Temperature after surgery - is this normal? This question may arise for any patient who has undergone surgery. The results of thermometry, that is, measuring body temperature, are the data on which the doctor relies when assessing the patient’s condition over time. High numbers indicate the occurrence of fever, but additional examination is required to establish the exact cause. Increase in temperature after surgery - nonspecific symptom, occurring in a variety of conditions, not all of which can be called a disease.

Postoperative fever is considered to be an increase in temperature above 38.5 °C, which is recorded at least 2 times during the first 24 hours after completion of the operation.

However, body temperature during development postoperative complications may be low-grade - it depends on the type of pathology, age and condition of the patient, and a number of additional factors. Therefore, other criteria for determining fever are used - an increase in temperature of more than 37.2 °C in the morning and more than 37.7 °C in the evening.

Temperature after surgery in a child or adult may be due to:

1. Infection.
2. Phlebothrombosis.
3. Thyrotoxic crisis.

In some cases, fever is explained by immune disorders, the development of a rejection reaction after transplantation, the presence of a neoplasm, exacerbation of chronic concomitant diseases. An increase in temperature combined with a decrease blood pressure characteristic of acute adrenal insufficiency.

In the first hours after surgery on the stomach or other organ, the temperature may rise due to trembling. Severe shivering occurs as a compensatory reaction if, during surgery, the body experiences heat loss (intraoperative hypothermia) due to low temperature in the operating room, the administration of anesthetics, transfusion of solutions and the use of breathing mixtures that were not sufficiently warmed. The temperature reaches 38-39 °C and returns to normal after the shaking stops.

Temperatures within 37.1-37.4 °C after abdominal and thoracic surgery may persist for several days. If the patient feels satisfactory, there are no pathological changes in the area surgical wound, there is no reason to think about infection or other complication.

Symptoms

Fever is usually accompanied by:

1. General malaise, drowsiness.
2. Trembling, chills, followed by a feeling of heat.
3. Decreased or lack of appetite.
4. Loss of body weight.
5. Pain in muscles, joints.
6. Increased skin sensitivity.

Increased blood pressure and tachycardia (increased heart rate) are classic symptoms of a temperature reaction.

In some diseases they are absent, but the opposite phenomenon may occur - bradycardia.

Infection

Infection is one of the most common causes of fever after surgery. knee joint or another option surgical intervention. To the group of frequently encountered infectious complications include:

• surgical wound infection;
• urinary tract infections;
• respiratory system infections.

According to clinical observations, the assumption of infection is more correct the later the fever appears.

In the first hours after lung surgery, the temperature is non-infectious origin, but if a febrile reaction occurs on the second day and beyond, it is necessary to include infectious pathology in the diagnostic search.

The likelihood of developing complications largely depends on the degree of bacterial contamination of the wound.

Temperature after surgery abdominal cavity for appendicitis is observed, as a rule, with delayed intervention and the presence of peritonitis. If the lumen of the digestive, respiratory and urinary tract is opened, the wound is considered conditionally contaminated, the risk of purulent infection increases by 5-10% compared to a clean wound surface (during prosthetics, hernia repair). Open fractures and fecal peritonitis belong to the group of contaminated wounds, in which infection is observed in almost 50% of cases.

In addition to wound infection, complications can be caused by artificial ventilation of the lungs (pneumonia), use of urethral catheter(cystitis), venous access (thrombophlebitis). Temperature after removal surgery gallbladder above 38.5 °C should suggest a probable purulent infection (liver abscess, subphrenic abscess, peritonitis). List of probable infectious diseases, one way or another related to surgical intervention, is quite wide. It is necessary to assume infection if there is elevated temperature after surgery, pain, redness and swelling in the area of ​​the surgical wound, the presence of purulent discharge.

It is necessary to pay attention not only to the presence of fever.

It is important to evaluate its duration, time of occurrence, the presence of sharp drops and rises in temperature, as well as symptoms indicating the location of the lesion.

For example, if the temperature after heart surgery is combined with weakness, chills and the appearance of heart murmurs, there is reason to suspect infective endocarditis.

The basis of treatment is antibacterial therapy. If the infection is associated with the urethral or venous catheter, it must be removed. When a purulent focus (abscess, phlegmon) forms, surgical intervention is required.

