DIFFERENTIATED APPROACH TO ANESTHETIC MANAGEMENT OF NEWBORNS AND INFANTS WITH SURGICAL PATHOLOGY

Abstract

Introduction. Various methods of combined anesthesia are used with a combination of inhalation, regional, intravenous anesthesia during surgical interventions in pediatric anesthesiology. It is important to carry out a differentiated approach to the appointment of anesthesia in children at all stages of surgical intervention to prevent complications and deaths in children.
 Aim. To analyze various types of anesthetic support for newborns and infants with congenital malformations during thoracic, urological and abdominal types of surgical treatment and determine the safest combination of anesthesia.
 Materials and methods. The retrospective study included newborns with congenital malformations of the surgical profile, as well as infants who received and continued stepwise surgical treatment for congenital malformations, depending on the chosen combined anesthetic accompaniment (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous one). After identification and assessment of 41 prognostic variables by simple logistic regression with the calculation of the odds ratio, stepwise multiple logistic regression analysis was performed to identify significant factors associated with death.
 Results. It has been proven that there is no relationship between the age of children, the type of surgical intervention in newborns and infants with congenital malformations with various options for anesthesiological support and deaths. It can be argued that the combination anesthesia options selected for analysis are safe.
 Conclusions. To prevent the chances of fatalities in various types of surgical interventions and options for anesthetic support of newborns and infants with congenital malformations, it is advisable to monitor blood pressure (especially diastolic), cerebral, peripheral oximetry at all stages of treatment more closely and correct the impaired condition of a child in time.