Inhalation anesthesia and stress in children with oncological pathology

Background. Children with cancer undergo many operations and procedures that require anesthesia in the acute phase of disease or during remission. An integral element a safe plan is consideration direct tumor effects. The localization process, features body child suffering from cancer, his reaction to stressful situation force an anesthesiologist select anesthetic carefully consider all possible complications anesthesia. Many researchers have compared effects different analgesics anesthetics, especially sevoflurane propofol, namely their effect on pain, ability prevent reduce intraoperative stress, as well postoperative recovery adverse after various surgical interventions. However, comparative study propofol treatment cancers children has not been conducted. aim study: сompare analgesic anti-stress inhalation intravenous by studying hemodynamic response, level cortisol, proinflammatory cytokines, heart rate variability indicators. Materials methods. We examined forty-nine (the first group) who were treated surgically. They divided into two subgroups depending type care — sevoflurane/fentanyl (n = 26) propofol/fentanyl 23). In structure interventions, laparotomy removal prevailed (36 children). Thoracic performed 13 oncological cases. To compare characteristics patients 49 second operated for traumatological pathologies included examination. Hemodynamic indicators (heart rate, systolic, diastolic blood pressure, mean arterial pulse pressure), number circulating cells, including neutrophils, lymphocytes, platelets, C-reactive protein interleukin-6, necrosis factor, plasma cortisol evaluated. activity autonomic nervous system was measured using variability. Results. During anesthesia, pressure had same direction decreased observed patients, but more sevoflurane. stress use lower Against background these increased 286.80 nmol/l (interquartile range 244.90–374.50), 303.20 299.90–398.60; p 0.0494). Similar dynamics difference its increase 7 %. Heart showed neither nor changed power low-frequency component spectrum. Only group value “very” spectrum indicated sympathetic division (p < 0.05). Conclusions. It still say convincingly about any advantage between reducing cancer. duration, degree potentially large physiological disorders should determine choice appropriate anesthetic.