PROSPECTS OF THE XENON ANESTHESIA IN PEDIATRIC SURGERY

Effective and safe anesthesia is the especially important problem in pediatric anesthesiology. The authors present data on the relatively new drug — xenon. Results of the investigations of both foreign and Russian scientists are cited. The mechanism of action of xenon and its effect on systemic and cerebral circulation and central nervous system, hemostasis, and other systems are demonstrated. The authors pay special attention to the factors responsible for the restricted use of the gas in general practice, indicate the peculiarities of its use in pediatric practice.Key words: xenon, the mechanism of action, anesthesia, advantages, disadvantages, impact on the body, children

PROSPECTS OF THE XENON ANESTHESIA IN PEDIATRIC SURGERY

Effective and safe anesthesia is the especially important problem in pediatric anesthesiology. The authors present data on the relatively new drug — xenon. Results of the investigations of both foreign and Russian scientists are cited. The mechanism of action of xenon and its effect on systemic and cerebral circulation and central nervous system, hemostasis, and other systems are demonstrated. The authors pay special attention to the factors responsible for the restricted use of the gas in general practice, indicate the peculiarities of its use in pediatric practice.Key words: xenon, the mechanism of action, anesthesia, advantages, disadvantages, impact on the body, children

COMPARATIVE EVALUATION OF THE ADEQUACY OF ANESTHESIA WITH XENON AND SEVOFLURANE IN CHILDREN SURGERY

Xenon have been used as an anesthetic in the Russian Federation for 11 years in anesthesia in adult patients. In April 2010, the permission of the Ministry of Health and Social Development for the clinical studies evaluating the efficacy and safety of medical xenon anesthesia in children based on the Institute of Emergency Children’s Surgery and Traumatology had been received. Xenon in pediatric anesthesiology is of a special interest because it has properties equivalent to an «ideal anesthetic». To assess its effectiveness in anesthesia in children 42 patients aged 1 to 18 years were included in the study. A comparative assessment of the adequacy of anesthesia with xenon and sevoflurane has been conducted. At different stages of the research in addition to clinical parameters the level of growth hormone and cortisol were measured. The study showed that anesthesia with xenon was different from sevoflurane by hemodynamic stability, and both have a high level of anesthetic anti-stress activity. Key words: anesthesia with xenon, stress hormones, anesthesia in children. (Pediatric pharmacology. — 2011; 8 (6): 77–81)

ПЕРСПЕКТИВЫ КСЕНОНОВОЙ АНЕСТЕЗИИ В ДЕТСКОЙ ХИРУРГИИ

Effective and safe anesthesia is the especially important problem in pediatric anesthesiology. The authors present data on the relatively new drug — xenon. Results of the investigations of both foreign and Russian scientists are cited. The mechanism of action of xenon and its effect on systemic and cerebral circulation and central nervous system, hemostasis, and other systems are demonstrated. The authors pay special attention to the factors responsible for the restricted use of the gas in general practice, indicate the peculiarities of its use in pediatric practice.Key words: xenon, the mechanism of action, anesthesia, advantages, disadvantages, impact on the body, children.Эффективное и безопасное обезболивание является важной проблемой в детской анестезиологии. Авторы представляют данные об относительно новом препарате — ксеноне. Приводятся результаты исследований как зарубежных, так и российских ученых. Представлены механизм действия ксенона, его влияние на системное и церебральное кровообращение, центральную нервную систему, гемостаз и другие системы. Авторы обращают внимание и на те факторы, которые обусловливают ограничение использования данного газа в широкой практике; указывают особенности его применения в детской практике.Ключевые слова: ксенон, механизм действия, анестезия, преимущества, недостатки, влияние на организм, дети. (Педиатрическая фармакология. — 2011; 8 (4): 87–91

COMPARATIVE EVALUATION OF THE ADEQUACY OF ANESTHESIA WITH XENON AND SEVOFLURANE IN CHILDREN SURGERY

Xenon have been used as an anesthetic in the Russian Federation for 11 years in anesthesia in adult patients. In April 2010, the permission of the Ministry of Health and Social Development for the clinical studies evaluating the efficacy and safety of medical xenon anesthesia in children based on the Institute of Emergency Children’s Surgery and Traumatology had been received. Xenon in pediatric anesthesiology is of a special interest because it has properties equivalent to an «ideal anesthetic». To assess its effectiveness in anesthesia in children 42 patients aged 1 to 18 years were included in the study. A comparative assessment of the adequacy of anesthesia with xenon and sevoflurane has been conducted. At different stages of the research in addition to clinical parameters the level of growth hormone and cortisol were measured. The study showed that anesthesia with xenon was different from sevoflurane by hemodynamic stability, and both have a high level of anesthetic anti-stress activity. Key words: anesthesia with xenon, stress hormones, anesthesia in children. (Pediatric pharmacology. — 2011; 8 (6): 77–81)

