ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 4 (2022), ANESTHESIA IN PEDIATRICS
No. 4 (2022)
ANESTHESIA IN PEDIATRICS

Effect of anesthesia on hemodynamics in correction of anorectal abnormalities in children: a randomized study

Published 28.10.2022
Yu.S. Aleksandrovich
Saint Petersburg State Pediatric Medical University, St. Petersburg, Russia
https://orcid.org/0000-0002-2131-4813
G.N. Alimkhanova
Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
https://orcid.org/0000-0001-7304-9102
Konstantin V. Pshenisnov
Saint Petersburg State Pediatric Medical University, St. Petersburg, Russia
https://orcid.org/0000-0003-1113-5296
T.I. Akimenko
Saint Petersburg State Pediatric Medical University, St. Petersburg, Russia
https://orcid.org/0000-0002-5403-1502
S.A. Razumov
Scientific Center of Pediatrics and Pediatric Surgery, Almaty, Kazakhstan
https://orcid.org/0000-0002-3167-4652
#2022-4
PDF_2022-4_125-134 (Russian)
HTML_2022-4_125-134 (Russian)

Keywords

anorectal malformations
anesthesia
hemodynamics
child

How to Cite

1.
Aleksandrovich Y.S., Alimkhanova G.N., Pshenisnov K.V., Akimenko T.I., Razumov S.A. Effect of anesthesia on hemodynamics in correction of anorectal abnormalities in children: a randomized study. Annals of Critical Care. 2022;(4):125-134. doi:10.21320/1818-474X-2022-4-125-134
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver

Download Citation

Endnote/Zotero/Mendeley (RIS) BibTeX

Statistic

Abstract Views: 77
PDF_2022-4_125-134 (Russian) Downloads: 48
HTML_2022-4_125-134 (Russian) Downloads: 32
Statistic from 01.07.2024

Language

English Русский

Most reader

Social Networks

Abstract

INTRODUCTION: Anorectal anomalies are one of the most common congenital malformations in children that require corrective surgical interventions. OBJECTIVE: To study the influence of anesthesia on the hemodynamic indices in the correction of anorectal anomalies in children. MATERIALS AND METHODS: A prospective single-center randomized study. Sixty children were examined, all underwent posterior sagittal anorectoplasty according to Penya. Children were divided into two groups: group 1 — combined anesthesia (n = 30), group 2 — general with regional anesthesia (n = 30). The study included five stages: Stage I — one day before surgery; Stage II — after induction of anesthesia; Stage III — bowel reduction; Stage IV — awakening; Stage V — one day after surgery. Heart rate (HR), systolic and diastolic blood pressure (BP), ejection fraction (EF) and stroke volume (SV) were assessed during the study. RESULTS: It was revealed that at the stage of bowel movement in children where concomitant anesthesia was used, there was a more pronounced decrease of HR (120 vs 106; p < 0.001). Similar changes were characteristic of diastolic BP (48 vs 42; p < 0.001). Mean BP was also significantly lower in the concomitant anesthesia group, and this was statistically significant in both stages III and IV (59.3 vs 54.7, p < 0.001; 61.5 vs 57.0, p < 0.001). In the group where combined anesthesia was used, a decrease in stroke volume was noted at the awakening stage, which was statistically significant compared to the I–III stages. The maximum ejection fraction indices were observed at the stage of bowel lowering against the background of combined anesthesia, which was statistically significant compared to other stages of the study CONCLUSIONS: At the stage of bowel reduction using concomitant anesthesia there was a significant statistically significant decrease of HR and systemic BP which was most probably due to the powerful sympatholytic effect of local anesthetics.

PDF_2022-4_125-134 (Russian)
HTML_2022-4_125-134 (Russian)