Phlebothrombosis

During anesthesia, the activity of the blood coagulation system increases and blood flow slows down. Phlebothrombosis is a likely complication general anesthesia with the use of muscle relaxants, it is more often observed in patients over 40 years of age. The risk of blood clots in the veins increases with a large volume of surgery, duration of surgical intervention over 4 hours, obesity, varicose veins of the lower extremities. A symptom of thrombosis may be fever after surgery to remove a tumor.

Clinical manifestations of deep vein thrombosis of the lower extremities:

1. Weakness, increased body temperature.
2. Swelling and pain in the limb.
3. Pale or bluish coloration of the skin.

Patients need bed rest, elevated position and elastic bandaging of the limb. Anticoagulants (fraxiparin, heparin, phenylin) and antiplatelet agents (chirantil, trental) are prescribed. Thrombolysis (dissolution of a blood clot by administering streptokinase, streptase) is used according to strict indications due to the risk of bleeding. Removal of a blood clot can also be done surgically.

Thyrotoxic crisis

One of the most likely endocrine disorders in the postoperative period is thyrotoxic crisis - a condition caused by a sharp increase in hormone levels thyroid gland in blood.

Occurs in patients with diffuse toxic goiter in case of untimely detection of pathology and/or lack of adequate therapy. During surgery, the body experiences stress associated with anesthesia and surgery - this is a trigger for the development of thyrotoxic crisis. The following symptoms are observed:

High temperature after surgery thyroid gland, intestines and other organs, which is a manifestation of thyrotoxic crisis - an indication for emergency medical care. Thyreostatic drugs (mercazolyl), beta blockers (anaprilin, propranolol), glucocorticosteroids (prednisolone), and infusion therapy are used.

What I didn't like:

1. The cost of treatment is very high. (2700 per tooth with pulpitis, 500 rubles examination by a pediatrician, 500 rubles insurance, 300 rubles examination by a dentist before treatment).
2. Pulpitis was found in eight teeth that we treated. I DO NOT BELIEVE. Lower teeth he had quite decent, ordinary caries (they said so in two different clinics). (It’s just easier to treat pulpitis (killed the nerve, drilled it out and that’s it), and more expensive). In general, there are doubts that these were all pulpitis, but there is no evidence.
3. The examination by a pediatrician before anesthesia did not seem complete enough to me. They measured the temperature, listened to the heartbeat, looked at the outpatient card from the clinic and that’s it. (or is that how it should be?)
4. Oooh, I didn’t like the anesthesia itself... The child was still scared. I was going through. After anesthesia (but it depends on everyone), the child vomited heavily and was lethargic. (Although I saw many children waking up, getting up and going home cheerful). And after the second anesthesia, we were completely terrified. :(In the evening, a high temperature rose, they called an ambulance. True, everyone says in unison that this is not from anesthesia or filling materials. But before the treatment, the child was absolutely healthy. The temperature quickly subsided, without medication. In the morning the child was in in perfect order. So it remains a mystery.
5. Yes, before anesthesia, not eating or drinking for 4 hours, it was painful, especially not drinking.

What I liked:

1. Made very well, you can’t even see that these are fillings. As the doctors said, our child has teeth like a Hollywood star.
2. The fillings were given an eternal guarantee, i.e. If something happens to the filling (a piece falls off, for example), it will be repaired for free. (These teeth will last up to 12 years, so the guarantee is quite decent).
3. Still, in such a short period of time, all the teeth were cured at once - this is a plus. I can’t imagine how much time it would take, and, in general, nerves (considering the child’s fear), if done locally one at a time.
4. Polite staff. (Everything is told and shown). Be attentive to the child.
5. The clinic is clean, beautiful, there is a playroom and cartoons and toys for you.
6. Now I have a discount card with a 10% discount. And free checkups for a year.

So that's how things are. Now I will have the most thorough control over my child’s teeth. If treatment or anesthesia is required, of course, I don’t want to do any more! I’d rather hold him by force if we don’t persuade him. I was scared from the anesthesia, he felt bad, I don’t want any more.
Sorry, everything is written a little chaotically, I just got home from work and wrote in a hurry.

Should you panic when you hear the word “anesthesia”? Should you be afraid? general anesthesia, and if so, what is its danger to the child? What could be the consequences of such anesthesia? Let's find out.

