[Effect of succinate-containing solution on the level of metabolism during perioperative period in children].

DESIGN: A randomized prospective study. PATIENTS AND METHODS: The study included 87 children aged from 5 to 18, ASA I-II. The patients were divided into two groups. We assessed the impact of reamberin 1.5% (succinate-containing infusion solution) on the level of metabolism and recovery after surgery in patients of main group (n = 44) and control group (n = 43) during different surgeries. All patients received general anaesthesia with sevoflurane, fentanyl, and rocuronium. RESULTS: Reamberin 1.5% promotes to increase the level of basal metabolism in the early postoperative period, decreases the duration of awakening periods, improves recovery of motor activity and adequate breathing.

[Haemodynamics during kidney transplantation and general anaesthesia in combination with epidural block and without it in pediatric patients].

RESEARCH OBJECTIVE: To compare haemodynamic effects of general anaesthesia in combination with epidural block and without it during kidney transplantation in Pediatric patients. METHODS: 61 Pediatric patients undergoing kidney transplantation were divided into two groups. General anaesthesia with sevoflurane, propofol, phentanilum and regional ropivacaine epidural block were used in the group 1. General anaesthesia was used only in the group 2. Haemodynamic parameters were assessed: Arterial blood pressure, stroke volume, central venous pressure and cardiac index. RESULTS: Both techniques of anaesthesia were adequate. CONCLUSION: regional ropivacaine epidural block and general anaesthesia combination provides more stable haemodynamic parameters than general anaesthesia single use.

[Postoperative infusion therapy in children].

The study investigates the influence of Voluven 6% and HAES-steril 10% on the hemodynamics and organism water balance of 40 children from 3 months to 17 years of age, which were divided into two groups according to the type of the administered colloid. It is acquired that infusion of colloids with 1:3 ratio compared to crystalloids in general volume of infused liquids (Voluven 6% in the dose of 5 ml/kg/hour in case of median blood loss of 15% of the total circulating blood volume during two hour long surgery and HAES-steril 10% in the dose of 4 ml/kg/hour in case of the blood loss up to 25% of TCBV) allows to effectively neutralize hemodynamic changes based upon administration of anesthetic agents and intraoperative fluid loss. While administration of Voluven 6% is accompanied by significant, statistically accurate decrease of lower limb impedance, which indicates the increased amount of water in them, HAES-steril 10% administration leads to redistribution of water in the body segments with its predominant significant increase in the torso.

[Pharmacokinetics of fentanyl during sevoflurane based general anesthesia in children].

The research is based on the analysis of 50 cases of anesthesia during reconstructive surgeries in children. The anesthesia was based on inhalation of sevolflurane and injection of fentanyl by the bolus infusion scheme. During the different stages of anesthesia the opioid concentration in plasma was measured. Analysis of hemodynamic parameters showed no statistically significant differences in changes in performance, indicating the steady flow of anesthesia. Infusion of fentanyl provided a smooth, gradual decrease in its concentration in plasma, while analgesia remained adequate. The combination of sevoflurane in a concentration of 1.3 MAC and infusion of fentanyl to a total dose 6 mkg/kg/h was effective in provisioning stable anesthesia in the given category of patients with surgical pathology.

[Effect of volatile inhalational anesthetics on cerebral blood volume and oxygen status in children].

The investigation evaluated the effect of various volatile anesthetics on cerebral blood volume and oxygen status in sick children at the stage of anesthesia induction. Ninety-two children were distributed into 3 groups: Groups 1 (n = 36) and 2 (n = 24) underwent stepwise induction with halothane and enflurane, respectively. Group 3 (n = 32) had vital capacity rapid inhalation induction with sevoflurane. Cerebral oximetry (NIRS method) was used to measure the content of hydroxyhemoglobin, deoxyhemoglobin, the total level of hemoglobin and to assess regional cerebral tissue saturation (rSO2). Halothane was ascertained to increase cerebral blood volume by 20.5% whereas enflurane and sevoflurane increased it only by 8.8 and 9.0%, respectively. In all cases, the value of rSO2 remained comparatively high, by exceeding the baseline level by 3-5%.

[Temperature balance and the possibility of its maintenance during general anesthesia in children].

The problems of hypothermia in the perioperative period, which are one of the most important ones in pediatric practice, in babies in particular, are solved, by using a broad spectrum of methods for preventing and correcting the patients' thermal balance. Convection heating systems exercise an on-line control over the baby's thermal regime during a surgical intervention and intensive care. The authors' own experience allows these systems to be recommended for wide practical application in the activities of anesthesiology and intensive care services.