions. The expediency and effectiveness of pulse oximetry for children with congenital malformations at all stages of anesthetic support during surgical treatment was confirmed. The risk group for the formation of oxygen deficiency in organs and tissues, the occurrence of pain during the operation were newborns and infants, for whom combined anesthesia was chosen in the form of an inhalation method and regional anesthesia. In the case of the appointment of this type of anesthetic support, it is necessary to more closely monitor the indicators and promptly correct the deterioration of the child's condition

scholarly journals Comparative evaluation of different types of anesthesia in surgical treatment of children with congenital defects

2021 ◽  
Vol 26 (1) ◽  
pp. 115-121
Author(s):  
О.О. Vlasov
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Surgical Treatment ◽  
Predictive Model ◽  
Regional Anesthesia ◽  
Surgical Intervention ◽  
Congenital Defects ◽  
Intravenous Anesthesia ◽  
Surgical Interventions ◽  
Combined Anesthesia

In pediatric anesthesiology in surgical interventions various methods of combined anesthesia with a combination of inhalation, regional, and intravenous anesthesia are used. The provision of high-quality anesthetic support in newborns and infants during surgical treatment of congenital defects is complicated by risk factors, concomitant diseases and different pathology conditions. The study of risk factors and their influence on the functional indices of the child's vital activity in prescribing anesthesia at all stages of the surgical intervention will help prevent complications and deaths in children. Aim – to сonduct a comparative assessment of various types of anesthesia for surgical correction of congenital defects in children and create a predictive model of the association of risk factors and deaths in the selected methods of anesthetic support. The retrospective study included 150 newborns and infants with congenital defects of the surgical profile depending on anesthesia (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous). After identifying and evaluating prognostic variables by simple logistic regression with calculating the odds ratio, stepwise multiple logistic regression analysis was performed and a predictive model of the association of risk factors and deaths with various types of anesthetic management was created. In thoracic operations a combined anesthesia with sevoran and fentanyl was most often used – 20.4%. In abdominal operations, in total anesthetic support with sevoran and regional anesthesia was used– 69.4%, while in urological operations combined total intravenous anesthesia with 2 drugs – 18.4% ranked first. No significant diffe­ren­ces were found between the types of anesthesia in various surgical interventions for congenital pathologies, between the types of surgery and deaths (p = 0.863). To prevent fatalities in various types of surgical intervention and options for anesthetic support of newborns and infants with congenital defects, it is advisable to more closely monitor the cerebral and peripheral oximetry indicators at all stages of treatment and timely correct the impaired condition of the child.

scholarly journals REGIONAL ANESTHESIA OF THE TRIGEMINAL NERVE IN CRANIOFACIAL SURGERY

2018 ◽  
Vol 12 (1) ◽  
pp. 15-23
Author(s):  
Andrey Yu. Zajcsev ◽  
V. A Svetlov ◽  
K. V Dubrovin
Keyword(s):  
Regional Anesthesia ◽  
Trigeminal Nerve ◽  
Craniofacial Surgery ◽  
3D Ct ◽  
Maxillofacial Region ◽  
Actual Problem ◽  
Muscle Response ◽  
Surgical Interventions ◽  
Maxillary Nerve ◽  
Combined Anesthesia

This article is devoted to the actual problem of regional blocks as a component of combined anesthesia with long andsuper-long surgical interventions in the maxillofacial region. The article describes in detail the anatomical and physiological features of the person’s innervation, the methods of performing regional blocks, describes the difficulties in performing them, the characteristics of performing neurostimulation, indications and probable complications. In particular, the incorrect interpretation of the appearance of a muscle response when stimulating the maxillary nerve is explained. The methods of neuroimaging are described in detail, from neurostimulation to ultrasound navigation and 3D-CT navigation.

scholarly journals The problem of choosing anesthesia method for surgical interventions on the lower limbs in young patients

2021 ◽  
pp. 43-47
Author(s):  
Marine Georgiyants ◽  
Olexii Popsuishapka ◽  
Victor Ryndenko ◽  
Sergiy Kursov ◽  
Volodymyr Babalian ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Regional Anesthesia ◽  
Young Patients ◽  
The Body ◽  
Lower Limbs ◽  
Optimal Method ◽  
Systematic Analysis ◽  
Surgical Interventions ◽  
Vital Functions ◽  
Working Age

