METHOD FOR POSTANESTHETIC EXCITATION PREVENTION FOR CHILDREN WITH CANCER

摘要

FIELD: medicine.;SUBSTANCE: standard mask inhalation anesthesia with sevoflurane with preserved spontaneous breathing is performed. At the same time, high-risk postanesthetic excitation is identified for children from 1 to 7 years with rapid awakening after anesthesia and presence of pain impulses in history at the stage of preliminary examination, before the operation by interviewing parents with answer yes or no answer selection. Childbirth (rapid, prolonged), childbirth using various kinds of maternity, regurgitation, not related to food intake, chin tremor, throwing the head back, difficulty in falling asleep, restless, short-term, superficial sleep, sleeptalking, sleepwalking, bedwetting, affective-respiratory convulsions, meteosensitivity, skin mottling, akro-, periorbital and perioral cyanosis, febrile convulsions, logoneurosis, obsessive-compulsive movements, headaches, tendency to constipation, attention deficit, expressed red or white dermographism, general and local hyperhidrosis, thermoregulatory dysfunction, retarded rate of mental and speech and motor development, presence of fear in a child, incoordination of movements. Upon reception of affirmative answers to 2 or more questions, the child is identified as a patient with high risk of postanesthetic excitation syndrome development. At the end of anesthesia, the breathing circuit of such patients is filled with pure oxygen and inhalation of 100% oxygen is continued via a face mask for 8 minutes. At that, 1% propofol at the rate of 1-1.5 mg/kg, dissolved in 0.9% sodium chloride solution in the ratio 1:5 is administered slowly intravenously.;EFFECT: method prevents excitation after inhalational anesthesia with sevoflurane when performing short painful manipulations in children with cancer due to reduced intracranial pressure, elongated phase of drug-induced sleep, achieved sympatho-vagal balance, improved tissue oxygen saturation and reduced pain intensity.;2 tbl, 2 ex