[General anesthesia using diprivan in patients with lesions of the locomotor system in a day hospital]

The study is aimed at investigating the possibility of using diprivan in total anesthesia of patients with consequences of infantile cerebral paralysis (ICP) during orthopedic surgery in an outpatient setting. The study was carried out at the Institute of Clinical Rehabilitology in the town of Tula. Ninety-two patients aged 4 to 15 years were examined. Hemodynamics was assessed by tetrapolar thoracic rheography after Kubecik. The patients were divided into 3 groups with disorders of static kinetic functions of different severity: I) walk-in patients, 29.3%; II) patients walking with difficulty, 59.7; III) patients incapable to walk by themselves, 9.2%. The autonomic status was studied using clino-orthostatic tests and cardiointervalography. Characteristic changes of the hemodynamics under conditions of narcosis and surgery were revealed in the patients with locomotor disorders of different severity. Diprivan can be used as the basic hypnotic component of anesthesia in orthopedic operations in patients with ICP consequences with locomotor disorders of different severity. It meets the requirements to the adequacy of anesthesiological protection in an outpatient setting. Assessment of the autonomic status in patients with ICP consequences permits a differentiated approach to total anesthesia with diprivan. Premedication with ketamine prevents the hypotensive effect of diprivan and ensures hemodynamic stability in the course of anesthesia and surgery.