ABSTRACT
The research is based upon comparative evaluation of methods of analgesia in 107 patients after surgical correction of scoliotic spinal deformities, which were divided into three comparable groups. The quality of analgesia was assessed on the basis of the clinical manifestations, central hemodynamic changes and total score of pain intensity on. With a combination of narcotic and non-narcotic analgesics (group 1), adequate blockade of nociceptive impulses and comfort of the child are not being reached. Postoperative wound irrigation with 0.1 - 0.2% solution of ropivacaine in combination with NSAIDs is more effective (group 2), if the length of the wound does not exceed 20-23 cm. This method reduces vomiting after surgery and is applied if the patient has not received epidural analgesia. The best effect is achieved with the constant introduction of 0.2% solution of ropivacaine into the epidural space (group 3). This method provides adequate analgesia, sympathetic blockade, and a comfortable postoperative period. It allows the earlier feeding, reduces the incidence of vomiting and can be considered the method of choice.
Subject(s)
Analgesia/methods , Pain, Postoperative/prevention & control , Scoliosis/surgery , Adolescent , Analgesia/instrumentation , Analgesia, Epidural/instrumentation , Analgesia, Epidural/methods , Analgesics, Non-Narcotic/administration & dosage , Analgesics, Non-Narcotic/therapeutic use , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/therapeutic use , Catheters, Indwelling , Child , Female , Hemodynamics/drug effects , Humans , Male , Pain Measurement , Pain Threshold , Pain, Postoperative/psychology , Therapeutic Irrigation , Treatment OutcomeABSTRACT
Various anesthetic methods during surgical simultaneous double-stage correction of scoliotic deformity in the spine were analyzed in 73 children. Analgesic quality was assessed from central hemodynamics and some biochemical parameters of stress, the volume of blood loss, and the number of complications. Forty children were operated on under general sevofluorane + fentanyl anesthesia and artificial ventilation. In 33 children, this general anesthesia mode was added by epidural analgesia with 1% morphine solution in 10-12 ml of a solvent. Epidural morphine analgesia used in the complex of general anesthesia upgraded the quality of nociceptive defense, substantially decreased the consumption of systemic narcotic analgesics, an anesthetic, and relaxants, lowered blood loss by 10%, and reduced the number of postoperative complications by 20%.
