Лечение делирия после кардиохирургических операций у детей

Аннотация

The aim of the study was to evaluate the effectiveness of using dexmedetomidine for the treatment of delirium in the early postoperative period of cardiac surgery in children. Materials and methods. The study was conducted in 28 children (3*7 years old) who underwent surgery for an atrial (ASD), interventricular (VSD) septal defect under general combined anesthesia (OCA), and 9 children (3-7 years old) with clinical manifestations of delirium in the early postoperative period (POP). Upon admission of children to the ICU, after cardiac surgery, intravenous infusion (50 μg/kg/h) of dexmedetomidine was performed, and analgesic therapy was also carried out: ketoprofen. trimeperidine. The level of sedation was assessed by Ramsay. RASS-scale AJdrete score VAS-scale. In the absence of consciousness, a visual assessment of motor excitation, lacrimation, sweating, negative facial expressions, vocal signs of pain (groans) was carried out. In patients with delirium, the type of delirium, the day of occurrence, the doses of administered drugs, the duration of therapy and the duration of the episode of psychomotor agitation, the incidence of side effects, and the number of days in the ICU were assessed. Results. The use of dexmedetomidine provides a dose-dependent level of sedation and retrograde amnesia with intact verbal contact with the patient, does not cause respiratory depression, reduces the duration of mechanical ventilation, and facilitates care. The need for narcotic analgesics is reduced, since the drug has an independent analgesic effect. The high efficacy of Dexdor in the treatment of delirium continues after the cessation of the infusion of the drug.