General anesthesia for a child

The baby will undergo surgery under general anesthesia. But just the thought of anesthesia makes you shiver. This happens to many parents. And all because a lot of rumors and conjectures are swarming around general anesthesia. It's time to find out once and for all which of this is true and which is an absolute myth.

What are the dangers of general anesthesia for a child?

Many parents believe that general anesthesia is very dangerous for a child, but they don’t know why. The main fear is that the baby will not wake up after surgery. Such cases do occur - in one situation out of a hundred. And as a rule, death is in no way connected with anesthesia. In the vast majority of such cases, death occurs as a result of the operation itself.

So what is the danger of general anesthesia for a child? We can talk about the negative only in the context of contraindications. The doctor is obliged to analyze them thoroughly. And only after analysis, the physician makes a decision about whether there is an urgent need for general anesthesia or not. As a rule, extensive anesthesia is never prescribed unnecessarily. Especially for children.

To perform general anesthesia, the doctor mandatory must obtain parental permission. But before you refuse him this, think about it. Many operations on the younger generation are performed under general anesthesia. This is necessary in order to avoid psycho-emotional consequences.

The main purpose of anesthesia is to save the child from having to attend his own operation.

Local anesthesia will allow the baby to see blood, open wounds and a lot of other unsightly things. How this will affect the fragile psyche is difficult to predict.

Consequences of general anesthesia for children

General anesthesia sometimes entails unpleasant consequences for children. The attending physician will definitely warn you about them before the operation. Based on this information, mom and dad will decide whether extensive anesthesia is necessary.

How does general anesthesia affect a child? How can it manifest itself after surgery?

• Headache,
• dizziness,
• panic attacks,
• memory loss,
• convulsions,
• heart failure,
• kidney problems and liver problems.

All of the listed consequences sometimes have no place at all in the life of a small patient. Some people experience short-term headache. Some people experience seizures a few days after surgery calf muscles. This does not mean that all of the listed conditions will “attack” the child without fail and en masse, no. It's just possible consequences extensive anesthesia. They may not exist at all. This is why it is so important to trust your doctor. Hardly good specialist will advise the child on what is not necessary. And if there is a need, then it is probably much more acute than all the consequences combined.

General anesthesia is a procedure by which the patient’s autonomic reactions are suppressed, turning off his consciousness. Despite the fact that anesthesia has been used for a very long time, the need for its use, especially in children, causes a lot of fears and concerns among parents. What are the dangers of general anesthesia for a child?

General anesthesia: is it really necessary?

Many parents are sure that general anesthesia is very dangerous for their child, but they cannot say exactly why. One of the main fears is that the child may not wake up after the operation.. Such cases have indeed been recorded, but they occur extremely rarely. Most often, painkillers have nothing to do with them, and death occurs as a result of the surgery itself.

Before performing anesthesia, the specialist obtains written permission from the parents. However, before abandoning its use, you should think carefully, since some cases require the mandatory use of complex anesthesia.

Typically, general anesthesia is used if it is necessary to turn off the child’s consciousness, to protect him from fear, pain and prevent the stress that the baby will experience while attending his own operation, which can negatively affect his still fragile psyche.

Before using general anesthesia, the specialist identifies contraindications, and also makes a decision: is there really a need for it.

Drug-induced deep sleep allows doctors to perform lengthy and complex surgical procedures. The procedure is usually used in pediatric surgery when pain relief is vital., for example, with severe congenital heart defects and other abnormalities. However, anesthesia is not such a harmless procedure.

Preparation for the procedure

It is wiser to prepare your baby for the upcoming anesthesia in just 2-5 days. For this purpose he is prescribed sleeping pills and sedatives, which affect metabolic processes.

About half an hour before anesthesia, the baby can be given atropine, pipolfen or promedol - drugs that enhance the effect of the main anesthetic drugs and help avoid them negative impact.

Before performing the manipulation, the baby is given an enema and the contents of the bladder are removed. 4 hours before the operation, the intake of food and water is completely excluded, since during the intervention vomiting may begin, in which the vomit can penetrate the organs of the respiratory system and cause respiratory arrest. In some cases, gastric lavage is done.

The procedure is performed using a mask or a special tube that is placed in the trachea. Together with oxygen, anesthetic medicine is supplied from the device. In addition, intravenous anesthetics, alleviating the condition of a small patient.

