ISSN: 2577-4301
Authors: Nasibova EM*
Propofol (diprivan) is the drug of choice in one-day surgery in children. The use of the drug provides rapid awakening (due to rapid redistribution and short half-life) and a minimum incidence of postoperative complications. The aim of the study: optimization of anesthetic benefits in one-day surgery by using propofol. Materials: The study included 58 patients operated on for inguinal and umbilical hernias, dropsy of testicular membranes, cryptorchidism, varicocele, hemangiomas of various localization, phimosis and paraphimosis. Depending on the age of the children, this group was divided into 3 subgroups: IA (n=12) age 0-3 years, IB (n=33) - 4-7 years old and IC (n=13) - 8-16 years old. This study was carried out in five stages. Results: Basically in all age groups, the performance of the cardiovascular system remained at the level of the initial values, however, certain hemodynamic changes characterizing the effect of propofol were revealed. The characteristic imbalances of the main parameters of the volumetric blood flow indicate hemodynamic stress that occurred against the background of the action of propofol in all groups during the induction of anesthesia. All this clearly and objectively characterizes the vasodilating properties of propofol, as a factor that causes the most typical changes in central hemodynamics. Indices of external respiration after premedication at the induction stage tended to decrease and indicated moderate hypoventilation. At the traumatic stage of the study, an increase in BH was observed, which was associated with the appearance of pain. Thus, propofol induction proceeded with a hypodynamic type of blood circulation. At the most traumatic time of the operation, despite an increase in the dose of fentanyl, hemodynamic parameters were hyperdynamic type of blood circulation, associated with insufficient relief of the pain component. And an increase in the dose of fentanyl led to the development of hypoventilation with subsequent apnea, which required mechanical ventilation. Thus, analyzing the results obtained, it should be noted that anesthesia during ″ small ″ surgical interventions with propofol and fentanyl is not an optimal method. Since at the most traumatic time of the operation, it is necessary to increase the dose of fentanyl, and this leads to hypoventilation with the subsequent development of apnea, which requires correction. Conclusion: Analyzing the results obtained, it should be noted that anesthesia during ″ small ″ surgical interventions with propofol and fentanyl is not an optimal method. Since at the most traumatic time of the operation, it is necessary to increase the dose of fentanyl, and this leads to hypoventilation with the subsequent development of apnea, which requires correction.
Keywords: Propofol; One-day surgery; Premedication
