Methods of local anesthesia in postoperative anesthesia of oncosurgical operations on the nasopharynx in children

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Abstract

BACKGROUND: Postoperative analgesia should begin even in the operating room, so that at the time of awakening the patient does not experience pain and discomfort. The work is devoted to the problems of postoperative analgesia using local anesthesia techniques in oncosurgery of the nasopharynx in children.

AIM: The aim of the study to analyze the primary results of the use of local anesthesia methods in postoperative analgesia in pediatric oncosurgery of the nasopharynx.

MATERIALS AND METHODS: A study was conducted in the immediate postoperative period (16 hours) in ten patients, whose average age was 14 years with ENT surgical pathology. The physical status of the children corresponded to the I–II class according to the ASA classification. The patients were divided into two equal groups of 5 people: the 1st group included children who, for the purpose of postoperative analgesia at the end of the surgical intervention, underwent conduction anesthesia of the nose from three points according to Weisblat; the 2nd group (comparison group) is represented by patients in whom infraorbital anesthesia was used after surgery. Non-invasive monitoring of systolic and diastolic blood pressure, heart rate was carried out. The oxygen status was monitored by pulse oximetry.

RESULTS: The data obtained from the analysis of hemodynamic parameters, pain assessment by VAS (Visual Analog Scale) testified to the effectiveness of pain relief in patients in the study groups. The main hemodynamic parameters and pain assessment data for the groups were similar to each other and were within the reference values. There were differences in the duration of postoperative analgesia.

CONCLUSIONS: The proposed methods of postoperative analgesia make it possible to abandon the use of narcotic drugs, synthetic opioid analgesics, non-steroidal anti-inflammatory drugs, but not excluding analgesics — antipyretics. The positive first results of this study provide for the need for a further set of observations, possibly in different clinics due to the relative rarity of oncological pathology of the nasopharynx in childhood.

About the authors

Lyudmila S. Korobova

Blokhin Scientific Research Institute of Pediatric Oncology and Hematology

Author for correspondence.
Email: lydmil@bk.ru
ORCID iD: 0000-0003-3047-412X
SPIN-code: 6197-8273

Cand. Sci. (Med.), Anesthesiologist-Intensivist

Russian Federation, 24, Kashirskoye highway, Moscow, 115478

Nune V. Matinyan

Blokhin Scientific Research Institute of Pediatric Oncology and Hematology; Pirogov Russian National Research Medical University

Email: n9031990633@yandex.ru
ORCID iD: 0000-0001-7805-5616
SPIN-code: 9829-6657

Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow

Oleg A. Merkulov

Blokhin Scientific Research Institute of Pediatric Oncology and Hematology

Email: 9166718244@mail.ru
ORCID iD: 0000-0002-8533-0724
SPIN-code: 1492-1083
Scopus Author ID: 382666

Dr. Sci. (Med.)

Russian Federation, Moscow

Vladimir A. Korolev

Blokhin Scientific Research Institute of Pediatric Oncology and Hematology

Email: korolev4@yandex.ru
ORCID iD: 0000-0003-1079-7589
SPIN-code: 9953-6402

Cand. Sci. (Med.)

Russian Federation, Moscow

Vladimir V. Lazarev

Pirogov Russian National Research Medical University

Email: lazarev_vv@inbox.ru
ORCID iD: 0000-0001-8417-3555
SPIN-code: 4414-0677
ResearcherId: P-6234-2015

Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Tatiana A. Ovchar

Morozov Children’s Hospital

Email: Shadum@yandex.ru
ORCID iD: 0000-0001-5764-4016
SPIN-code: 8387-5141

Anesthesiologist-Intensivist, Neonatologist

Russian Federation, Moscow

Vasily P. Akimov

Blokhin Scientific Research Institute of Pediatric Oncology and Hematology

Email: akimovvp87@gmail.com
ORCID iD: 0000-0002-2064-1716
SPIN-code: 5603-4790

Anesthesiologist-Intensivist

Russian Federation, Moscow

Ekaterina A. Kovaleva

Blokhin Scientific Research Institute of Pediatric Oncology and Hematology

Email: mel_amory@mail.ru
ORCID iD: 0000-0001-9492-034X
SPIN-code: 7122-7508

Anesthesiologist-Intensivist

Russian Federation, Moscow

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Landmarks for pterygopalatine anesthesia (arrow indicates injection site)

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3. Fig. 2. Infiltration anesthesia of the nose from three points according to Weissblatt: а — bridge of the nose; b — left point

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4. Fig. 3. Infraorbital anesthesia

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5. Fig. 4. Dynamics of hemodynamic parameters in group 1 in the postoperative period: ADsist — systolic blood pressure; ADdiast — diastolic arterial pressure; HR — heart rate; SpO2 — level of blood oxygen saturation

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6. Fig. 5. Dynamics of hemodynamic parameters in group 2 in the postoperative period: ADsist — systolic blood pressure; ADdiast — diastolic arterial pressure; HR — heart rate; SpO2 — level of blood oxygen saturation

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