[Oxygenation state of brain in children upon reamberin infusion during post-anesthesia recovery].

The effect of reamberin (1.5% solution of succinic acid and ion complex) on the oxygenation status of the brain was studied in children aged 1 - 14 years during recovery from anesthesia. It is established that reamberin in a dose of 2 ml/kg administered twice at the end of an operation increases the fraction of oxidized hemoglobin and cytochrome oxidase and enhances the regional saturation of brain tissue with oxygen, which is indicative of an increase in the potential of metabolism activation in neurons.

[Reamberin administration for early postnarcosis recovery in children].

The possibility of using 1.5% succinic acid solution (reamberin) in order to activate recovery from anesthesia was studied in a group of 91 patients aged 1-14 years. Based on clinical data and BIS-index, it is established that the administration of reamberin during exit from anesthesia stage shortens the wake-up period, decreases the time of restoration of the motor activity and adequate respiration, and accelerates brain function recovery.

[Immune reaction to anesthesia and surgical injury in neonatal infants].

The impact of surgical injury and anesthesia on cellular and humoral immunity parameters was studied in neonatal infants with surgical pathology. These were found to have immunosuppressive activity, which appeared as evolving absolute lymphopenia and a reduction in the serum concentration of IgG. The magnitude of these changes depends on the functional state of the immune system in the preoperative period and is higher in infants with signs of an infectious-inflammatory process in the preoperative period, which increases the risk of septic complications. Preoperative immune replacement therapy with intravenous immunoglobulins (Pentaglobin) in neonates with severe developmental defects stops a fall in the level of cytotoxic lymphocytes in the early postoperative period.

[High-frequency oscillatory lung ventilation in neonatal infants with surgical diseases].

The paper presents data on the varieties and modes of the present artificial ventilation and high-frequency artificial ventilation (AV). It describes the basic impact of various ventilation modes on gas exchange, hemodynamics, and mechanical lung properties. The data on the use of high-frequency AV in neonatal infants with various surgical diseases are given. Its place and indications in malformations, such as diaphragmatic hernia and esophageal atresia, are defined. High-frequency oscillatory AV may be recommended for use as an alternative method in the treatment of respiratory failure in neonates with difuse lung lesion and in those with congenital surgical diseases when it is impossible to ensure adequate gas exchange.

[Prevention of pain during finger prick in neonatal infants].

Finger pricking for blood sampling is the most common manipulation in hospital units. Pain control using the rating scales for neonatal acute pain and its analgesia are necessary as the consequences of experienced pain are well known. The oral use of glucose solutions substantially relieves pain during this procedure as compared with neonates receiving no analgesics.

[Characteristics of anesthesia in newborn infants].

The paper describes the specific features of anesthetic maintenance in preterm and full-term neonates, intraoperative monitoring, and the effects of inhaled anesthetics, narcotic analgesics, sedatives, and myorelaxants with emphasis on the anatomic and physiological features of a developing organism.

[Non-drug prevention of pain in neonatal infants].

When treated at a hospital unit, full-term and preterm neonatal infants undergo a large number of manipulations and procedures, most of them are rather painful; anesthesia is used inadequately frequently. Pain prevention during procedures is able to reduce a baby's discomfort and to improve his/her tolerance of medical manipulations and care procedures.

[Myoplegia with rocuronium bromide in children].

This study has evaluated the efficacy and safety of different doses of Esmerone in children under fluorothane anesthesia. It enrolled 85 children from a senior age group (7-14 years). According to the myorelaxant used, all the patients were divided into 2 groups: S and R. In the S group (n=25), myoplegia was carried out administering succinylcholine in a dose of 1 mg/kg. In the R group, myorelaxation was achieved using rocuronium bromide (Esmerone). According to the dose used, the group was divided into 3 subgroups, each comprising 20 patients. The initial dose of Esmemrone was 0.3, 0.6, and 0.9 mg/kg, respectively. The efficacy of the agent was evaluated by accelerographic and clinical data. The study has demonstrated that Esmerone was safer than succinylcholine. Increasing the dose (0.3-0.6-0.9 mg/kg) of Esmerone advantages in the onset of NMB and shows an increase in the duration of its action.

