[Peripheral regional block role in orthopedics in pediatric patients with cerebral palsy].

Haemodynamics of 58 Pediatric patients with cerebral palsy was studied during combined anaesthesia based on sevoflurane and peripheral nerve block. Sevoflurane and peripheral nerve block with infusion support 14-15 ml/kg/ hr provide stable cardiac output during orthopedic surgeries in Pediatric patients with cerebral palsy. Excessive arterial hypotension and total peripheral vascular resistance decrease were registered in older patients as results of more pronounced vascular effect of anaesthetics in patients with decreased adaptive-compensatory possibilities and insufficient infusion support. The proposed anaesthesia method provides adequate intraoperative analgesia, fast recovery and comfortable postoperative period.

[Anesthesia in surgical treatment of patients with cerebral palsy (a review)].

Anesthesia in surgical treatment and anesthetization in post operative period in patients with children cerebral palsy (CCP) is considered as an actual problem due to some specific features. The authors review the current state of the problem in aspects of efficacy and setting priorities in the development of methods of anesthesia in patients with CCP. Some methods of anesthesia, positive and negative sides of their application in CCP are characterized.

[Epidural use of electrostimulation catheters in a complex of balanced anesthesia in patients with infantile cerebral paralysis].

The paper presents the results of epidural blocks using Arrow electrostimulation catheters in 25 patients with infantile cerebral paralysis for anesthetic provision of reconstructive orthopedic operations. The findings lead to the conclusion that epidural anesthesia with electrostimulation catheters provides a high anesthesia quality and safety.

[Methods of anesthesia during surgical treatment for scoliosis in children].

Various anesthetic methods during surgical simultaneous double-stage correction of scoliotic deformity in the spine were analyzed in 73 children. Analgesic quality was assessed from central hemodynamics and some biochemical parameters of stress, the volume of blood loss, and the number of complications. Forty children were operated on under general sevofluorane + fentanyl anesthesia and artificial ventilation. In 33 children, this general anesthesia mode was added by epidural analgesia with 1% morphine solution in 10-12 ml of a solvent. Epidural morphine analgesia used in the complex of general anesthesia upgraded the quality of nociceptive defense, substantially decreased the consumption of systemic narcotic analgesics, an anesthetic, and relaxants, lowered blood loss by 10%, and reduced the number of postoperative complications by 20%.

[Central hemodynamic reactions to exercise in patients with infantile cerebral paralysis as a possibility of choosing a procedure for anesthesia and predicting its course].

The major parameters of physical development and central hemodynamics were studied in children suffering from moderate and severe infantile cerebral paralysis (ICP) at rest and after routine exercise. Examinations were made in 2 groups of children: 1) 15 patients aged 3 - 8 years (5.4 +/- 0.49 years); 15 patients aged 9 - 16 years (13.3 +/- 0.97 years). The children' height in the young group was an average 12% less; their hemodynamic changes followed the hyperdynamic type with an increase in cardiac index (CI) (by 49% higher than the normal values) due to stroke index. In the old group, SI was increased by 32% of the normal value due to tachycardia with normal growth-height indices. In ICP patients, central hemodynamic parameters were linked with the pathogenesis of the disease and should be taken into account while choosing an anesthetic mode in the surgical correction of the locomotor apparatus.

[Combined regional anesthesia of the lower extremities in children with cerebral paralysis].

The authors share their first experience of combined regional anesthesia during surgical interventions into the lower extremities in children with infantile cerebral paralysis (ICP). A hundred and twenty-five blocks were performed in patients aged 5 to 20 years. Lidocaine, marcaine, naropine, or a mixture of lidocaine and marcaine mixture, were used. The paper describes the specific features of techniques for femoral-sciatic nerve blocks in these patients, shows the adequacy of anesthesia at surgery and the very good course of the postoperative period due to continuous analgesia and the alleviation of muscle spasticity in the operated limb.

[Central hemodynamic changes in children reoperated on for congenital spinal cord hernia using balanced anesthesia based on midasolam and propofol].

The central hemodynamics was studied and analyzed in 51 patients reoperated on for congenital spinal cord hernia under balanced anesthesia based on midasolam and proforol. The procedure for anesthesiological provision of replastic repair of operated spinal hernia, which is based on propofol of bolus administration of midasolam with a hypnotic appliance, was found to cause no negative hemodynamic effects. When the benzodiazepine antagonist flumazenyl is used, the interval between the end of surgery and tracheal extubation is virtually identical in the propofol and midasolam groups since the intravenous injection of flumazenyl induces a drastic awakening effect.