MODERN TRENDS IN ANESTHETIC MANAGEMENT IN SURGERY OF ENT ORGANS
Keywords:
septoplasty, surgical field, anesthesia, analgesia, adjuvants.Abstract
Introduction. Nowadays, the issues of improving anesthesiology support of surgical interventions in ENT practice remain relevant. And many questions of anesthesia, perioperative analgesia, hemostasis, regulation of the autonomic nervous system require further solutions. Aim. To study the features and possibilities of improving general anesthesia for plastic surgery of the nasal septum using new adjuvants. Materials and methods. We studied the indicators of 89 patients who underwent septoplasty under intravenous anesthesia (propofol, fentanyl, tracrium) with mechanical ventilation + local anesthesia (lidocaine). The patients were divided into 3 groups - “Control” (n = 28), “Paracetamol” (n = 31) and “Dexmedetomidine” (n = 30). Such indicators as the evaluation of the surgical field by the surgeon on a 10-point scale and its correlation with other indicators, the duration of the operation and anesthesia, the dose of anesthetics and analgesics were studied. Results. In the group of patients who underwent dexmedetomidine infusion, an operative field within 9.87 ± 0.06, in the paracetamol group - 6.03 ± 0.09, in the control group - 5.04 ± 0.14, respectively (p <0.001 ) was evaluated. The duration of anesthesia and surgery, the dose of propofol and fentanyl were less in the paracetamol group and significantly less in the dexmedetomidine group (p <0.001). In patients of all groups, a high degree of inverse correlation was observed between the evaluation of the operative field by the surgeon and the volume of blood loss, the duration of the operation, the duration of general anesthesia, the dose of analgesics and anesthetics (p <0.001). Соnclusion. The use of new adjuvants in the composition of anesthetic management of the nasal septum plastics leads to improved visualization of the surgical field during surgery, reducing the time of surgery and general anesthesia, reducing the dose of analgesics and anesthetics.
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