RESUMEN
Twenty-five studies were made in patients aged 12 to 15 years, who had been operated on for extremity injuries. The patients were divided into 2 groups: (1) those who had been given regional anesthesia with sedation (n=10) and (2) those who had received apparatus-mask anesthesia (n=15). The following parameters: heart rate, blood pressure, stroke volume, cardiac output were estimated. The study included 6 steps: (1) premedication; (2) postmedication; (3) postblock; (4) 20 min after block; (5) during skin incision; (6) after consciousness recovery. The findings suggest that there are insignificant hemodynamic changes when regional anesthesia is made in combination with drug sedation as compared with fluorotane-oxide-oxygen anesthesia.
Asunto(s)
Anestesia de Conducción/métodos , Sedación Consciente/métodos , Extremidades/lesiones , Extremidades/cirugía , Adolescente , Anestesia de Conducción/efectos adversos , Presión Sanguínea , Niño , Sedación Consciente/efectos adversos , Frecuencia Cardíaca , Humanos , Monitoreo Fisiológico , Volumen SistólicoRESUMEN
Thirty-nine patients, aged 8 to 15, who were operated for damaged bones in the upper lower limbs were examined. The parameters of central hemodynamics, heart rate and arterial pressure were studied (monitor HP "Viridia m3", USA). Strike volume was determined automatically (rheography monitor NCCOM-3"Boomed Co.", USA). Cardiac output, body area, stroke index and the peripheral vascular resistance were calculated by the routine formulae. Group 1 comprised 20 children who were operated on with the halothane-oxide-oxygen narcosis. Group 2 comprised 19 patients who received regional anesthesia combined with drug sedation (midazolam). A 1% lydokain solution with adrenalin was used as a local anesthetic. The block of the brachial plexus with auxiliary approach and the "3 in 1" block were in use. The changes of hemodynamics detected in the children of group 1 revealed an insufficient analgetic and antistress efficiency of halothane. The data obtained for group 2 are indicative of insignificant hemodynamic changes observed at all examination stages and related with the impact exerted by drugs, used for sedation and regional anesthesia, on the vascular tonus of the original undetected hypovolemia. A lack of complications, a fast awakening and recovery of an adequate consciousness after combined regional anesthesia as well as comfort and a lack of need in extra analgetics that are normally used in the immediate postoperative period make it possible to refer to the discussed anesthesia variation as to the preferential one in cases of surgeries for damaged bones in children.