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[Central hemodynamic changes in children with locomotor system diseases during surgery and anesthesia]
Insights
Children with infantile cerebral paralysis (ICP) experience neurocirculatory issues, particularly during surgery. This study identifies a link between motor disorder severity and hemodynamic changes, proposing preventive measures for outpatient narcosis.
Area of Science:
- Pediatric Anesthesiology
- Neurology
- Cardiovascular Physiology
Context:
- Children with infantile cerebral paralysis (ICP) often exhibit neurovegetative and circulatory disturbances.
- These manifestations correlate with motor impairment severity and localized pain.
Purpose:
- To investigate central hemodynamic changes during narcosis in pediatric orthopedic surgery patients with ICP.
- To develop preventive strategies for these hemodynamic alterations in an outpatient setting.
- To evaluate the feasibility of using calypsol in day-case surgery for this population.
Summary:
- This study examined 120 children (aged 7-14) with ICP, categorized by motor disorder severity.
- Autonomic reactivity (cardiointervalography) and central hemodynamics (thoracic rheography) were assessed.
- Findings revealed a correlation between the severity of motor deficits and the extent of autonomic and hemodynamic dysregulation during narcosis.
Impact:
- Proposes an optimized approach to prevent and manage narcosis-induced hemodynamic instability in pediatric ICP patients undergoing outpatient orthopedic surgery.
- Highlights the importance of considering motor disorder severity when planning anesthesia.
- Suggests calypsol as a potential anesthetic agent for day-case procedures in this cohort.
Abstract:
Various neurovegetative reactions and disorders of circulation are observed in children with consequences of infantile cerebral paralysis (ICP). The manifestation of these reactions depends on the severity of motor disorders and the local painful syndrome. This study was aimed at detecting the changes in the central hemodynamics and development of measures preventing these changes during narcosis in patients with orthopedic consequences of ICP subjected to surgical treatment in an outpatient setting. In addition, we studied the possibility of wide use of calypsol in this category of patients in a one-day hospital. Autonomic reactivity was studied by cardiointervalography after Baevskiĭ. The stroke and minute volume were assessed by tetrapolar thoracic rheography after Kubecik. A total of 120 patients aged 7-14 years with ICP consequences were divided into 3 groups with motor disorders of different severity. Examinations during preparation to narcosis and narcosis revealed a relationship between autonomic and hemodynamic disorders and the severity of motor disorders. An optimal method for preventing hemodynamic changes associated with narcosis in an outpatient setting is proposed.