md-medicaldata

Authors

 

Dragan Turanjanin¹, Anna Uram Benka^1,2, Gordana Turanjanin Tomić¹, Nikola Bošković<sup>1,2

1</sup>Institut za zdravstvenu zaštitu dece i omladine Vojvodine
²Univerzitet u Novom Sadu, Medicinski fakultet Novi Sad

 

UDK: 616-089.5-053.2
616-083.98-053.2

The paper was received / Rad primljen: 01.11.2023.

Accepted / Rad prihvaćen: 21.11.2023.

 

Correspondence to:

Dragan Turanjanin
Tome Maretića 55, Petrovaradin;
Tel/Phone: 065 3503609
e-mail: dturanjanin@icloud.com

 

 

Sažetak

 

 

Hitna hirurška stanja su svakodnevna, a neretko su životno ugrožavajuća. Uloga anesteziologa u proceni, zbrinjavanju i stabilizaciji bolesnog deteta je od izuzetnog značaja, međutim, timski pristup lečenju bolesnog deteta je imperativ. Iako se većina zahvata planira, postoje i operativni zahvati koji su neodložni i zahtevaju hitan odlazak u operacionu salu. Aspiracija stranog tela, bilo u disajni put, ili jednjak, je glavni uzrok morbiditeta i mortaliteta kod male dece, posebno mlađe od tri godine. Hipertrofična stenoza pilorusa, ingvinalna kila i apendicitis su najčešća stanja digestivnog sistema koja zahtevaju brz hirurški tretman. Ostala stanja, poput hidrcefalusa, posttonzilektomijskog krvarenja, traumatskih lezija i otvorenih preloma takođe iziskuju brzo saniranje. Anesteziolog uvek pretpostavlja da je dete punog stomaka, te uz obebeđen venski put, dete uvodi u svim navedenim stanjima u opštu anesteziju. Disajni put treba obezbediti endotrahealnim tubusom, a tehnika brzog uvoda se najčešće sprovodi kako bi se smanjio rizik od aspiracije želudačnog sadržaja. Za održavanje anestezije koriste se volatilni ili intravenski anestetici u zavisnosti od mogućnosti i samih karakteristika pacijenta. Na kraju hirurške intervencije, ukoliko uslovi dozvoljavaju, dete se ekstubira i postoperativni monitoring se nastavlja, uz adekvatnu analgeziju bilo na odeljenju, bilo u jedinici intenzivne terapije. Dobra preoperativna priprema i procena, adekvatna stabilizacija, korekcija poremećaja, monitoring, izbor anestezije i prevencija i tretman komplikacija značajno doprinose ishodu hitnog hirurškog stanja.

 

Ključne reči:

hitna hirurška stanja; anestezija; intravenski put; deca.

 

 

 

Abstract

 

Emergency surgical conditions are not rare and are often life-threatening. The role of the anesthesiologist in the assessment, care and stabilization of a sick child is of exceptional importance, and furthermore, a team approach to the treatment of a sick child is imperative. Although most interventions are elective, there are also surgical conditions that are urgent and require an immediate intervention in the operating room. Aspiration of a foreign body, either into the airway or esophagus, is a major cause of morbidity and mortality in young children, especially those under three years of age. Hypertrophic pyloric stenosis, inguinal hernia and appendicitis are the most common conditions of the digestive system that require prompt surgical treatment. Other conditions, such as hydrocephalus, post-tonsillectomy bleeding, traumatic lesions and open fractures also require adequate treatment. The anesthesiologist always assumes that the child has a full stomach, and with the venous line secured, the child is introduced to general anesthesia in all of the aforementioned conditions. The airway should be secured with an endotracheal tube, and the rapid introduction technique is most often performed to reduce the risk of aspiration of gastric contents. To maintain anesthesia, volatile or intravenous anesthetics are used, depending on the possibilities and the characteristics of the patient. At the end of the surgical intervention, if conditions allow, the child is extubated and postoperative monitoring continues, with adequate analgesia. Good preoperative preparation and assessment, stabilization of the patients general condition, correction of disorders, monitoring, choice of anesthesia and prevention and treatment of complications significantly contribute to the outcome of an emergency surgical condition.

 

Key words:

emergency surgical conditions; anesthesia; intravenous line; children.

 

 

 

 

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PDF: 06-Turanjanin D. et al MD-Medical Data 2023;15(3) 095-100.pdf