Just like any surgery, a surgical operation pertaining to the eye and its appendages is a common cause of stress that changes the functions of all organs and systems. Numerous previous studies have shown this. The task of anesthesia is to protect a body from stress.The purpose of the study was to estimate the severity of a stress reaction when using different methods of anesthesia during eye surgeries in children.Material and methods. Plasma concentrations of glucose, lactate and cortisol were measured in children aged 4 to 18 years old at three surgical stages. Various methods of anesthesia were used in 5 groups. The patients were distributed at random with 20 children in every group. Results. All estimated values were within the age-specific reference range. Glucose and cortisol levels tended to increase, whereas lactate level was decreasing.Conclusion. The suggested anesthesia types can sufficiently protect patients during eye surgeries and be applied in the practice.
Purpose. The objective of the present study was the comparative evaluation of the effectiveness and adequacy of the regional anesthetic medication as a component of multimodal anesthesia applied in ophthalmological surgery for the treatment of the children presenting with retinopathy of prematurity. Materials and methods. The study included the comparative analysis of anesthetic support in 120 cases of the surgical intervention for the treatment of retinopathy of prematurity in the children at the age varying from 1 month to 1 year. The comparison involved three groups of the patients. The main group was comprised of the children treated with the non-steroidal anti-inflammatory agent paracetamol in the combination with retrobulbar (peribulbar) or infraocular anesthesia and the peripheral van Lint block (14 anesthesias). The control group 1 consisted of the children treated with the narcotic analgesic fentanyl (46 anesthesias) while the control group 2 was composed of the children (n = 60) given inhalation anesthesia with the use of oxygen, nitrous oxide, and sevorane). The principal hemodynamic characteristics including the heart rate, mean, systemic, systolic, and diastolic arterial pressure as well as electrocardiogram, concentration of inhalation anesthetics, capnometry, and the blood oxygenation level were monitored. In addition, the severity of pain and the frequency of apnoea during the postoperative period were evaluated. Results. The application of regional anesthesia with the use of a 0.2% solution of naropin in ophthalmological surgery for the treatment of retinopathy of prematurity in the children ensures strong enough anesthetic effect in the absence of the additional therapeutic interventions that might influence the hemodynamic characteristics and allows to refuse to use narcotic preparations as well as reduce the concentration of inhalation anesthetics. This method improves the course of the postoperative period by virtue of the long-standing anesthetic effect, rapid restoration of consciousness, the absence of postoperative apnoea, reduction of the postoperative starvation time, and the promotion of accelerated rehabilitation of the patients.
BACKGROUND: According to world statistics, about 15% of all malignant tumors are localized in the nasal cavity and rhinopharynx. Endoscopic rhinolaryngosurgery is considered to be low-traumatic. Combining general anesthesia with regional anesthesia improves the quality of the operation and ensures the effectiveness and safety of surgical intervention. To optimize the anesthetic support for endoscopic pediatric rhinolaryngology, we proposed a method of combining bilateral cranial anesthesia with palatal access (or palatine) to guarantee perioperative analgesia and provide comfortable conditions for the surgeon (minimize bleeding). Comfortable conditions also imply a reduction in the intensity of postoperative pain. Pain syndrome after surgery is also associated with the use of a Merocel nasal tampon, which also results in reflexogenic reactions. Therefore, we proposed to perform infiltration anesthesia of the nose from three points according to Weissblatt immediately after surgery to reduce the manifestations of discomfort, pain syndrome, and reflex reactions from standing with a Merocel nasal tampon. AIM: This study aimed to optimize the anesthetic provision with the use of regional anesthesia in pediatric endorinolaryngology. MATERIALS AND METHODS: At the end of July 2021, two endoscopic rhinosinusosurgical interventions were performed at the N.N. Blokhin Research Institute of DO and G, which were of interest for the development of optimized anesthesia approach. Two patients of comparable age were treated in the 1st surgical department and underwent combined anesthesia with the use of wing anesthesia with palatal access. For postoperative anesthesia, one patient underwent infiltration anesthesia of the nose from three points according to Weissblatt, and the other underwent infraorbital anesthesia. RESULTS: In both subjects, combined anesthesia with the use of regional anesthesia methods provided sufficient efficacy and safety; ensured the comfort of the surgeons work; and reduced the risk of trigeminocardial reflex, postoperative nausea, and vomiting and the concentrations of inhalation anesthetics to be applied. Therefore, the use of infiltration anesthesia of the nose from three points according to Weissblatt significantly improves the quality of life in the postoperative period and eases the discomfort from the Merocel nasal tampon. CONCLUSIONS: The results elucidated the combination of preventive analgesia and multimodal anesthesia.
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