[Evaluation of psychological methods for determining the degree of psychological stress in children in dentistry].

The article deals with results of comparative evaluation of system of assessment of children's fear and anxiety in dentistry (SDS test) and other objective and subjective methods for assessing anxiety in pediatric patients. We studied 381 pediatric patients aged from 3 to 7 years. The aim of the study was to prove validity mathematical derived FCD test as a technique of anxiety detection in dentistry. During the study following subjective test were used: MAS, DAS, mYPAS, VAS, STAI, STAIC, EASI, PHBQ, and some history data and stress factors were also considered. Objective data used were vital signs (hemodynamics and respiratory rate). Test SDS has strong correlation with YALE, MAS, DAS, STAIlich, VAS and other parameters such as age, sex, person which is responsible for bringing up a child and so on.

[Combined spinal epidural anesthesia in abdominal surgery].

The use of combined spinal epidural anesthesia (CSEA) in 37 patients during operations on abdominal organs has revealed a number of advantages of the procedure over endotracheal anesthesia. CSEA reduces the consumption of analgesics and myorelaxants and the time of postoperative artificial ventilation and offers the prospect of more qualitative analgesia.

[Oral premedication in ambulatory surgical otorhinolaryngology in children]. / Peroral'naia premedikatsiia v ambulatornoi khirurgicheskoi otorinolaringologii u detei.

34 children selected into two groups due to age (patients from 4 to 7 year old were included in the 1st group, the 2nd group consisted of children, aged from 8 years to 14 years, were premedicated with dormicum, and in other 37 patients standard premedication was applied. The state of cardiovascular system was estimated by means of indices of central hemodynamics and heart rate monitoring data. Every patient was examined both before and 30 minutes after premedication. While standard premedication activates central hemodynamics, increases, especially in older children, left ventricular performance, premedication with dormicum influence neither indices of central hemodynamics nor left ventricular performance, and causes moderate sympatical activation by dormicum in dose of 0.5 mg/kg, appearing to be effective in children of any age and can be used in ambulatory surgical otorhinolaryngology in children.

[State of central hemodynamics in various kinds of anesthesia during short-term ENT surgery in children]. / Sostoianie tsentral'noi gemodinamiki pri razlichnykh vidakh anestezii vo vremia kratkovremennykh LOR-operatsii u detei.

The study was carried out in 124 children aged 4-10 years with ASA risk I or II. Group 1 consisted of 40 patients operated on under combined anesthesia with midazolam, fentanyl, and N2O, group 2 were 30 children operated on under mask anesthesia with fluothane, and nitric oxide + oxygen, group 3 patients were operated on under combined anesthesia with ketamine, midazolam, and N2O + CO2, and group 4 patients were operated on under thiopental and N2O + CO2. Cardiovascular function was evaluated by the NCCOM3-R-7 device (BoMed) by the bioimpedance method. Satisfactory cardiovascular function was observed in all groups, but the best stability was noted in the midazolam-fentanyl group. Hence, midazolam-fentanyl combination can be the method of choice in short-term ENT operations.

[Oral dormicum premedication of children in day surgery]. / Peroral'naia premedikatsiia dormikumom u detei v odnodnevnom khirurgicheskom statsionare.

Thirty-four patients aged 5-14 years were observed, divided into age groups OF 5-8 and 8-14 years. Cardiovascular function was evaluated by central hemodynamic parameters and cardiointervalography. Changes in external respiration parameters were studied. The efficacy of premedication was assessed by objective parameters and by clinical signs. Each patient was examined 4 times at the following stages: 1) before premedication; 2) at the 10th min; 3) at the 20th min; and 4) at the 30th min. Oral premedication with dormicum in a dose of 0.5 mg/kg did not affect heart rate or arterial pressure. By the 20th min it notably decreased total peripheral resistance, significantly decreased the respiratory volume, increased respiration rate, and decreased sympathetic tone in younger children. In older children the premedication virtually did not affect total peripheral resistance and facilitated heart work, increased the respiratory volume, rarefied the respiratory rate, and did not affect the autonomic regulation balance. Younger children fell asleep without excitation or negativism; 35.2% developed psychomotor reactions. In older group the effect was good in 71.1% children, the rest had "apparitions" starting from the 17th min: doubling of the staff's faces, white spiders, or white moths.

[Clinical picture of awakening after general anesthesia with midazolam, propofol, ketamine and fluothane in children treated at one-day ambulatory facility]. / Klinicheskaia kartina perioda probuzhdeniia posle obshchei anestezii s ispol'zovaniem midazolama, propofola, ketamina i ftorotana u detei v statsionare odnogo dnia.

The study was carried out in 75 children aged 6-12 years with the physical status ASA I. The operations were performed on the lymphadenoid throat ring in a one-day setting. Awakening after anesthesia was evaluated by the following parameters: time between the end of intervention and extubation of the trachea, opening the eyes when asked, transportation from the operation room into the ward, and first dialogue with the doctor. A system of evaluating the level of recovery of respiration, motor activity, and consciousness by Aldret and Kroulik's score was used for objective assessment of the data. Postoperative pain and discomfort were evaluated using Hannallah's score in all age groups. The most rapid recovery of muscle tone, defense reflexes, and higher functions of the brain was observed in the patients anesthesized with propofol; adequate doses of narcotic analgetics during short-term interventions ensured satisfactory analgesia and psychological condition during the immediate postoperative period.

[Central hemodynamics in conditions of combined intravenous anesthesia using propofol and ketamine in pediatric ophthalmology]. / Tsentral'naia gemodinamika v usloviiakh kombinirovannoi vnutrivennoi anestezii s ispol'zovaniem propofola i ketamina v oftal'mologicheskoi praktike u detei.

A total of 152 patients aged 4-14 years at risk of ASA I or II were examined. Planned operations were carried out: correction of myopia, strabismus, and eyelid ptosis. The patients were divided into 4 groups: 1) 54 patients operated on under combined anesthesia (propofol infusion and ketamine bolus), 2) 60 children operated on under combined anesthesia by ketamine and propofol infusions, 3) 24 patients operated on under ketamine + seduxene infusion narcosis, and 4) 34 children in whom ketamine and seduxen were injected in boluses. All operations were carried out under conditions of spontaneous respiration. Central hemodynamic parameters were studied by tetrapolar chest rheography with NCCOM3-R7 device (BIOMED). Methods of combined anesthesia with diprivan (propofol) are indicated for children subjected to ophthalmological surgery as methods with the minimum effects on the hemodynamics and ensuring adequate anesthesiological protection as regards the clinical and hemodynamic status.