THE EFFECT OF MULTICOMPONENT BALANCED GENERAL AND COMBINED ANESTHESIA ON THE EFFECTIVENESS OF POSTOPERATIVE ANESTHESIA IN ORTHOPEDIC AND TRAUMATOLOGICAL OPERATIONS ON THE LOWER EXTREMITIES IN CHILDREN
Journal: Journal of the Grodno State Medical University (Vol.21, No. 6)Publication Date: 2024-01-11
Authors : Y. E. Rozin A. V. Marochkov A. E. Kulagin D. A. Suvorov;
Page : 575-582
Keywords : pediatric orthopedics; postoperative anesthesia; combined anesthesia; operations on the lower extremities; general anesthesia;
Abstract
Background. The problem of acute pain control after orthopedic and traumatological operations in children has not been completely solved. This article presents data from our own research on the effectiveness of postoperative anesthesia in orthopedic and traumatological surgical interventions on the lower extremities in children. Objective. To determine the effectiveness of postoperative anesthesia in orthopedic and traumatological operations on the lower extremities in children performed using multicomponent balanced general and combined anesthesia. Material and methods. A single-center prospective simple blind randomized study was conducted. The study included 52 patients aged 6 to 17 years who underwent planned orthopedic and traumatological surgical interventions on the lower extremities. Depending on the method of anesthesia the patients were divided into two groups: in group 1 (n=22), children underwent multicomponent balanced general anesthesia, in group 2 (n=30) – combined anesthesia (multicomponent balanced general anesthesia in combination with regional blockades of the sciatic and femoral nerve). After the surgical interventions the duration of postoperative anesthesia, the need for analgesics were estimated, and a quantitative assessment of the severity of acute pain on the Wong-Baker scale 2,6,24 hours after the end of the operation was performed. Results. In all cases, surgical interventions were successful. As a result of the study, it was found that the duration of postoperative anesthesia in the group of children where combined anesthesia was used was 305 [215; 385] minutes. In the group of patients who underwent multicomponent general anesthesia, the duration of anesthesia was 8.7 times less and amounted to 35 [10; 65] minutes. In patients of group 1, the pain score on the Wong-Baker scale 2 hours after surgery was 3 [2; 4] points, after 6 hours 3.5 [2; 5] points, after 24 hours 2 [1; 3] points; in patients of the 2nd group 0 [0; 1], 3,5 [0; 5], 2 [1; 3] points, respectively. Narcotic analgesics were used in 14 (64%) of 22 children of group 1 and 15 (50%) of 30 children of group 2. Paracetamol was used in 19 (86%) of 22 patients of group 1 and 28 (93%) of 30 patients of group 2; ketorolac in 2 children (9%) from the 1st group and 3 children (10%) from the 2nd group. Conclusion. Combined anesthesia provides longer postoperative anesthesia and reduces the need for narcotic analgesics in the postoperative period during orthopedic and traumatological operations on the lower extremities in children.
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