OUR EXPERIENCE WITH THE USE OF SEVOFLURANE INHALATION ANESTHETIC IN ONE-DAY SURGERY IN CHILDREN

Abstract

The choice of the optimal method of anesthesia in one-day surgery in children to this day remains open and relevant. The aim of the study: To determine the advantages and disadvantages of the use of sevoflurane in one-day surgery in children and to develop a methodology for anesthesia with it. Material and research methods: The study was conducted in the surgical clinic of the Azerbaijan Medical University from 2014 to 2018. The study included 106 children aged 0 to 16 years with a risk of ASA grade I and II anesthesia, who were operated on as planned in one-day surgery in the department’s neonatal surgery, abdominal surgery, urology, maxillofacial, ophthalmology, laryngotorhinology, neurosurgery, traumatology and orthopedics. Induction anesthesia and maintenance of anesthesia in patients of this group was carried out by inhalation of sevoflurane through a facial mask and a bolus of fentanyl. Depending on age, this group was divided into 3 subgroups: IA (n = 56) age 0-3 years, IB (n = 24) - 4-7 years, IC (n = 26) - 8-16 years. At the time of anesthesia with sevoflurane, the children did not have concomitant severe systemic neurological, cardiovascular and bronchopulmonary diseases and the general condition was assessed as satisfactory. Results of the study: Our own practical experience in one-day surgery in children allowed us to develop and successfully use the algorithm of various anesthesia options with sevoflurane in children. 1. Features of step-by-step (step-by-step) anesthesia with sevoflurane with oxygen without preliminary filling of the respiratory circuit. 2. “Bolus” induction with preliminary filling of the anesthesia apparatus circuit with a mixture containing 6-8 vol% sevoflurane. Conclusions: The anesthesia technique of sevoflurane + fentanyl was fast and safe for the patient and operating personnel, with the correct observance of the algorithm for its implementation: 1) the correct filling of the respiratory circuit, maintaining the parameters of the gas flow and the concentration of anesthetic on the evaporator and in the circuit; 2) thorough tightness of the system ″ patient-anesthesia apparatus ″; 3) maintaining a high gas flow in the respiratory circuit for another 2 minutes after the end of the induction of anesthesia and the transition to a maintenance concentration of anesthetic.