Kurochkin M. Central neuroaxial anesthesia in newborns and infants

Dissertation is devoted to the investigation of central neuroaxial anesthesia and their modifications wide usage possibilities for improving the quality of anesthesiologic implementation in newborn and infants. Very high level of dye spreading in epidural space was demonstrated by pathomorphologic study on 20 cadavers of newborns. A comparative study of central hemodynamics, oxygen transport, pulmonary hydration, toxemia, markers of humoral and cellular stress defense was conducted in 160 newborns and infants for whom central neuroaxial anesthesia or traditional methods of multi-component anesthesia were used. On the base of clinical and experimental investigations the benefits of more common caudal access usage in intra and postoperative periods of thoracic and abdominal operations in neonates and infants are justified. The safety and considerably higher anti-stress effect of central neuroaxial blocks in comparison with traditional methods of multi-component anesthesia are proven. The perioperative intensive care algorithms with central neuroaxial anesthesia usage are created, that gives an opportunity to decrease narcotic analgesics doses in 6,0±1,1 times, reduce the terms of mechanical lung ventilation and restore intestinal motility to 24 hours of postoperative period.