RT Journal Article
SR Electronic
T1 Continuous epidural ropivacaine infusion reduces intra-abdominal pressure, postoperative pain and normalizes lungs' mechanical changes in critically ill children after major abdominal operation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1092
VO 42
IS Suppl 57
A1 Dmytro Dmytriiev
A1 Olexander Mazulov
A1 Nataliia Kosechenko
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P1092.abstract
AB Background: We aimed to study the influence of prolonged infusion of ropivacaine on postoperative pain, intra-abdominal pressure (IAP) and mechanical lungs' changes that may happen in children.Methods: First group (14 patients) we used for analgesia morphine hydrochloride (0,1 mg/kg), second (10 patients) - infusion of continuous epidural ropivacaine 0,2%. Interdependency of lungs' mechanical characteristics with effectiveness of post-operative analgesia and abdominal wall relaxation was studied in the way of continuous monitoring of dynamic compliance (Cdyn), pressure-volume and flow-volume loops. We measured blood level of cortisol, analyzed subjectively postoperative pain syndrome using visual analogue scales (VAS). IAP was controlled by Cron. For statistic analysis we used Student's t-test.Results: In the first group the increase of IAP (14,4±1,2 vs 5,2±0,6 cm H2O, second group). Levels of pain according to VAS were variable in first group, increase of cortisol levels in first group (670,3 ± 34,4 nmol/l, vs 230,4 ± 20,2 nmol/l, second group). Periods with high traumatic effects and poor analgesia (morphine group) reasoned the increase of IAP, Cdyn decreasing in 3,4 times, resistance in 2,2 times and PIP rising till 22,1± 1,4 cm H2O and maximum changes in graphic monitor.Conclusions: To provide adequate analgesia in peri-operative period is better to give prolongation epidural infusion of ropivacaine, because it results in stability of IAP, prevents pain, decreases intra-abdominal hypertensive mechanisms, gives the possibility to lungs function in physiological conditions.