Xenon analgesia in children with extensive wounds
V. G. Bagaev,
N. G. Rauschenbach,
V. A. Mitish,
P. V. Medinsky,
V. G. Amcheslavsky,
I. V. Kolesnik,
V. I. Lukyanov,
Yu. V. Bagaeva,
M. A. Dvornikova https://doi.org/10.33667/2078-5631-2021-25-52-57
Abstract
Purpose. To assess the effectiveness of sub-narcotic concentrations of xenon in the local treatment of extensive wounds in children with severe injuries.
Material and methods. 14 patients (average age 9.3 ± 4.0 years) with extensive wounds were taken into the trial. 67 dressings in them were done with 30 % xenon and oxygen. Pain intensity was assessed by the numerical rating scale of pain (NRSp) (1–10 points); sedation depth – by Ramsay scale (1–6 points) and BIS index.
Results. Inhalations of 30 % xenon with oxygen during wound dressings reduced the intensity of pain from Me 3.67 (1.2; 6.0) to Me 2.0 (1.0; 3.3) points by NRSp scale (p < 0.05); after sedanalgesia, it increased again to Me 3.0 (1.0; 5.3). Analgesia with 30 % xenon was effective in 55 (82.0 %) dressings; in 8 (11.9 %) patients with trauma, xenon concentration was increased to 50 %, and in 4 (5.9 %) cases 50 % xenon was added with Fentanyl 1–2 mcg/kg. The depth of sedation assessed by the Ramsay scale decreased (p < 0.05) from 6.0 (5.6; 6.0) to 3.1 (2.2; 4.5) points; after sedanalgesia it increased to Me 5.0 (4.5; 5.4) points. At the same time, the mean value of BIS index decreased (p < 0.05) from 97.5 ± 1.5 to 86.5 ± 5.0 U; after dressing, it rapidly increased to 93.0 ± 2.1 U. During dressings, 82 % of children were calm, had contact with a doctor. Afterwards, their sleep was restored, their mood improved.
Conclusion. Sedanalgesia with xenon in sub-narcotic concentrations is an effective technique to relieve pain during treatment of extensive wounds in children.
About the Authors
V. G. Bagaev
Research Institute for Emergency Pediatric Surgery and Traumatology; Russian Medical Academy for Continuing Professional Education
Russian Federation
Russian Federation
Bagaev Vladimir G., DM Sci, leading researcher of Dept of Anesthesiology and Intensive Care; prof. at Dept of Anesthesiology, Resuscitation and Pediatric Toxicology
Moscow
N. G. Rauschenbach
Research Institute for Emergency Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
Rauschenbach Nikolay G., anesthesiologist-resuscitator of Dept of Intensive Care
Moscow
V. A. Mitish
Research Institute for Emergency Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
Mitish Valery A., PhD Med, associate professor, head of Dept of Purulent Surgery, director
Moscow
P. V. Medinsky
Research Institute for Emergency Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
Medinsky Pavel V., head of Dept of Purulent Surgery
Moscow
V. G. Amcheslavsky
Research Institute for Emergency Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
Amcheslavsky Valery G., DM Sci, professor, head of Dept of Anesthesiology and Intensive Care
Moscow
I. V. Kolesnik
Research Institute for Emergency Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
Kolesnik Irina V., anesthesiologist-resuscitator of Dept of Anesthesiology and Intensive Care
Moscow
V. I. Lukyanov
Research Institute for Emergency Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
Lukyanov Valery I., senior researcher at Laboratories of New Medical Technologies
Moscow
Yu. V. Bagaeva
Research Institute for Emergency Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
Bagaeva Julia V., exercise physician, Rehabilitation Dept
Moscow
M. A. Dvornikova
Research Institute for Emergency Pediatric Surgery and Traumatology
Russian Federation
Russian Federation
Dvornikova Maria A., surgeon of Dept of Purulent Surgery
Moscow
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Review
For citations:
Bagaev V.G., Rauschenbach N.G., Mitish V.A., Medinsky P.V., Amcheslavsky V.G., Kolesnik I.V., Lukyanov V.I., Bagaeva Yu.V., Dvornikova M.A. Xenon analgesia in children with extensive wounds. Medical alphabet. 2021;(25):52-57. (In Russ.) https://doi.org/10.33667/2078-5631-2021-25-52-57
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