Gastric duplication in a teenager: A case report

Introduction: A duplication cyst (DC) of the gastrointestinal (GI) tract is a rare developmental anomaly of the digestive system. The latency and variability of clinical manifestations hamper the physician's ability to make the correct diagnosis, often leading to a marked delay in diagnosing the disease. The patient in the current report repeatedly sought medical help for four years before the correct diagnosis was made. Case presentation: A 14-year-old boy was admitted to the emergency department complaining of abdominal pain and repeated vomiting. A more thorough history revealed that similar pain accompanied by vomiting of gastric contents had been periodically noted for the last four years. According to the parents, the boy has had a poor appetite throughout the period, resulting in minor weight loss. On physical examination, the patient's abdomen was not distended and could be examined with only moderate pain on deep palpation in the epigastric and right mesogastric regions. To exclude perforation of a hollow organ and intestinal obstruction, plain abdominal radiography in two standing projections was performed, which showed no free air under the diaphragm and no features characteristic of intestinal obstruction. Ultrasonography of the abdomen, in the area of the major curve of the stomach near the head and body of the pancreas, revealed a cystic mass with echogenic contents 40 × 30 mm in size. The patient underwent an esophagogastroduodenoscopy (EGD). In the antrum, along the posterior gastric wall, there was an ovoid-shaped mass measuring about 40 × 30 mm and covered with smooth pink mucosa. According to the MRI, there was a clearly outlined cystic mass, 38 x 36 × 40 mm in size. A complete examination allowed for the diagnosis of a gastric DC and a decision was made to perform laparoscopic surgery. The laparoscopy was performed under general anesthesia using the three-port technique. The duplication cyst in the stomach was removed laparoscopically. The course of the postoperative period was smooth. Conclusion: The latency and variability of clinical manifestations of gastric DC in children complicate the correct diagnosis and lead to a delay in definitive diagnosis. Modern imaging techniques allow for diagnosing rare GI pathology before surgery. Minimally invasive surgical techniques facilitate the early recovery of patients

СРАВНИТЕЛЬНАЯ ОЦЕНКА АДЕКВАТНОСТИ АНЕСТЕЗИИ КСЕНОНОМ И СЕВОФЛУРАНОМ У ДЕТЕЙ В ПЛАНОВОЙ ХИРУРГИИ

Xenon have been used as an anesthetic in the Russian Federation for 11 years in anesthesia in adult patients. In April 2010, the permission of the Ministry of Health and Social Development for the clinical studies evaluating the efficacy and safety of medical xenon anesthesia in children based on the Institute of Emergency Children’s Surgery and Traumatology had been received. Xenon in pediatric anesthesiology is of a special interest because it has properties equivalent to an «ideal anesthetic». To assess its effectiveness in anesthesia in children 42 patients aged 1 to 18 years were included in the study. A comparative assessment of the adequacy of anesthesia with xenon and sevoflurane has been conducted. At different stages of the research in addition to clinical parameters the level of growth hormone and cortisol were measured. The study showed that anesthesia with xenon was different from sevoflurane by hemodynamic stability, and both have a high level of anesthetic anti-stress activity. Key words: anesthesia with xenon, stress hormones, anesthesia in children. (Pediatric pharmacology. — 2011; 8 (6): 77–81).На территории Российской Федерации в течение 11 лет при анастезии у взрослых пациентов в качестве анестетика используется ксенон. В апреле 2010 г. получено разрешение Минздравсоцразвития РФ на проведение клинических исследований по оценке эффективности и безопасности медицинского ксенона при анестезиях у детей на базе НИИ неотложной детской хирургии и травматологии. К ксенону в детской анестезиологии проявляется особый интерес, поскольку он по своим свойствам приравнивается к «идеальному анестетику». Для оценки его эффективности при анестезиях у детей в исследование были включены 42 пациента в возрасте от 1 года до 18 лет. Проводилась сравнительная оценка адекватности анестезии ксеноном и севофлураном. На разных этапах исследования помимо клинических показателей определялся уровень соматотропного гормона и кортизола. Исследование показало, что анестезия с использованием ксенона отличается от анестезии севофлураном гемодинамической стабильностью, при этом оба анестетика обладают высоким уровнем антистрессорной активности. Ключевые слова: анестезия ксеноном, гормоны стресса, анестезия у детей. (Педиатрическая фармакология. — 2011; 8 (6): 77–81)