How does anesthesia affect a child?

Currently the probability of severe consequences for the child’s body from anesthesia is 1-2%. However, many parents are confident that anesthesia will negatively affect their baby.

Due to the characteristics of the growing body, this type of pain relief in children proceeds somewhat differently. Most often, clinically proven drugs of a new generation are used for anesthesia, which are approved in pediatric practice. Such drugs have a minimum of side effects and are quickly removed from the body. That is why the influence of anesthesia on the child, as well as any negative consequences, is minimized.

Thus, it is possible to predict the duration of the effect of the dose of the drug used, and, if necessary, repeat anesthesia.

In the vast majority of cases, anesthesia alleviates the patient's condition and can help the surgeon's work.

The introduction of nitric oxide, the so-called “laughing gas,” into the body leads to the fact that children who have undergone surgery under general anesthesia most often do not remember anything.

Diagnosis of complications

Even if a small patient is well prepared before surgery, this does not guarantee the absence of complications associated with anesthesia. That is why specialists should be aware of all the possible negative effects of drugs, common dangerous consequences, probable causes, as well as ways to prevent and eliminate them.

Adequate and timely identification of complications that arise after the use of anesthesia plays a huge role. During the operation, as well as after it, the anesthesiologist must carefully monitor the baby’s condition.

To do this, the specialist records all the manipulations performed and also enters the test results into a special card.

The card must indicate:

• heart rate indicators;
• breathing rate;
• temperature readings;
• the amount of blood transfused and other indicators.

These data are strictly recorded hourly. Such measures will allow you to identify any violations in a timely manner and quickly eliminate them..

Early consequences

The effect of general anesthesia on the child’s body depends on the individual characteristics of the patient. Most often, the complications that arise after the baby returns to consciousness are not much different from the reaction to anesthesia in adults.

The most commonly observed negative consequences are:

• the appearance of allergies, anaphylaxis, Quincke's edema;
• heart disorder, arrhythmia, incomplete blockade His bundle;
• increased weakness, drowsiness. Most often, such conditions go away on their own, after 1-2 hours;
• increase in body temperature. It is considered normal, but if the level reaches 38 ° C, there is a possibility of infectious complications. Having identified the cause of this condition, the doctor prescribes antibiotics;
• nausea and vomiting. These symptoms are treated with the use of antiemetics, for example, cerucal;
• headaches, feeling of heaviness and squeezing in the temples. Usually do not require special treatment, but with prolonged pain symptoms a specialist prescribes painkillers;
• painful sensations V postoperative wound. A common consequence after surgery. To eliminate it, antispasmodics or analgesics can be used;
• fluctuations in blood pressure. Usually observed as a result of large blood loss or after a blood transfusion;
• falling into a coma.

Any drug used for local or general anesthesia can have a toxic effect on the patient’s liver tissue and lead to liver dysfunction.

Side effects of anesthesia agents depend on the specific drug. Knowing about all the negative effects of the medicine, you can avoid many dangerous consequences, one of which is liver damage:

• Ketamine, often used in anesthesia, can provoke psychomotor overexcitation, seizures, and hallucinations.
• Sodium hydroxybutyrate. May cause convulsions when used in large dosages;
• Succinylcholine and drugs based on it often provoke bradycardia, which threatens to stop the activity of the heart - asystole;
• Muscle relaxants used for general anesthesia may lower blood pressure.

Fortunately, severe consequences occur extremely rarely.

Late complications

Even if the surgical intervention went without complications, no reactions to the drugs used occurred, this does not mean that there was no negative impact on the child’s body. Late complications may appear after some time, even after several years..

Dangerous long-term consequences include:

• cognitive impairment: memory disorder, difficulty logical thinking, difficulty concentrating on objects. In these cases, it is difficult for the child to study at school, he is often distracted, and cannot read books for a long time;
• attention deficit disorder, hyperactivity. These disorders are expressed by excessive impulsiveness, a tendency to frequent injuries, restlessness;
• susceptibility to headaches, migraine attacks, which are difficult to suppress with painkillers;
• frequent dizziness;
• the appearance of convulsive contractions in the leg muscles;
• slowly progressive pathologies of the liver and kidneys.