The relevance of the topic is due to the prevalence of lower limbs injuries in people of working age, the complexity of the methods of their surgical treatment and the problem of finding the optimal method of anesthesia in terms of efficiency and safety. Objective of the study: to conduct a systematic analysis of modern scientific literature data on the possibility of using anesthesia methods during surgical interventions and in the case of anesthesia for injuries of the lower limbs in people of working age. Materials and methods. A search for scientific sources was carried out in the scientometric databases Scopus and Web of Science, Google Scholar, archives of journals using the keywords "general anesthesia", "regional anesthesia", "injuries of the lower limbs", "young people", "general anesthesia". The search depth was 8 years. Conclusions. The problem of choosing the method of anesthesia during traumatological surgeries in people of working age has no final solution. In general, both general and regional anesthesia can be used, despite their advantages and the possibility of complications in each case. However, in clinical practice over the past decade, general anesthesia is not always the best method of pain relief. But regional methods have less effect on the vital functions of the body, and the use of ultrasound navigation and modern local anesthetics in a minimum sufficient amount makes anesthesia conduction more effective and safe. The disadvantages of regional anesthesia can be avoided by combining it with general anesthesia. However, in the available literature, there are no recommendations on the differentiated choice of the method of anesthesia for surgical interventions on the lower limbs in people of working age and the factors that influence this

scholarly journals Three-dimensional Surface Profile Analysis of Different Types of Flowable Restorative Resins Following Different Finishing Protocols

2007 ◽  
Vol 8 (5) ◽  
pp. 9-17 ◽  
Author(s):  
A. Rüya Yazici ◽  
Gerard Kugel ◽  
Ali Müftü
Keyword(s):  
Surface Roughness ◽  
Aluminum Oxide ◽  
Profile Analysis ◽  
Three Dimensional ◽  
Surface Profile ◽  
Group Iii ◽  
Group I ◽  
Different Types ◽  
Post Hoc ◽  
Dimensional Surface

Abstract Aim The aim of this study was to investigate the surface roughness of different types of flowable restorative resins and compare the effectiveness of diamond finishing burs followed by aluminum oxide discs with aluminum oxide discs alone in producing smooth surfaces. Methods and Materials Twenty-four specimens (10 mm X 2 mm) for each flowable resin (flowable microhybrid composite, flowable liquid microhybrid composite, flowable compomer, and flowable ormocer) were fabricated in an acrylic mold and randomly assigned to three groups. In group I samples were left undisturbed after the removal of a Mylar strip (control). In group II samples were polished with diamond finishing burs, followed by aluminum oxide discs. In group III samples were finished with only aluminum oxide discs. The mean surface roughness (Ra, μm) was determined with 3-D non-contact interferometry. Data were subjected to one way analysis of variance (ANOVA), and post hoc comparison was accomplished using Tukey's HSD. Results Although significant differences in surface roughness (Ra) values were observed among the materials using a Mylar strip (control), no significant differences between restorative materials were found when all finishing/polishing methods were combined. For all flowable restorative resins tested, the Mylar strip produced surfaces smoother than those produced by a diamond finishing bur followed by a disc or by using discs alone. Surface roughness values were statistically similar for a diamond finishing bur followed by a disc and for disc treated surfaces within each material except for Dyract Flow, a flowable compomer. Conclusion Although the surface roughness of flowable restorative resins differs among the types, this difference can be overcome with different finishing/polishing methods. Citation Yazici AR, Müftü A, Kugel G. Three-dimensional Surface Profile Analysis of Different Types of Flowable Restorative Resins Following Different Finishing Protocols. J Contemp Dent Pract 2007 July;(8)5:009-017.

scholarly journals Epidemiology of benign and malignant tumors in children in the Republic of Moldova (1 year of activity-2020)

2021 ◽  
Vol 70 (2) ◽  
pp. 8-23
Author(s):  
Gheorghe Tibirna ◽  
◽  
Eva Gudumac ◽  
Ion Mereuta ◽  
Silvia Railean ◽  
...  
Keyword(s):  
Pediatric Oncology ◽  
Malignant Tumor ◽  
Malignant Tumors ◽  
Benign Tumors ◽  
Dental Surgery ◽  
Surgical Interventions ◽  
Group Iii ◽  
Group I ◽  
The Republic ◽  
Chemotherapeutic Treatment

