Sedation effectiveness evaluation in children with cerebral palsy in the early postoperative period after acute multilevel surgical orthopedic interventions

Евреинов В.В., Томов А.Д., Попков Д.А.

Abstract


Purpose. To make a comparative evaluation of Dexmedetomidine and Midazolam sedative effect in children with cerebral palsy (CP) in the early postoperative period in Resuscitation and Intensive Care Unit (RICU) after performing multilevel acute interventions accompanied by reconstructive procedures of the hip.
Materials and Methods. We made a comparative evaluation of the effectiveness of sedation with Dexmedetomidine and Midazolam in 14 children with CP in the early postoperative period after multilevel acute surgical orthopedic interventions who divided into three comparable groups. Ramsay Scale, Scale of Excitement Evaluation – Richmond sedation used in order to evaluate sedation level. Postoperative analgesia in all the groups performed by 0.2 % Ropivacaine infusion into the epidural space using a previously set epidural catheter.
Results. As demonstrated, the children in the Group 1 (without sedation) were excited, anxious, they felt uncomfortable. In Groups 2 (sedation with Dexmedetomidine) and 3 (sedation with Midazolam) the level of sedation was significantly higher than in the control group, it attained light and moderate levels.
Conclusion. Thus, Dexmedetomidine and Midazolam appeared to be effective preparations to sedate the children with CP staying in RICU in the early postoperative period, and no significant advantages in achieving surface sedation not revealed between them.

Keywords


children, infantile cerebral palsy, orthopedic interventions, postoperative period, sedation

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