[CAUSES AND PREVENTION OF POSTOPERATIVE NAUSEA AND VOMITING AFTER ADENOTONSILLECTOMY IN CHILDREN IN THE GENERAL ANESTHESIA].

The aim of the research is to determine the reasons of post operative nausea and vomiting and to compare the efficiency of taken PONVprophylaxis after adenotonsillectomy with general anesthesia in children. 155 patients took part in the research work at the age from 3 to 10 years, of ASAI-II physical status, who were operated on in planned order because of adenotonsillectomy. The patients were divided into 5 groups according to the type of holding PONV prophylaxis. The 1-st group consisted of 30 patients who were given antiemetic--Metoclopramidum (0.15 mg/kg); the 2-nd group (30 patients) was given ondansetronum (0.1 mg/kg); the 3-d group also consisted of 30 patients who were given Dexamethasone (0.2 mg/kg, but not more than 8 mg); the 4-th included 30 patients who were given Dexamethasone (0.2 mg/kg, but not more than 8 mg) and Metoclopramidum (0,15 mg/kg) as the antiemetic; the 5-th group the test one, included 35 patients who were not given PONVprophylaxis. During the first day after the operation the amount of nausea and vomiting have been estimated, the time of occurrence and the character of vomiting. According to the results of the research the PONV in postoperative period consisted 22.6% in which in 13.6% vomiting with blood was pointed out during coming out from general anesthesia, and in early post operative period (p < 0.01), which is connected with blood swallowing on the phase of awaking or possible postoperative bleeding. According to given prophylaxis the least number of PONV is revealed in the group which was given ondansetronum, and the high frequency of post operative nausea and vomiting was pointed out in the group which wasn't given prophylaxis of PONV.

[AIRWAY MANAGEMENT IN CHILDREN DURING RESECTION OF THE TONSILS].

MATERIALS AND METHODS: We conducted a comparative evaluation of anesthesia used during tracheal intubation with and without the application of muscle relaxants in cases of adenotonsillectomy in children. Intubation parameters were evaluated according to Cormack-Lehane scale; the presence of cough reflex, limb movement, laryngospasm and desaturation during intubation was also taken into account. The presence of cough, husky voice, and complaints of pain in the throat were recorded in the monitoring report after extubation. We used the MOPS scale to evaluate postoperative pain and discomfort in children. RESULTS: Tracheal intubation in children with adenotonsillectomy without the use of muscle relaxants was successfid in 100% of the cases, despite the fact that, according to the Cormack-Lehane classification, first degree of visualisation of the glottis during direct laryngoscopy was observed in 79.3% of the cases and the second degree was observed in 20.7% of the cases. No significant reactions in the cardiovascular system to the endotracheal tube were noted. The group without the use of muscle relaxants (p < 0.05) experienced earlier extubation and a shorter duration of anesthesia, which in turn contributed to a more rapid activation of the patients. According to the number of post-intubation complications, no significant differences in the two groups were observed. According to the MOPS scale, higher scores (p < 0.05), indicating discomfort in the early postoperative (within the first 15 minutes after the operation) period were observed in the group with the use of muscle relaxants. CONCLUSIONS: Thus, the method of tracheal intubation without the use of muscle relaxants can be used for adenotonsillectomy in children.

[Efficiency assessment of preoperative preparatory programs in pediatric patients in dentistry].

Research objective was to compare the efficiency of different preoperative preparatory programs which had been used for anxiety decrease in Pediatric patients before oral cavity sanation with general anaesthesia. Two preparatory programs were used. In the first program patients were informed about the treatment they were undergoing. Patients visited the operating unit and watched the videos about forthcoming procedure (group of Information Technologies (IT), n = 82). The second program included the tutorials (face mask use, acquaintance with equipment alarms etc.) in addition to Information Technologies (group of lnformation Technologies and tutorials (ITT) n = 83). Information Technologies and tutorials were not used in the control group (n = 86). Both used programs were effective. ITT program was the most effective.

[Contemporary opinion about anticholinergics use in premedication].

The article deals with the analysis of publications which discuss anticholinergics use in premedication. The article briefly says about the use history and characteristics of anticholinergics. In conclusion the article stresses the need to abandon the routine anticholinergics use. Intravenous anticholinergics application is preferable if there are indications for its use. New inhalation and intravenous anaesthetics promote to prescribe the anticholinergics individually

[Postoperative behavior syndrome in dental practice in children].

The literature contains numerous publications on the issue of Postoperative Behavior. The purpose of this study was to obtain installment of the objective data on the occurrence of Postoperative Behavior in dental profile patients depending on various factors. Age of the children who underwent the study ranged from 3 to 5 years. The study group included 531 patients, while the control group contained 103 children who were treated independently. During the hospital admission patient's parents were asked to fill in the appropriate grading systems, such as MAS, DAS, STAI, mYPAS and PHBQ, the general information table was filled in as well, which, in addition to general demographic characteristics, considered factors such as: age, number of unsuccessful attempts to sanate the oral cavity, the number of caries, etc. The most important factors that are strongly correlated with the development of PHBQ, were statistically considered as r < 0.1 and p > 0.005. Number of the unsuccessful attempts to cure the child by a dentist forms a phobic syndrome of dental treatments, manifestation of which are different psychosomatic disorders inherent to Postoperative Behavior.

[BIS-monitoring of sedative therapy of children in intensive care units].

The depth of sedation was studied in children at intensive care units. Sixty-five children aged 4 to 14 years who had severe purulent abdominal processes and somatic diseases were examined. The depth of sedation was recorded by BIS monitoring and the Ramsey clinical sedation scale was used to make a clinical evaluation. Changes caused by relanium administration were observed in two groups. Midazolam was given in Group 3. There were differences when these agents were administered. The depth of sedation was found to depend on the given dose of an agent.