Optimisation of acute pain treatment in children in abdominal surgery at the stages of the perioperative period

Authors

DOI:

https://doi.org/10.15587/2519-4798.2022.265222

Keywords:

perioperative analgesia, child on the operating table, surgical stress, multimodal anaesthesia, effectiveness of analgesia

Abstract

The aim of the study. To improve the quality of perioperative analgesia by combined multimodal use of paracetamol and ketorolac tromethamine in children after abdominal surgery.

Materials and methods. 48 children (6-17 years old) with choledochal, pancreatic cysts, hepatic echinococcosis, and abdominal trauma. The study period was from January 2021 to January 2022. Group 1 (main group, n=28): baseline analgesia - 15 min before surgery, intravenous paracetamol administration at 25-30 mg/kg. In order to prevent postoperative pain syndrome 15 minutes before the end of the surgery, we administered ketorolac and tromethamine in a dose of 0.5 mg/kg. Pain relief was repeated 6-8 h later with ketorolac at a dose of 0.5 mg/kg. Group 2 (comparison, n=20), who received 0.2 – 0.3 mg/kg promedol (trimeperidin) in the postoperative period. Both groups received standard endotracheal anaesthesia (propofol + fentanyl + arduan against the background of Low-flow anaesthesia with sevoflurane MAK=1). Systemic haemodynamics, C-reactive protein, and glucose were investigated, and a visual analogue scale was applied at the main stages of the study.

Results: Analysis of the parameters of central hemodynamics, parameters of the operational stress response and clinical data showed that in the postoperative period, sufficient analgesic effect was established only in children in group 1 with the preventive combined administration of paracetamol and ketorolac on the operating table, which allows recommending them in the practice of perioperative analgesia during abdominal surgical interventions.

Conclusions. Optimised method of preventive (preoperative) use of paracetamol in children at a dose of 25-30 mg/kg during abdominal surgery followed by administration of ketorolac tromethamine (15 minutes before the end of the surgery) increases the degree of nociceptive protection. It ensures high efficiency of postoperative pain relief, which allows to recommend it in the practice of perioperative analgesia for the above abdominal surgical interventions in children

Author Biographies

Elmira Satvaldieva, National Children's Medical Center; Tashkent Pediatric Medical Institute

Professor, Scientific Adviser

Professor, Head of Department

Children's Anaesthesiology and Resuscitation Department

 

Eldor Turgun ugli Kuralov, National Children's Medical Center

Anesthesiologist

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Published

2022-09-30

How to Cite

Satvaldieva, E., & Kuralov, E. T. ugli. (2022). Optimisation of acute pain treatment in children in abdominal surgery at the stages of the perioperative period. ScienceRise: Medical Science, (5 (50), 8–15. https://doi.org/10.15587/2519-4798.2022.265222

Issue

No. 5 (50) (2022)

Section

Medical Science

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Copyright (c) 2022 Elmira Satvaldieva, Eldor Turgun ugli Kuralov

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