I СЪЕЗД
детских анестезиологов
-
реаниматологов
Республики Узбекистан с международным участием
62
ADVANTAGES OF MULTIMODAL ANALGESIA WITH
PARACETAMOL AND IBUPROFEN IN PEDIATRIC ABDOMINAL
SURGERY
Kuralov E.T.
National Children
’
s Medical Center, Tashkent, Uzbekistan
Introduction.
Enhancing the effectiveness of preoperative pain
management in children remains a crucial task in modern pediatric surgery.
Particular attention is given to the combination of paracetamol and ibuprofen,
which, by acting on different pain mechanisms, provides powerful and prolonged
analgesic effects with minimal side effects. Combining these drugs significantly
reduces the need for opioids, thus decreasing the incidence of opioid-related
complications such as respiratory depression and postoperative nausea
[Friedrichsdorf SJ et al., 2015; Sing QW et al., 2017].
Objective.
To evaluate the effectiveness and safety of multimodal analgesia
(MMA) using paracetamol and ibuprofen in children undergoing abdominal
surgical procedures.
Materials and Methods.
The study included 68 children aged 6 to 17 years
who underwent abdominal surgeries at the National Children
’
s Medical Center in
Tashkent from 2021 to 2023. The patients in the main group (n=38) received
combined perioperative analgesia using paracetamol and ibuprofen, while the
comparison group (n=30) received standard endotracheal anesthesia and
postoperative analgesia with promethazine. The main regimen included prophylactic
administration of paracetamol (15-20 mg/kg) and ibuprofen (10 mg/kg) before
surgery, followed by repeated administration of ibuprofen 6-8 hours later.
Results.
Children in the main group who received paracetamol and
ibuprofen showed a significant reduction in the intensity of postoperative pain
syndrome (PPS) and a decrease in inflammatory response, as evidenced by more
stable hemodynamic parameters and lower levels of C-reactive protein (CRP) in
the early postoperative period. In the comparison group, marked increases in
hemodynamic indicators and blood glucose were observed, indicating insufficient
intraoperative protection. The transition from the intraoperative to the
postoperative stage was smooth in 70% of the patients in the main group,
confirming the effectiveness of the selected multimodal approach.
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лечении глаукомы у детей в условиях комбинированного наркоза.
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