Combined Multimodal Anesthesia for Abdominal Surgeries in Children

Abstract

Introduction. The article presents findings which may be useful for solving an urgent medical problem on the adequacy of anesthetic management during planned surgical interventions in children with abdominal pathology. Purpose. To compare the effectiveness of combined multimodal anesthesia and multicomponent neuroleptanalgesia in abdominal interventions in children by evaluating central and peripheral hemodynamics. Material and methods. 96 children, aged 1-17, who had various surgical pathologies and were operated on, were examined. In 52% of patients (n = 50), a combined multimodal anesthesia with Propofol, Fentanyl, epidural anesthesia and Sevoflurane was used (main group 1); and in 48% of patients (n = 46), a multicomponent neuroleptanalgesia with Droperidol and Fentanyl combined with epidural anesthesia was used (control group 2) . Results. Trial findings showed that hemodynamics stability is determined by a differential blockade of sympathetic fibers and by a gradual development of epidural block at the level of segmental innervation of surgical intervention zone, thus preventing disorders in parameters of central hemodynamics. Conclusion. The combined multimodal anesthesia as a part of epidural block and inhalation anesthesia with Sevoflurane contributes to a high controllability of anesthesia, to the smooth course of the most traumatic stage, early enteral nutrition, early activation and rehabilitation of patients, starting from the first hours in the intensive care unit, which is an important factor in the prevention of postoperative complications.