Peculiarities of post-operative analgesia after the extensive surgical interventions in children

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INTRODUCTION. Postoperative pain syndrome remains a serious problem in pediatric surgery and anesthesiology. Epidural analgesia is considered to be effective in the early postoperative period, as it provides better pain control compared with the use of opioids.PURPOSE OF THE WORK. To evaluate the the effectiveness and safety of epidural analgesia after extensive surgical interventions on abdominal organs in children. MATERIALS AND METHODS. The study included 22 children from 1 year to 17 years. They were divided into two groups: 1 group included children who received opioid analgesics parenterally as a postoperative analgesia (n = 10), in group 2 there were patients in whom a prolonged epidural anesthesia was carried out (n = 12).RESULTS AND DISCUSSION. When studying the variability of blood pressure and heart rate during the day, as a marker of pain, it was found that in children of the first group, these fluctuations were much more expressed than in the second group. Peristalsis appeared in 54.61 ± 9.66 hours after surgery in patients of the first group and in 14.22 ± 6.89 hours – in the second group. Diluting the 0.25% solution of anesthetic to a concentration of 0.125% gave an opportunity to increase the rate of solution delivery to cover more dermatomes and expand the analgesia zone.CONCLUSIONS: 1. Prolonged epidural analgesia has advantages over the use of opioids, providing more reliable and effective analgesia in children. 2. Prolonged epidural anesthesia, with the correct technique of catheter placement and strict dosing of local anesthetic, does not have clinically significant side effects in children, and can be recommended for postoperative analgesia after extensive surgical interventions on abdominal organs in children.