The safety and comfort of surgical intervention, as well as the absence of any dangerous consequences, often depend on the professionalism of the anesthesiologist and surgeon.

Consequences for children 1-3 years old

Due to the fact that the central nervous system in children early age is not fully formed, the use of general anesthesia can negatively affect their development and general condition. In addition to attention deficit disorder, pain relief can cause brain disorders, and lead to the following complications:

• Slow physical development. Medicines used in anesthesia can disrupt the formation parathyroid gland responsible for the growth of the baby. In these cases, he may lag behind in growth, but subsequently is able to catch up with his peers.
• Psychomotor development disorder. Such children learn to read late, have difficulty remembering numbers, pronounce words incorrectly, and construct sentences.
• Epileptic seizures. These disorders are quite rare, but several cases of epilepsy have been identified after surgical interventions using general anesthesia.

Is it possible to prevent complications?

It is impossible to say for sure whether any consequences will arise after the operation in children, as well as at what time and how they may appear. However, you can reduce the likelihood of negative reactions in the following ways:

• Before the operation, the child’s body must be completely examined. having passed all the tests prescribed by the doctor.
• After surgery, medications should be used to improve cerebral circulation, as well as vitamin and mineral complexes prescribed by a neurologist. The most commonly used are B vitamins, piracetam, and Cavinton.
• Carefully monitor the baby's condition. After the operation, parents need to monitor its development even after some time. If any deviations appear, you should once again visit a specialist to eliminate possible risks.

Having decided to carry out the procedure, the specialist compares the need for it with the possible harm. Even after learning about possible complications, you should not refuse surgical procedures: not only the health, but also the life of the child may depend on this. The most important thing is to be attentive to his health and not self-medicate.

At my daughter's inguinal hernia. We were diagnosed almost from birth, but the hernia did not bother us at all. Now the child is 2.6 years old, and the doctor is already insisting on surgery. I am very worried about general anesthesia. I'm worried how my daughter will cope with it. Tell us... I’m very worried... What are the consequences of anesthesia for a child at this age? I read that general anesthesia affects a child’s intelligence and brain function (especially in young children under 4 years old) and that negative consequences may remain. Maybe we should wait a little longer with the operation?

• Irina, Moscow
• January 16, 2018, 11:18

Currently, general anesthesia does not involve much risk if the treatment is carried out in a specialized institution equipped necessary equipment, and in the presence of an anesthesiologist-resuscitator. Of course, the tolerability of anesthesia depends on the individual characteristics of the child and his somatic status. But I cannot say that general anesthesia increases the risk of developing intellectual problems and affects brain function, as well as the fact that a child’s reaction to anesthesia will change after 4 years. Modern drugs for anesthesia have low toxicity, are hypoallergenic, are quickly eliminated from the body, and allow anesthesia to be administered with minimal consequences.

If you choose the right drug and its dosage, taking into account the upcoming surgical intervention, current state health of the baby and others important factors, the risks of negative consequences are practically eliminated.

In our clinic, in addition to traditional clinical assessment depth and adequacy of anesthesia, we use hardware control of anesthesia depth using BIS monitoring. This system measures the functional activity of the patient's brain (using the EEG method), allowing the anesthesiologist to more accurately manage anesthesia. Focusing on monitoring indicators, we are able to use anesthetics more rationally (usually by reducing the dose), prevent excessive dosage of the drug and achieve a smoother recovery of the patient from anesthesia. The method is harmless, has no contraindications, and can be performed on children of any age (including newborns).

BIS monitoring is widely used in the USA, Western Europe and is already included in the standard of mandatory intraoperative monitoring in a number of foreign countries. In Russia, unfortunately, only some medical institutions have this equipment.

Currently, during surgical operations and complex diagnostic studies You can’t do without pain relief. Anesthesia allows you to perform medical procedures with maximum comfort for the doctor and the patient. During general anesthesia, a person’s consciousness is briefly switched off, which allows the doctor to calmly carry out the necessary medical actions. A morally adult person can independently prepare himself for upcoming surgical events. It’s another matter if the operation is to be performed on a small child. Therefore, such a phrase as anesthesia for children often plunges parents into shock.

