Comparative evaluation of different types of anesthesia in surgical treatment of children with congenital defects

Authors

  • О.О. Vlasov MI «Dnepropetrovsk Regional Children’s Clinical Hospital» Dnepropetrovsk Regional Council», Kosmichna str., 13, Dnipro, 49100, Ukraine, Ukraine https://orcid.org/0000-0003-1575-9872

DOI:

https://doi.org/10.26641/2307-0404.2021.1.228024

Keywords:

newborns, infants, congenital defects, combined anesthesia, surgical treatment

Abstract

In pediatric anesthesiology in surgical interventions various methods of combined anesthesia with a combination of inhalation, regional, and intravenous anesthesia are used. The provision of high-quality anesthetic support in newborns and infants during surgical treatment of congenital defects is complicated by risk factors, concomitant diseases and different pathology conditions. The study of risk factors and their influence on the functional indices of the child's vital activity in prescribing anesthesia at all stages of the surgical intervention will help prevent complications and deaths in children. Aim – to сonduct a comparative assessment of various types of anesthesia for surgical correction of congenital defects in children and create a predictive model of the association of risk factors and deaths in the selected methods of anesthetic support. The retrospective study included 150 newborns and infants with congenital defects of the surgical profile depending on anesthesia (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous). After identifying and evaluating prognostic variables by simple logistic regression with calculating the odds ratio, stepwise multiple logistic regression analysis was performed and a predictive model of the association of risk factors and deaths with various types of anesthetic management was created. In thoracic operations a combined anesthesia with sevoran and fentanyl was most often used – 20.4%. In abdominal operations, in total anesthetic support with sevoran and regional anesthesia was used– 69.4%, while in urological operations combined total intravenous anesthesia with 2 drugs – 18.4% ranked first. No significant diffe­ren­ces were found between the types of anesthesia in various surgical interventions for congenital pathologies, between the types of surgery and deaths (p = 0.863). To prevent fatalities in various types of surgical intervention and options for anesthetic support of newborns and infants with congenital defects, it is advisable to more closely monitor the cerebral and peripheral oximetry indicators at all stages of treatment and timely correct the impaired condition of the child.

References

Holovanova IA, Byelikova IV, Lyakhova NO. [Fundamentals of medical statistics: textbook. way. for graduate students and clinical residents]. Poltava; 2017. р. 113. Ukrainian.

Vlasov OO. [Condition of problems of congenital developments and surgical diseases in the newborn in Ukraine and the Dnepropetrovsk region]. Neonatology, surgery and perinatal medicine. 2020;35(1):6-13. Ukrainian.

doi: https://doi.org/10.24061/2413-4260.X.1.35.2020.1

Znamenska TK, Vorobiova OV, Dubinina TYu. [Strategic directions for reconstruction of the health system newborns and children of Ukraine]. Neonatology, surgery and perinatal medicine. 2017;4(26):5-12. Ukrainian.

doi: https://doi.org/10.24061/2413-4260.VII.4.26.2017.1

[Monitoring the quality of medical services during the reform of obstetric and pediatric care to the population of Ukraine in health care facilities under the Ministry of Health of Ukraine / analytical and statistical guide for 12 months of 2015-2019]. Kyiv; 2020. р. 113. Ukrainian.

Ajao AE, Adeoye IA. Prevalence, risk factors and out¬come of congenital anomalies among neonatal admis¬sions in OGBOMOSO, Nigeria. BMC Pediatr. 2019;9(1):88. doi: https://doi.org/10.1186/s12887-019-1471-1

Wittekindt B, Schloesser R, Doberschuetz N, et al. Epidemiology and Outcome of Major Congenital Malformations in a Large German County. Eur J Pediatr Surg. 2019 Jun;29(3):282-9. doi: https://doi.org/10.1055/s-0038-1642630

McNeill S, Gatenby JC, McElroy S, Engelhardt B. Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants. J Perinatol. 2011;31:51-57. doi: https://doi.org/10.1038/jp.2010.71

Poets CF. Noninvasive Monitoring and Assessment of Oxygenation in Infants. Clin Perinatol. 2019;46(3):417-33. doi: https://doi.org/10.1016/j.clp.2019.05.010

Tin W, Lal M. Principles of pulse oximetry and its clinical application in neonatal medicine. Semin Fetal Neonatal Med. 2015;20(3):192-7. doi: https://doi.org/10.1016/j.siny.2015.01.006

Ziyaeifard M, Azarfarin R, Azarfarin R. New aspects of anesthetic management in congenital heart disease “common arterial trunk”. J Res Med Sci. 2014;19(4):368-74. PMID: 25097611.

Published

2021-03-26

How to Cite

1.
Vlasov О. Comparative evaluation of different types of anesthesia in surgical treatment of children with congenital defects. Med. perspekt. [Internet]. 2021Mar.26 [cited 2024Jul.14];26(1):115-21. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/228024

Issue

Section

CLINICAL MEDICINE