NEW TYPE OF ANAESTHESIA WITH SEVOFLURAN
IMPROVES SURGICAL AND POST-SURGICAL COURSE OF
BURNS TREATMENT (IGA 6116/2)
Málek J.1, Šimánková E.1, Jandová J.1, Brož L.2
1Clinic of Anaesthesiology and Resuscitation and 2Clinic of Burns Medicine, 3rd School of Medicine, Charles University, Prague, Czech Republic |
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Souhrn:
The objectives of this open-perspective clinical study were to test the effect of a new type of anaesthesia using
sevofluran during surgical treatment of patients with burns, and to compare it with that of ketamin, at present the
most frequently used anaesthetic. The study, conceived as a pilot study, was performed on 10 paediatric and 8
adult patients with 2nd degree burns covering between 7% and 35% of body surface. Owing to highly significant
differences in parameters in favour of sevofluran, it was recommended by our ethical committee not to increase
the number of patients. The parameters considered were ease of induction, undesirable effects, span of time before
oral administration of liquids. Daily uptake of energy was measured for both types of anaesthetics in another
group of 10 patients. In adult patients the two anaesthetics, ketamin versus sevofluran, differed in terms of incidence
of unrest during surgery (ketamin 50% vs. sevofluran 0%, p<0.05), time between end of surgery and return
to full consciousness (11.3 min. vs. 2.7 min. p< 0.001), post-surgical inhibition (75% vs. 0%, p<0.01) psychomimetic
reactions after surgery (50% vs. 0%, p<0.05), time until first intake of liquids (86.7 min. vs. 8.5 min,
p<0.001), and mobilisation (110.8 min. vs. 17 min., p<0.001). In paedriatic patients, differences in speed of onset
of anaesthesia (216 sec. vs. 66 sec., p<0.001) and time until first uptake of liquids (75 min. vs. 22 min., p<0.001)
were statistically significant. Apart from problems associated with anesthesia, another considerable advantage of
the new anaesthetic sevofluran was a significantly increased uptake of calories after use than was the case after
ketamin (1645 kJ higher on the average, p<0.05). Based on these results, sevofluran was introduced to burns surgery
as a routine anaesthetic.
Klíčová slova:
treatment of burns, anaesthesia of burn casualties, post-surgical course
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