References

  1. Gupta D.K. Anorectal Malformations — Wing spread to Krickenbeck. J Indian Assoc Pediatr Surg. 2005; 10: 75–7.
  2. Lawal T.A. Overview of Anorectal Malformations in Africa. Front Surg. 2019; 6: 7. DOI: 10.3389/fsurg.2019.00007
  3. Moore S.W., Sidler D., Hadley G.P. Anorectal malformations in Africa. S Afr J Surg. 2005; 43(4): 174–5.
  4. Theron A.P., Brisighelli G., Theron A.E., et al. Comparison in the incidence of anorectal malformations between a first- and third-world referral center. Pediatr Surg Int. 2015; 31(8): 759–64. DOI: 10.1007/s00383-015-3740-x
  5. Smith C.A., Avansino J. Anorectal Malformations. 2021 Aug 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
  6. Wijers C.H., de Blaauw I., Marcelis C.L., et al. Research perspectives in the etiology of congenital anorectal malformations using data of the International Consortium on Anorectal Malformations: evidence for risk factors across different populations. Pediatr Surg Int. 2010; 26(11): 1093–9. DOI: 10.1007/s00383-010-2688-0
  7. Mundt E., Bates M.D. Genetics of Hirschsprung disease and anorectal malformations. Semin Pediatr Surg. 2010; 19(2): 107–17. DOI: 10.1053/j.sempedsurg.2009.11.015
  8. Teerlink C.C., Bernhisel R., Cannon-Albright L.A., Rollins M.D. A genealogical assessment of familial clustering of anorectal malformations. J Hum Genet. 2018; 63(10): 1029–34. DOI: 10.1038/s10038-018-0487-y
  9. Fuchs M.E., Halleran D.R., Bourgeois T., et al. Correlation of anorectal malformation complexity and associated urologic abnormalities. J Pediatr Surg. 2021; 56(11): 1988–92. DOI: 10.1016/j.jpedsurg.2021.02.051
  10. Ogundoyin O.O., Olulana D.I., Lawal T.A. Experience with the management of anorectal malformations in Ibadan, Nigeria. Pan Afr Med J. 2021; 38: 214. DOI: 10.11604/pamj.2021.38.214.21690
  11. Ameh E.A., Seyi-Olajide J.O., Sholadoye T.T. Neonatal surgical care: a review of the burden, progress and challenges in sub-Saharan Africa. Paediatr Int Child Health. 2015; 35(3): 243–51. DOI: 10.1179/2046905515Y.0000000033
  12. Заболотский Д.В., Корячкин В.А., Ульрих Г.Э. и др. Проект клинических рекомендаций по применению нейроаксиальной анестезии у детей для периоперационной аналгезии. Регионарная анестезия и лечение острой боли. 2017; 4: 279–90. [Zabolotskii D.V., Koryachkin V.A., Ulrikh G.E., et al. Draft of clinical recommendations on the use of neuroaxial anesthesia in children for perioperative analgesia. Regionarnaya аnesteziya i lechenie ostroy boli (Regional Anesthesia and Acute Pain Management, Russian journal). 2017; 11(4): 279–90. DOI: 10.18821/1993-6508-2017-11-4-279-290 (In Russ)]
  13. Кровообращение и анестезия. Оценка и коррекция системной гемодинамики во время операции и анестезии. Под ред. К.М. Лебединского. СПб., 2015. [Krovoobrashhenie i anestezija. Ocenka i korrekcija sistemnoj gemodinamiki vo vremja operacii i anestezii. Pod red. K.M. Lebedinskogo. SPb., 2015. (In Russ)]
  14. Сичкарь С.Ю., Афуков И.И. Эпидуральная анестезия у новорожденных и грудных детей с хирургическими заболеваниями. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2015; 2: 47–53. [Sichkar S.Yu., Afukov I.I. Epidural anesthesia in newborns and infnats with surgical diseases. Russian journal of pediatric surgery, anesthesia and intensive care. 2015; 2: 47–53. (In Russ)]
  15. Александрович Ю.С., Воронцова Н.Ю., Гребенников В.А. и др. Рекомендации по проведению инфузионно-трансфузионной терапии у детей во время хирургических операций. Вестник анестезиологии и реаниматологии. 2018; 2: 68–84. [Aleksandrovich Yu.S., Vorontsova N.Yu., Grebennikov V.А., et al. Recommendations on infusion-transfusion therapy in children undergoing surgery. Messenger of anesthesiology and resuscitation. 2018; 15(2): 68–84. DOI: 21292/2078-5658-2018-15-2-68-84 (In Russ)]
  16. Гржибовский А.М. Типы данных, проверка распределения и описательная статистика. Экология человека. 2008; 1: 52–8. [Grjibovski A.M. Data types, control of distribution and descriptive statistics. Human ecology. 2008; 1: 52–8. (In Russ)]
  17. Кузовлев А.Н., Ядгаров М.Я., Берикашвили Л.Б. и др. Выбор метода статистического анализа. Анестезиология и реаниматология. 2021; (3): 88–93. DOI: 17116/anaesthesiology202103188 [Kuzovlev A.N., Yadgarov M.Ya., Berikashvili L.B., et al. Choosing the right statistical test. Russian Journal of Anaesthesiology and Reanimatology. 2021; (3): 88–93. DOI: 10.17116/anaesthesiology202103188 (In Russ)]
  18. Samantaray D.J., Trehan M., Chowdhry V., Reedy S. Comparison of hemodynamic response and postoperative pain score between general anaesthesia with intravenous analgesia versus general anesthesia with caudal analgesia in pediatric patients undergoing open-heart surgery. Ann Card Anaesth. 2019; 22(1): 35–40. DOI: 10.4103/aca.ACA_215_17
  19. Mercan A., Ture H., Sayin M.M., et al. Comparison of the effect of sevoflurane and halothane anesthesia on the fall in heart rate as a predictor of successful single shot caudal epidural in children. Saudi Med J. 2009; 30(1): 72–6.
  20. Yuki K., Matsunami E., Tazawa K., et al. Pediatric Perioperative Stress Responses and Anesthesia. Transl Perioper Pain Med. 2017; 2(1): 1–12.
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Copyright (c) 2022 ANNALS OF CRITICAL CARE

Most read articles by the same author(s)