PEDİATRİK OFTALMOLOGİYADA MƏRKƏZİ HEMODİNAMİK GÖSTƏRİCİLƏRƏ ƏSASƏN OPTİMAL ANESTEZİYA ÜSULUNUN SEÇİLMƏSİ

Abstract

SUMMARY

Purpose. Comparative evaluation and choice of the optimal method of anaesthesia rely on the central
hemodynamics findings in pediatric ophthalmology using multicomponent ketamine narcosis (MCKN) and ketofol
with intubation by LMA.

Materials and methods
Research was performed from 2010-2011 in pediatric department of the National
Ophthalmology centre named by acad. Zarifa Aliyeva, Baku. The operations were performed in one eye in 48
children, at the age from 8 to 15 years.20 from these patients were girls, 28 were boys. 25 patients were subjected MCKN, 23 patients were subjected ketofol with intubation by LMA.

Results
Using MCKN for ophthalmosurgery, after intravenous injection of ketamine leads to hyperkinetic
type of hemodynamics, independently of primary state of hemodynamics. The following injections of ketamine
every 30-40 minutes in appropriate doses brings to the stimulation of the hemodynamics.
However, ketofol with intubation by LMA leads to decrease of the cardiac output and heart rate. Increase of
the heart rate in children in the preoperative period is a reason of the emotional excitement, so making sedative
injection very important. For the sedation we had injected propofol which decreases heart rate and the average
arterial pressure, and the stroke volume and the minute stroke remained unchangeable. According to above we
can make a conclusion that MCKN leads to hyperkinetic type of hemodynamics ketofol with intubation by LMA
unlike the MCKN brings to normokinetic type of hemodynamics, that in its turn played a big role in the prophilaxis
of the intraoperative complications(for example oculovisceral reflex).

Conclusion
Thereby, we can conclude that during pediatric ophthalmology operations the method ketofol
with intubation by LMA is atraumatic, less invasive, provide adequate airway, ventilation of the lungs and the
oxygenation. This method of anaesthesia as compared with MCKN influence lesser is less function to the central
hemodynamics and is simple method, which don’t take a lot of time.