Comparative assessment of hemodynamic parameters during anesthesia in orthopedic and traumatological operations on the lower extremities in children

   Objective. To conduct a comparative analysis of hemodynamic parameters during orthopedic and traumatological operations on the lower extremities in children performed under conditions of multicomponent balanced general and combined anesthesia.

   Materials and methods. A single-center prospective study. The present study included 60 children aged 6 to 17 years who underwent planned orthopedic and trauma surgery interventions on the lower extremities. Patients were divided into two groups depending on the method of anesthesia: Group 1 (n = 25) - multicomponent balanced general anesthesia, Group 2 (n = 35) - combined anesthesia (multicomponent balanced general anesthesia in combination with regional blocks of the sciatic and femoral nerves). To solve these problems, a comparative analysis of heart rate, systolic, diastolic and mean arterial blood pressure was carried out at seven stages of the study: 1^st stage - initial, child on the operating table; 2^nd stage - induction of anesthesia; 3^rd stage - placement of the laryngeal mask; 4^th stage - start of the operation; 5^th stage - traumatic stage of the operation; 6^th stage - completion of the operation; 7^th stage - after removal of the laryngeal mask.

   Results. In all cases, the surgical interventions were successful. The study found that in the group of children who underwent multicomponent general anesthesia at the 4^th (start of surgery), 5^th (traumatic stage of surgery) and 6^th (end of surgery) stages, heart rate (HR) was higher compared to the group of combined anesthesia. Systolic and mean arterial blood pressure during the traumatic phase of surgery were also higher in children undergoing multicomponent general anesthesia. The values of diastolic blood pressure did not differ between groups throughout the study with the exception of the 3^rd stage (laryngeal mask placement) where lower values were observed in patients of the Group 1. Diastolic blood pressure values did not differ between groups throughout the study, with the exception of 3^th stage (laryngeal mask placement), where lower values were noted in Group 1 patients.

   Conclusion. Combined methods of anesthesia based on the combination of multicomponent general anesthesia and conductive peripheral nerve blocks provide the greatest hemodynamic stability during orthopedic and traumatologic surgeries on the lower extremities in children.

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