[Central and cerebral hemodynamics during gynecological laparoscopic interventions in children].

The authors examined central and cerebral hemodynamics in children during gynecological laparoscopic interventions. The course of 64 anesthesias was analyzed in girls aged 3 to 16 years, who had undergone laparoscopic surgery. Central hemodynamics was studied by tetrapolar rheography on a Diamant apparatus; cerebral oximetry was examined on a Critikon RedOx Monitor 2020 device. The findings demonstrate that pneumoperitoneum application causes immediate cardiovascular changes. Transfer of patients to Trendelenburg's position had a beneficial impact on central hemodynamics, by facilitating the normalization of venous return, thus maintaining cardiac output. Central hemodynamic disorders promptly affected cerebral blood volume and oxygen status. After pneumoperitoneum application, there was an average of 3% reduction in regional cerebral tissue saturation.

[Prevention of pain during manipulations in neonatal infants: analysis of physicians' questionnaire survey].

The paper presents the results of an anonymous questionnaire survey among the physicians of 7 children's health care facilities, who should assess and prevent pain in neonatal infants from 5 Russia's cities (Moscow, Cheboksary, Kursk, Novosibirsk, and Kyzyl). The questionnaire survey has indicated that all responding physicians agree with the statement that a neonate senses pain, but the severity of pain being uncontrolled and the pain syndrome unevaluated, pain analgesia and prevention are inadequately applied by comfort measures, particularly the use of glucose through a nipple, a pacifier, diapering, when procedures are performed. All the physicians are unanimous that analgesics or comfort measures should be more frequently used during any manipulations and procedures irrespective of whether they are performed for a long or short period.

[Induction of anesthesia with halogen-containing anesthetic agents in children].

The study has comparatively evaluated the effectiveness and safety of halothane, enflurane, and isoflurane in children during induction. Seventy hundred and eight patients aged 1-14 years who had ASA I-II anesthetic risks were examined. Gas induction was performed as monoanesthesia through the semi-open circuit with high gas flow (100% O2 6 l/min) in combination with halothane (n = 236), enflurane (n = 236), or isoflurane (n = 236) without N2O. The authors have compared the following criteria: the speed and comfort of induction, the parameters of hemodynamics and external respiration, and the rate of adverse reactions and complications during induction. The studies have established that in terms of comfort, safety, and the rate clinical effect achievement, the drugs of choice for gas induction in children are enflurane and, to a lesser extent, halothane. Gas induction with isoflurane should not be performed in children since the agent rather frequently exerts an irritant action on the upper airways, which reduces the speed of initial narcosis and increases the likelihood of one or another adverse reactions; however; it has advantages as a less hemodynamic effect.

[Modern approaches to the management of an anesthesiological support in pediatric ENT surgery].

The paper deals with the topical problem of pediatric anesthesiology--current approaches to performing an anesthesiological appliance in pediatric ENT surgery. The study included 1299 children aged 3 days of life to 14 with various surgical ENT abnormalities at anesthesia risk I-III (ASA) in whom surgical intervention was performed under multicomponent general anesthesia or under local anesthesia. The paper comparatively characterizes the currently available methods for general anesthesia used during both short ENT surgery and long endonasal microendoscopic interventions. The effectiveness and safety of different procedures for maintenance of free airway patency, such as endotracheal intubation, a laryngeal mask, a COPA-airline, were compared. Since adenoid- and/or tonsillectomy, as well as tonsillotomy are the most common operations in pediatric ENT surgery, indications for and contraindications to these interventions under general anesthesia were defined. It has been shown that endonasal microendoscopic operations in children should be performed exclusively under general endotracheal anesthesia and local anesthesia is a mere one of its important constituents.