The work was carried out within the State Program (1 year of activity-2020); „Modern personalized surgery in the diagnosis and complex treatment of tumors in children” N. 20.80009.8007.06. Analyzing the statistical data during the first year of activity of the project were registered 777 children with tumors, of which 279 (35.2%) primary and 498 (64.8%) – secondary. Of the 777 children, 455 (58.5%) had benign tumors and 97 (12.4%) had malignancies, 231 (29.7%) patients underwent surgical treatment, 455 (58.5%) chemotherapeutic treatment, 13 (1.9%) radiotherapy. Since March 2020, we have been active under the SARS-CoV-2 pandemic. We have developed a special proce- dure for the prevention of coronavirus infection. The COVID-19 pandemic is a new situation, unprecedented for the whole world, with many unknowns, including for the field of Pediatric Oncology and Dental Surgery. First of all, we highlight the adult or child oncological ill patient – as an emergency patient, therefore, the child with the malignant tumor must be treated urgently. Therefore, the treatment of oncological ill patients was conditionaly devided into 3 groups. Group I – primary patients with a diagnosis of malignant tumor, histologically confirmed, who must undergo treat- ment. Postponing this treatment is more dangerous than coronavirus. The treatment should be conducted under pandemic conditions: at distance, using disinfectants, masks, visiting relatives prohibition. Group II – pediatric patients, who at the beginning of the pandemic were at the treatment stage (chemo- or radiother- apy). If the concrete situation allows, the treatment continues. Hormone injection therapy can be performed at home by the specialized team (doctor and nurse). Group III – consisting of children – patients, who have undergone treatment and currently have no signs of disease, but require monitoring. These patients must be in quarantine. Oncological ill patients are considered to have compromised immunity. In adolescent and children, immunity is rela- tively good if there are no serious diseases such as systemic diseases. The tactics must be personalized, strictly individual. During 2020 we performed 3 types of surgical interventions in pediatric oncology: typical surgeries, enlarged surger- ies, combined surgeries.

STATE OF SYSTEMIC HEMODYNAMICS FOR CHILDREN WITH CONGENITAL SURGICAL PATHOLOGY IN DIFFERENT COMBINED ANESTHESIA TYPES

2021 ◽  
pp. 27-30
Author(s):  
O. O. Vlasov
Keyword(s):  
Blood Pressure ◽  
Congenital Malformations ◽  
Surgical Correction ◽  
Systemic Hemodynamics ◽  
Intravenous Anesthesia ◽  
Abdominal Tumors ◽  
Intravenous Drugs ◽  
Different Types ◽  
Combined Anesthesia ◽  
The Impact

General anesthesia for a surgical correction of congenital malformations in children is accompanied, in particular, by the disorders of systemic hemodynamics. In order to assess the impact of different types of combined anesthesia on the state of systemic hemodynamics in surgical correction of congenital malformations, a retrospective study of the treatment of 150 newborns and infants was conducted. These were children with various congenital malformations, but the most common were intestinal obstruction and abdominal tumors. Three groups of patients were formed depending on the type of combined anesthesia during surgical correction of abnormalities: I − inhalation (sevorane) + regional anesthesia; II − inhalation (sevorane) + intravenous anesthesia (fentanyl); III − total intravenous anesthesia with two drugs: analgesic (fentanyl) and drug sleep on the background of intravenous injection of hypnotics (20 % sodium oxybutyrate). There were preformed the surgeries: thoracic, urological, abdominal. The study was retrospectively evaluated in five stages. The analysis of systemic hemodynamics showed a tendency to reduce diastolic blood pressure in children treated with anesthesia with two intravenous drugs (hypnotic and fentanyl), during all observation stages and a significant decrease in this index at the most painful and traumatic period. At the time of induction of anesthesia in children there was a decrease in heart rate. According to the research results, it is concluded that when using the pre−hypnotics as part of combined anesthesia in children with congenital malformations during surgery there is a risk of complications from central hemodynamics in the form of vasodilation, which leads to a drop in blood pressure and increases compensatively the heart contractions. Key words: infants, congenital malformations, anesthesia, hemodynamics.

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