Local and general anesthesia

Pain relief can be general and local. With local anesthesia, pain impulses are blocked in a specific area of ​​the child’s body, which is injected with special drugs. During the treatment, the child does not feel pain, being fully conscious. On the one hand, this type of anesthesia has an important advantage, since local anesthetic drugs do not affect the functioning of the brain. But on the other hand, there are significant drawbacks. Firstly, local anesthesia is not always able to provide the necessary analgesic effect. Secondly, the preparation for the treatment procedure itself is extremely stressful for the child. View of people in special clothes and masks laid out medical instruments cause fear in most children. Therefore, most often, when performing surgical procedures, doctors use combined anesthesia for children, that is, they simultaneously administer general and local anesthesia.

When using general anesthesia, the child is unconscious, but for a limited period. The medications introduced into his body ensure the complete absence of pain syndrome, followed by a gradual restoration of the child’s normal state and consciousness. General anesthesia can be performed in different ways. There are inhalation, intramuscular and intravenous anesthesia. The choice of general anesthesia method is influenced by the volume of the upcoming operation, the recommendations of the surgeon and the qualifications of the anesthesiologist.

“Major” and “minor” anesthesia

Depending on the combination of inputs medications and the amount of time required for pain relief, general anesthesia is conventionally divided by doctors into “major” and “minor”. When it is necessary to turn off the child’s consciousness for a short period of time, “minor” anesthesia is used. It is used for short operations and low-traumatic diagnostic studies. “Minor” anesthesia can be administered by inhalation or intramuscular method.

Surgeons usually call the inhalation method of anesthesia hardware-mask anesthesia. When using it, the child inhales the inhalation mixture, after which his consciousness turns off. The most well-known inhalational anesthetics are the drugs Sevoflurane, Isoflurane, Ftorotan.

Another method of administering “minor” anesthesia, intramuscular anesthesia, is not currently used. According to the latest data, this type of anesthesia is not harmless to the child’s body. For intramuscular anesthesia, the drug Ketamine is usually used, which is capable of long time“turn off” memory, creating problems for the full development of the child.

During complex long-term operations, surgeons use “major” anesthesia for children, which is considered the most effective method pain relief. The drugs are administered into the child's body by inhalation or intravenously. “Major anesthesia” is a multicomponent effect of various pharmacological agents. Can take part in general anesthesia local anesthetics, sleeping pills, infusion solutions, muscle relaxants, analgesics and even blood products. As a rule, during the surgical procedure, the child is artificial ventilation lungs.

Certainly, great importance has the correct emotional mood child before the upcoming operation. Parents are allowed to accompany the child to the operating room and remain nearby until the child falls asleep. When waking up, the first thing the baby should see is the familiar face of loved ones.

Parents should not be afraid of using general anesthesia for children. Modern drugs used in anesthesiology allow safe pain relief even for newborn babies. And the main thing for any parent is to cure the child!

Why is general anesthesia dangerous for a child? Yes, in some cases it is necessary. Often - to save the life of a child.

But also negative sides the effects of anesthesia exist. That is, it is like a coin that has two sides, like a double-edged sword.

Naturally, before a child’s upcoming operation, parents try to find out how dangerous this intervention is and what exactly is the danger of general anesthesia for the child.

Sometimes general anesthesia scares people even more than surgery. In many ways, this anxiety is fueled by numerous conversations around.

Surgeons who prepare a patient for surgery talk little about anesthesia. And the main specialist in this matter - the anesthesiologist - advises and explains everything only shortly before the operation.

So people are looking for information on the Internet. And here she is, to put it mildly, different. Who to believe?

Today we’ll talk about the types of anesthesia in pediatric medical practice, about indications and contraindications for it, about possible consequences. And, of course, we will dispel myths in this topic.

Many medical procedures are very painful, so even an adult cannot endure them without pain relief. What can we say about the child?..

Yes, subjecting a child to even a simple procedure without pain relief is a huge stress for a small organism. This may cause neurotic disorders(tics, stuttering, sleep disturbances). And also this is a lifelong fear of people in white coats.

That is why, in order to avoid unpleasant sensations and reduce stress from medical procedures, use pain-relieving techniques in surgery.

General anesthesia is actually called anesthesia. This is an artificially created, controlled state in which there is no consciousness and no reaction to pain. At the same time, vital important functions body (breathing, heart function).

