ABSTRACT
The paper presents the results of use of continuous epidural bupivacaine infusion for postoperative anesthesia in 88 children operated on for malignant tumors. Two groups of patients differing in the procedure of epidural bupivacaine infusion are compared. The use of bupivacaine at a higher concentration (0.25%) within the first 12 hours of the early postoperative period can provide a more effective anesthesia than that at a concentration of 0.125%. The efficacy and tolerability of the above procedures for injecting the local anesthetic are studied and their after-effects are analyzed.
Subject(s)
Analgesia, Epidural/methods , Anesthetics, Local/therapeutic use , Bupivacaine/therapeutic use , Neoplasms/surgery , Pain, Postoperative/drug therapy , Adolescent , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Child , Drug Administration Schedule , Humans , Infusion Pumps , Treatment OutcomeSubject(s)
Androstanols/administration & dosage , Anesthesia, General , Hemodynamics/physiology , Intubation, Intratracheal , Neoplasms/surgery , Neuromuscular Nondepolarizing Agents/administration & dosage , Adolescent , Anesthesia, General/methods , Child , Humans , Muscle Relaxation/drug effects , RocuroniumABSTRACT
Modern concept of intraoperative blood loss compensation differs crucially from the old rule to compensate the blood loss by donor blood in the same volume, which is explained by serious risks associated with blood transfusions. The parameters of infusion/transfusion therapy with 6% Infucol GEK are presented. The drug was used with good results in adults and children. Volemic parameters are presented and dynamic changes in the blood clotting system after transfusion of infucol GEK and Russian colloid preparation polygluquine are analyzed. Infucol GEK improved vascular blood filing and decreased the volume of other preparations used for blood loss compensation.
Subject(s)
Blood Transfusion , Neoplasms/surgery , Blood Loss, Surgical , Child , Humans , Infusions, Intravenous , Intraoperative CareABSTRACT
The paper presents the results of study of neuromuscular conduction and neuromuscular block by accelerography (TOF) in 100 children operated on for abdominal, retroabdominal, and mediastinal tumors. The currently available myorelaxants Arduan, Tracrium, and Mivacron are studied. There is evidence for the high informative and prognostic values of accelerography, in infusion of drugs in particular, which makes it possible to lower the total dose of muscular relaxants, to avoid decurarization, and to change myoplegia policy in accordance with the intraoperative situation.
Subject(s)
Abdominal Neoplasms/surgery , Electromyography , Mediastinal Neoplasms/surgery , Monitoring, Intraoperative/methods , Muscle, Skeletal/physiopathology , Neuromuscular Blocking Agents/administration & dosage , Adolescent , Child , Child, Preschool , Electromyography/methods , Female , Humans , Infusions, Intravenous , Male , Muscle, Skeletal/drug effects , Muscle, Skeletal/innervation , PrognosisABSTRACT
Neuro-muscular transmission was studied in 100 children operated on for retroperitoneal and mediastinal tumors using the TOF-Guard accelograph. The device was instrumental in cutting down intubation time, monitoring neuro-muscular transmission system (NMTS), predicting the point of transmission recovery and making extubation possible. NMTS monitoring established such advantages of continuous myorelaxant infusion as lower rate of drug administration and lower total dose; the latter is important to avoid drug cumulation. Due to TOF-Guard application 25-30 and 20% of such myorelaxant drugs as arduan and mivacron was saved, respectively; infusion technique required no decurarization medication. There is quite a potential of variation of myorelaxant administration at different stages of surgery and anesthesia.
