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[Experience in the use of propofol in surgical interventions in children]
Insights
Total intravenous anesthesia (TIVA) with propofol, ketamine, and fentanyl provides safe and effective anesthesia in pediatric patients undergoing surgery. This combination reduced anesthetic doses and minimized hemodynamic risks, particularly in younger children.
Area of Science:
- Pediatric Anesthesiology
- Surgical Patient Management
Background:
- Assessing anesthetic adequacy is crucial for pediatric surgical procedures.
- Propofol-based total intravenous anesthesia (TIVA) is a common technique.
- Optimizing anesthetic protocols for diverse pediatric age groups is essential.
Purpose of the Study:
- To evaluate the efficacy and safety of TIVA with propofol, ketamine, and fentanyl in children undergoing abdominal and urological surgery.
- To compare anesthetic outcomes between different TIVA regimens.
- To determine the suitability of this protocol for infants and young children.
Main Methods:
- Study included 48 children (3 months to 7 years, ASA I-III) undergoing surgery.
- Two groups received TIVA: propofol/fentanyl vs. propofol/ketamine/fentanyl.
- Anesthesia adequacy assessed via electroencephalography and hemodynamic monitoring.
Main Results:
- TIVA with propofol, ketamine, and fentanyl showed no significant drop in arterial pressure during induction.
- Anesthesia and recovery phases were smooth.
- Reduced doses of propofol and fentanyl were observed with the ketamine-containing regimen.
- Adequate anesthesia with minimal hemodynamic risk was achieved in children under 3 years.
Conclusions:
- TIVA with propofol, ketamine, and fentanyl is an effective anesthetic strategy for pediatric abdominal and urological surgeries.
- This protocol is well-tolerated, leading to smooth anesthesia and recovery.
- The combination offers a safe option for younger children, minimizing hemodynamic complications.
Abstract:
The adequacy of anesthesia with propofol is evaluated in 48 children aged 3 months to 7 years (ASA I-III) subjected to abdominal and urological interventions. The children were divided into groups administered different general anesthesias: 9 children aged 3-7 years operated under total intravenous anesthesia (TIVA) with propofol and fentanyl and 39 children aged 3 months to 6 years operated under TIVA with propofol, ketamine, and fentanyl. The efficiency of anesthesia was evaluated by electroencephalography and hemodynamic monitoring. TIVA with propofol, fentanyl, and ketamine did not notably decrease arterial pressure during induction; the course of anesthesia and recovery ran a smooth course; the doses of propofol and fentanyl were appreciably decreased. Use of this protocol in children aged under 3 years ensured adequate anesthesia with the minimum risk of hemodynamic disorders.