Infiltrative analgesia of the skin flap in children with craniosynostosis after reconstructive surgery on skull bones
https://doi.org/10.21292/2078-5658-2019-16-6-37-45
Abstract
The objective of the study is to evaluate the effectiveness of analgesia by infiltration of the skin flap with local anesthetic in children with craniosynostosis after reconstructive surgery.
Materials and subjects. 50 children with craniosynostosis, who underwent reconstructive surgery on skull bones, were divided into two groups based on the method of postoperative anesthesia: in Group 1(experimental), the infiltration of the skin flap was used within multimodal anesthesia, while in Group 2, it was standard parenteral use of analgesic drugs. In the postoperative period, pain severity was assessed by FLACC scales, the amount of opioid and non-opioid analgesics consumed was assessed by the formalized Analgesiс Assessment Scale (FSA), and non-invasive hemodynamic monitoring (BP, HR) was performed.
Results. The statistical analysis of the results revealed significant differences between groups in the assessment results of FSA and FLACC scales. In Group 1, the level of postoperative pain was significantly lower compared to Group 2. The amount of opioid and non-opioid analgesics consumed was also significantly lower in Group 1.
Conclusion. The use of the infiltration of the skin flap as part of multimodal analgesia in children with craniosynostosis, after reconstructive surgery on skull bones significantly reduces the intensity of pain and the amount of opioid analgesics consumed in the postoperative period.
Keywords
Supporting agencies: The authors express their deepest gratitude to the intensive care specialists, who participated in this study: D. D. Gryaznov, E. S. Savina, K. V. Berezkina
About the Authors
O. N. Pulkina
Almazov National Medical Research Center
Russian Federation
Russian Federation
Olga N. Pulkina – Anesthesiologist and Emergency Physician of Pediatric Anesthesiology and Intensive Care Department no. 3.
2, Akkuratova St., St. Petersburg, 197341
V. P. Ivanov
Almazov National Medical Research Center
Russian Federation
Russian Federation
Vadim P. Ivanov – Neurosurgeon of Pediatric Neurosurgery Department.
2, Akkuratova St., St. Petersburg, 197341
V. I. Gurskaya
Almazov National Medical Research Center
Russian Federation
Russian Federation
Viktoria I. Gurskaya – Anesthesiologist and Emergency Physician of Pediatric Anesthesiology and Intensive Care Department no. 3.
2, Akkuratova St., St. Petersburg, 197341
E. V. Parshin
Pavlov First Saint Petersburg State Medical University
Russian Federation
Russian Federation
Evgeniy V. Parshin – Doctor of Medical Sciences, Professor, Professor of Anesthesiology and Intensive Care Department.
6-8, Lva Tolstogo St., St. Petersburg, 197022
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Review
For citations:
Pulkina O.N., Ivanov V.P., Gurskaya V.I., Parshin E.V. Infiltrative analgesia of the skin flap in children with craniosynostosis after reconstructive surgery on skull bones. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2019;16(6):37-45. (In Russ.) https://doi.org/10.21292/2078-5658-2019-16-6-37-45
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