Анестезиологическое обеспечение при энуклеации глазного яблока в педиатрической онкохирургии

Abstract

Aiml. Optimization of anesthesia during enucleation of the eyeball in pediatric oncosurgery with an emphasis on regional methods. Material and Methods. Eight anesthesias were performed in children, whose average age was 3 years, operated on for retinoblastoma from July 2021 to January 2022. All patients underwent combined endotracheal anesthesia. A triple block was used as a regional component: palatal anesthesia, infraorbital anesthesia and van Lint block. Results. The effectiveness and adequacy of the proposed method of anesthesia using regional anesthesia was assessed in terms of hemodynamics – heart rate, systolic and diastolic blood pressure, the level of oppression of consciousness (BIS-index). The assessment was made at five stages: the beginning of anesthesia, tracheal intubation, 10 minutes after the triple block, at the traumatic stage of surgery, and at the end of anesthesia before tracheal extubation. As a result, it was noted that the studied variant of anesthetic management is characterized by a stable hemodynamic profile, and also does not provoke the development of an oculocardial reflex. There was a decrease in the level of the BIS-index below 40 c.u. at the stage of maintenance of anesthesia, which indicated the possibility of using lower concentrations of sevoflurane. Conclusions. This option of anesthetic management has sufficient efficiency and safety, and also allows to ensure the comfort of the surgeon. Key words: retinoblastoma; combined anesthesia; regional anesthesia.