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Abstract
Research in Pediatrics & Neonatology
Current Issues of Modern Pediatric Anesthesiology in the Conditions of Combined Epidural Anesthesia in Children
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Open or CloseFayziev OY*, Satvaldieva EA, Yusupov AS and Abzalova MY
Department of Anesthesiology and Resuscitation, Pediatric Anesthesiology and Resuscitation, Tashkent Pediatric Medical Institute. Tashkent, Uzbekistan
*Corresponding author: Fayziev OY, Department of Anesthesiology and Resuscitation, Pediatric Anesthesiology and Resuscitation, Tashkent Pediatric Medical Institute. Tashkent, Uzbekistan
Submission: February 12, 2024;Published: March 18, 2024
ISSN : 2576-9200Volume8 Issue2
Abstract
Introduction: In pediatrics, the study of pain has also become a highly relevant task, which is intensively
studied in the framework of pediatric surgery, oncology, anesthesiology, neurology, cardiology,
gastroenterology, rheumatology, not counting palliative medicine, age-related physiology.
Method and materials: The study was conducted in the postoperative period in 34 patients after abdominal
surgery. For an objective assessment of the effectiveness of anesthesia, the following research methods were
carried out: A clinical study with the determination of the intensity of pain on a Visual Analogue Scale (VAS)
and the determination of blood pressure, blood pressure, pulse oximetry and echocardiographic study of
central hemodynamic parameters.
Result: Studies of the clinical picture of the course of the postoperative period with monitoring of blood
pressure, oxygen saturation, pulse oximetry, studies of the subjective assessment of pain intensity according
to VAS and an echocardiographic method for studying central hemodynamic parameters showed the relative
stability of patients after adequate pain relief. The use of a combination of drugs: Infulgan - develops an
early analgesic effect, while tramadol realizes its action later, provides prolongation of analgesia. Tramadol
with infulgan in analgesic effect several times exceeded ketorolac.
Conclusion: Multimodal epidural analgesia based on bupivacaine at a dose of 1.0mg/kg reduces early
postoperative complications, promotes rapid rehabilitation and recovery. Pain and its equivalents are one of
the most common reasons for children seeking medical help [1,2]. Postoperative pain syndrome is associated
with the action of a pathogenic irritant and is characterized by subjectively unpleasant sensations, as well
as significant changes in the body, up to serious disruption of its vital functions [3-9]. Pain affecting a child’s
body as a phenomenon of the somatosensory sphere can be accompanied by motor, autonomic, affective
and other manifestations. Almost everyone who has undergone abdominal surgery is characterized by the
occurrence of postoperative pain syndrome, the relief of which improves the quality of life of patients [10-
13]. Pain management is a very important task that must be addressed after surgery. Early rehabilitation is
facilitated by effective pain relief for the patient. It reduces postoperative complications and chronic pain
syndromes [13,14]. Pain as a syndrome is characterized by varying severity and in the vast majority of cases
(more than 80-90%) is accompanied by emotional, psychological and mental disorders. There are many
medications and methods for postoperative pain relief. But, as many different studies in many countries
show, in the early postoperative period, almost half of the patients experience insufficient analgesia [15-
18]. Elimination of pain is a priority in organizing treatment, otherwise a situation arises of treating not
the patient, but the disease. Invasive techniques (spinal cord stimulation, deep brain stimulation and
motor cortex stimulation) are used in neurological clinics [19]. For severe pain in seriously ill children,
epidural anesthesia or intravenous drip administration of analgesics is used, but these methods require
the supervision of an anesthesiologist. It is very important to use effective, optimal epidural analgesia
with the use of bupivicaine, which can be provided to the greatest extent in accordance with the principle
of a multimodal approach: “maximum effect - minimum side effects” [20]. Children do not have special
mechanisms for pain tolerance, but reflex nerve pathways and mediators of the feeling of pain are already
present at the stage of intrauterine development. Children, unfortunately, do not always clearly characterize
the intensity of pain reactions and may tell lies for completely objective reasons [21,22].
Purpose of the work: To increase the effectiveness and safety in the postoperative period undergoing
abdominal surgery by introducing epidural analgesia in children.
Keywords:Urinary tract infections; Pathogen; Escherichia coli; Urinary cultures; Antibiotic resistance
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