Infiltrative analgesia of the skin flap in children with craniosynostosis after reconstructive surgery on skull bones

Author:

Pulkina O. N.1,Ivanov V. P.1,Gurskaya V. I.1,Parshin E. V.2

Affiliation:

1. Almazov National Medical Research Center

2. Pavlov First Saint Petersburg State Medical University

Abstract

The objective of the study is to evaluate the effectiveness of analgesia by infiltration of the skin flap with local anesthetic in children with craniosynostosis after reconstructive surgery.Materials and subjects. 50 children with craniosynostosis, who underwent reconstructive surgery on skull bones, were divided into two groups based on the method of postoperative anesthesia: in Group 1(experimental), the infiltration of the skin flap was used within multimodal anesthesia, while in Group 2, it was standard parenteral use of analgesic drugs. In the postoperative period, pain severity was assessed by FLACC scales, the amount of opioid and non-opioid analgesics consumed was assessed by the formalized Analgesiс Assessment Scale (FSA), and non-invasive hemodynamic monitoring (BP, HR) was performed.Results. The statistical analysis of the results revealed significant differences between groups in the assessment results of FSA and FLACC scales. In Group 1, the level of postoperative pain was significantly lower compared to Group 2. The amount of opioid and non-opioid analgesics consumed was also significantly lower in Group 1.Conclusion. The use of the infiltration of the skin flap as part of multimodal analgesia in children with craniosynostosis, after reconstructive surgery on skull bones significantly reduces the intensity of pain and the amount of opioid analgesics consumed in the postoperative period.

Publisher

New Terra

Subject

Anesthesiology and Pain Medicine,Critical Care and Intensive Care Medicine,Emergency Medicine

Reference12 articles.

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3. [Lechenie posleoperatsionnoy boli – kachestvennaya klinicheskaya praktika: obschie rekomendatsii i printsipy uspeshnogo lecheniya boli]. Treatment of postoperative pain – quality clinical practice: General recommendations and principles of successful treatment of pain. A.M. Ovechkin, transl. and eds., Moscow, AstraZeneka Publ., 2006, 55 p.

4. [Obezbolivanie vzroslykh i detey pri okazanii meditsinskoy pomoschi: metodicheskie rekomendatsii]. Anesthesia of adults and children in the provision of medical care: guidelines. Moscow, 2016, 94 p.

5. Pulkina O.N., Kuklin D.V., Kalinin Yu.V., Bragilevskiy V.M. et al. Formalization of the account of analgesics in patients with spine disorders. Khirurgiya Pozvonochnika, 2017, no. 1, pp. 89‒90.(In Russ.)

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