Varun O. Optimisation premedication and anesthesia from the position of their influence on the higher mental functions in children

12 scientific works were devoted to studying of the influence of pharmacological premedication and psychological preparation on a psycho-emotional conditions of 119 schoolchildren aged 6-11 years and 12-16 years, admitted to the surgery for laparoscopic appendectomy, and also to research of influence of total intravenous anesthesia (propofol/fentanyl) and combined anesthesia using halotane/tiopental/fentanyl on cognitive functions of brain. Research objective. To improve preoperative psychophysiological condition of sick children of school age by improvement of technique of their preparation for surgical interventions and to optimise anaesthesia choice, having studied its influence on the higher cognitive functions of brain in children in the postoperative period. It is shown that all children regardless of their age, before the surgery felt psychoemotional pressure and stress which were more expressed in patients of the senior school age. So the autogenic factor exceeded 20 % and the uneasiness factor on 38 % in comparison with younger schoolchildren. In patients of 6-11 years pharmacological premedication well reduced feeling of alarm and anxiety, and psychological preparation did not reduce psychoemotional pressure and stress. In children of 12-16 years after introduction of the preparations which were a part od premedication, psychological pressure, alarm and anxiety remained still. Thus, the preoperative psychological preparation provided them with good psychoemotional correction. Fentanyl/propofol influenced memory of the children of all age groups, but soon released the central nervous system from their influence. In the postoperative period fast restoration of short-term memory and considerable improvement of indicators of long-term memory were observed. After combined anesthesia (halotane/tiopental/fentanyl) short-term and long-term memory did not reach the initial levels, and perception and thinking indicators in comparison with ТIVA (fentanyl/propofol) in the end of treatment were more low in children of 6-11 years at 11,5 %, and in 12-16 years - at 19,8 %. The algorithm of preparation for children to the surgery and anesthesia was offered, advantages ТIVA vs combined anesthesia were defined.