Sevoflurane in Anaesthesia of Burn Adult Patients
MÁLEK J.1 ,JANDOVÁ J.1 ,KURZOVÁ A.1 ,ŠIMÁNKOVÁ E.1 ,BROŽ L.2
1 Klinika anesteziologie a resuscitace UK,3.LF,Praha,přednosta doc.MUDr.J.Pachl,CSc. 2 Klinika popáleninové medicíny 3.LF UK,Praha,přednosta MUDr.L.Brož |
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Summary:
Anaesthesia of burn patients is important medical problem.The use of anaesthetics is limited by severe patient conditions,repeated anaesthesia and
necessity of rapid emergence from general anaesthesia to ensure adequate nutrition.The most frequent combination is composed of ketamine,diazepam
and fentanyl.It has some advantages but in higher doses it stimulates the sympathetic system and causes the long period of sleep after anaesthesia,
hallucinations and the development of tolerance.The new inhalational anaesthetic agent –sevoflurane –seems to be anaesthetic of choice because of
its minimal side effects,high speed of onset and recovery and easy control.With this demanding problem in mind we performed the pilot study enrolling
10 patients with repeated anaesthesia.The goal of the study was to verify eligibility of sevoflurane in anaesthesia of burn patients and to compare the
effect of sevoflurane to ketamine.Both types of anaesthesia alternated.Statistical significant differences (ketamine vs sevoflurane)in the study were:
agitation during surgery (43%vs 0%,P<0.05),interval to full awakening after the end of anaesthesia (10.7 min vs 2.9 min,P<0.001),postoperative
sedation (64%vs 0%,P<0.01),psychomimetic reactions after surgery (50%vs 0%,P<0.05),interval to the first oral fluids (76.7 min vs 8.1 min,
P<0.001)and mobilization (110.8 min vs 17 min,P<0.001).The early oral intake on the day of surgery allowed statistical significant higher energy
intake in patients after sevoflurane anaesthesia compared to ketamine anaesthesia (in average of 1645 kJ,P<0.05).
Key words:
anaesthesia of burn patients –ketamine –sevoflurane
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