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[Diprivan as a component of the anesthesia in emergency surgical interventions in children]
Insights
Diprivan (propofol) anesthesia in children undergoing surgery showed a stable anesthetic course with fewer cardiovascular responses compared to controls. This suggests propofol offers a safer anesthetic option for pediatric surgical patients.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Context:
- Pediatric surgical patients require careful anesthetic management.
- Diprivan (propofol) is an anesthetic agent used for induction and maintenance of anesthesia.
- Evaluating anesthetic efficacy and safety in pediatric populations is crucial.
Purpose:
- To compare the anesthetic effects and physiological responses of Diprivan (propofol) versus traditional central analgesia in children.
- To assess the impact of propofol on respiratory rate, heart rate, blood pressure, and oxygen saturation during pediatric surgery.
- To evaluate the clinical course and recovery of anesthesia in pediatric patients receiving propofol.
Summary:
- Sixty-seven children (5-15 years) received Diprivan for various surgeries (appendicitis, peritonitis, osteomyelitis, phlegmons, head injuries).
- Diprivan was administered for induction (3-4 mg/kg IV) and maintenance (6-9 mg/kg/h infusion) with nitrous oxide and oxygen.
- Compared to controls (central analgesia without propofol), Diprivan group showed less pronounced cardiovascular responses during surgery and earlier return of pain sensitivity.
Impact:
- Diprivan anesthesia demonstrated a stable anesthetic course in pediatric patients.
- The study highlights reduced cardiovascular system reactivity in the propofol group during surgical stress.
- Findings suggest propofol may offer a favorable safety profile for pediatric surgical anesthesia, potentially leading to improved patient outcomes.
Abstract:
Sixty-seven children aged 5-15 years were induced to narcosis and narcotized with diprivan. The patients were operated on for appendicitis, peritonitis, osteomyelitis, phlegmons of different localization, and craniocerebral injuries. For induction, diprivan was intravenously injected in a dose of 3-4 mg/kg. During the main narcosis (central analgesia with fentanyl in a total dose of 0.008 mg/kg/h) diprivan was infused by microjets in a dose of 6-9 mg/kg/h in combination with nitrogen oxide and oxygen in 1:1 ratio. Control group consisted of similar age-matched patients, to whom central analgesia without diprivan was administered. Respiration rate, heart rate, systolic and diastolic arterial pressure, mean arterial pressure (MAP), SaO2, and clinical course of anesthesia were examined at different stages of analgesia and surgery. During induction anesthesia the respiratory rate decreased by 27% and SaO2 decreased to 92.75 +/- 1.2% due to the specific effect of diprivan. MAP decreased by 4.8%. During the traumatic moment of surgery, respiratory rate increased by 20.1%, SaO2 was 98.25 +/- 0.24%, and heart rate increased by 22.6%. In the controls this period of surgery was associated with a more expressed reaction of the cardiovascular system, presenting as tachycardia (114.5 +/- 3.6) and increase of MAP by 10.1%. After anesthesia pain sensitivity returned earlier, due to which tachycardia and negligible hypertension were observed.