Клінічний аналіз вітальних показників у новонароджених і немовлят із хірургічною патологією при різних видах анестезіологічного супроводу

Abstract

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.