CHANGES IN THE INDICATORS OF ABDOMINAL ARTERIAL CIRCULATION WHEN APPLYING VARIOUS ANESTHETIC TECHNIQUES IN CHILDREN

Abstract

Intra-abdominal hypertension and abdominal compartment syndrome result from increased intra-abdominal pressure. In addition, intra-abdominal hypertension has been reported to be an independent risk factor for pediatric intensive care unit mortality.The study aimed to compare the efficacy and the effect of various anesthetic techniques using regional anesthesia on the indicators of abdominal arterial circulation in anterior abdominal wall surgery in children.Materials and Methods. The study included 90 children at the age of 7-18 years. All children underwent anterior abdominal wall surgery under general anesthesia and were divided into 3 groups: Group I included 30 children who underwent anterior abdominal wall surgery under general anesthesia using morphine; Group II comprised 30 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block combined with the quadratus lumborum block 4 via a single injection; Group III included 30 children who underwent anterior abdominal wall surgery under general anesthesia using the TFPB.The manuscript was approved by the Ethics Committee of the Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”, as evidenced by an Excerpt from the Minute of the Committee Meeting No. 2 dated February 24, 2022.The results obtained were statistically processed using statistical measures of variation, correlation analysis, Student’s t-test. Differences were considered statistically significant at p<0.05. The proportions were statistically compared by using a z-test.The study is a fragment of the research project of the Department of Children Diseases of Postgraduate Medical Education Faculty, Ivano-Frankivsk National Medical University “Health Status and Adaption of Children from the Precarpathian Region with Somatic Diseases, Their Prevention” 2021-2026, state registration number 0121U111129; the author is a co-researcher.Results and Discussion. The analysis of acute pain on the selected scales found significantly higher indicators of acute pain on the FLACC scale in the group of conventional anesthesia (Group I, p<0.001) as compared to Group II, where the TFPB in combination with the QLB-4 was used. The analysis of the Likert scale responses found that, over the course of treatment, there was a significant reduction in pain indicators among patients of Group II as compared to those in Group I and Group III (p<0.001). High pain intensity in children who received conventional anesthesia led to a prolonged length of hospital stay and increased IAP (FLACC scale (rx,y=0.38±0.16, р=0.02).Conclusions. A combination of regional anesthesia techniques and conventional anesthesia leads to a reduction in IAP, and increase in APP, a decrease in the resistance index in the superior mesenteric artery and shortens the length of hospital stay as compared to conventional anesthesia management.