[Experience in the use of propofol in surgical interventions in children]. / Opyt primeneniia propofolia pri operativnykh vmeshatel'stvakh u detei.

The adequacy of anesthesia with propofol is evaluated in 48 children aged 3 months to 7 years (ASA I-III) subjected to abdominal and urological interventions. The children were divided into groups administered different general anesthesias: 9 children aged 3-7 years operated under total intravenous anesthesia (TIVA) with propofol and fentanyl and 39 children aged 3 months to 6 years operated under TIVA with propofol, ketamine, and fentanyl. The efficiency of anesthesia was evaluated by electroencephalography and hemodynamic monitoring. TIVA with propofol, fentanyl, and ketamine did not notably decrease arterial pressure during induction; the course of anesthesia and recovery ran a smooth course; the doses of propofol and fentanyl were appreciably decreased. Use of this protocol in children aged under 3 years ensured adequate anesthesia with the minimum risk of hemodynamic disorders.

[Features of anesthesia in surgery of liver cirrhosis in children]. / Osobennosti anestezii pri operatsiikakh u detei s tsirrozom pecheni.

Central hemodynamics, aminotransferases, and alpha-fetoprotein were studied during surgery in 26 children with cirrhosis of the liver. In contrast to total intravenous anesthesia with preinjection of clofelin, in anesthesia with neuroleptanalgesia agents and N2O circulation hyperdynamia develops in the course of surgery, the process grows more active, and liver capacity to regeneration in the early postoperative period is depressed.

[Effects of infusion hemodilution on the state of hemodynamics and oxygen transport in urologic surgery in children]. / Vliianie infuzionnoi gemodiliutsii na sostoianie gemodinamiki i kislorodnogo transporta pri urologicheskikh operatsiiakh u detei.

Analysis of the results of infusion hemodilution and traditional restitution of surgical blood less in 32 children subjected to urological surgery showed that hemodilution is associated with an increase of cardiac output and a reduction of the peripheral vascular resistance. Despite an increase of the volume of blood loss in hemodilution, the parameters of oxygen transport remain the optimal in the course of operation and the immediate postoperative period, an increased level of inorganic phosphates being conducive to maintenance of adequate oxygen metabolism. The authors claim that under conditions of infusion hemodilution donor blood preparations should not be transfused to children with surgical blood loss of up to 20%.