Modern anesthesiology has advanced significantly over the past 20 years. Thanks to it, today it is possible to use new drugs and their combinations to suppress involuntary reflex reactions of the body and reduce muscle tone when the need arises.

According to the method of administration, general anesthesia in children can be inhalation, intravenous and intramuscular.

In pediatric practice, inhalation (hardware-mask) anesthesia is more often used. With machine-mask anesthesia, the child receives a dose of painkillers in the form of an inhalation mixture.

This type of anesthesia is used for short, simple operations, as well as for some types of research when a short-term switching off of the child’s consciousness is required.

Painkillers used during hardware-mask anesthesia are called inhalational anesthetics (Ftorotan, Isoflurane, Sevoflurane).

Intramuscular anesthesia is practically not used for children today, since with such anesthesia it is difficult for the anesthesiologist to control the duration and depth of sleep.

It has also been established that such a frequently used drug for intramuscular anesthesia as Ketamine is unsafe for the child’s body. Therefore, intramuscular anesthesia is leaving pediatric practice.

For prolonged and heavy operations use intravenous anesthesia or combine it with inhalation. This allows you to achieve a multicomponent pharmacological effect on the body.

Intravenous anesthesia includes the use of various medications. It uses narcotic analgesics (not drugs!), muscle relaxants that relax skeletal muscles, sleeping pills, various infusion solutions.

During the operation, the patient is given artificial ventilation (ALV) using a special device.

Only the anesthesiologist makes the final decision on the need for one or another type of anesthesia for a particular child.

It all depends on the condition of the little patient, on the type and duration of the operation, on the presence of concomitant pathology, on the qualifications of the doctor himself.

To do this, before the operation, parents must tell the anesthesiologist as much information as possible about the characteristics of the child’s growth and development.

In particular, the doctor should learn from parents and/or medical records:

• how pregnancy and childbirth proceeded;
• what type of feeding was it: natural (up to what age) or artificial;
• what illnesses the child suffered;
• whether there were cases of allergies in the child himself or in close relatives and to what exactly;
• what is the child’s vaccination status and whether any negative reactions of the body during vaccination have been previously identified.

Contraindications

There are no absolute contraindications to general anesthesia.

Relative contraindications may include:

The presence of concomitant pathology that can negatively affect the condition during anesthesia or recovery after it. For example, constitutional anomalies accompanied by hypertrophy of the thymus gland.

A disease accompanied by difficulty in nasal breathing. For example, due to a deviated nasal septum, proliferation of adenoids, chronic rhinitis (for inhalation anesthesia).

Having allergies to medications. Sometimes the child is given allergy tests before surgery. As a result of such tests (skin tests or in vitro tests), the doctor will have an idea of ​​which drugs the body takes and which it gives an allergic reaction to.

Based on this, the doctor will decide in favor of using one or another drug for anesthesia.

If the child suffered an acute respiratory viral infection or another infection with an increase in temperature the day before, then the operation is postponed until the body has fully recovered (the interval between past illness and treatment under anesthesia should be at least 2 weeks).

If the child has eaten before surgery. Children with a full stomach are not allowed to undergo surgery, as there is a high risk of aspiration (stomach contents entering the lungs).

If the operation cannot be postponed, the gastric contents can be evacuated using a gastric tube.

Before the operation or hospitalization itself, parents should provide psychological preparation to the child.

Hospitalization itself for a baby, even without surgery, is a difficult ordeal. The child is frightened by separation from his parents, a foreign environment, a change of regime, people in white coats.

Of course, not in all cases the child needs to be told about the upcoming anesthesia.

If the disease interferes with the child and brings him suffering, then the child needs to be explained that the operation will relieve him of the disease. You can explain to the child that with the help of a special children's anesthesia, he will fall asleep and wake up when everything is done.

Parents should always talk about how they will be with their child before and after surgery. Therefore, the baby must wake up after anesthesia and see the people closest to him.

If the child is old enough, you can explain to him what awaits him in the near future (blood test, blood pressure measurement, electrocardiogram, cleansing enema, etc.). This way, the child will not be frightened by various procedures due to the fact that he did not know about them.

The hardest thing for parents and young children is to maintain a hunger pause. I have already spoken about the risk of aspiration above.

The child should not be fed 6 hours before anesthesia, and 4 hours before the anesthesia the child should not even be given water.

A breastfed baby can be put to the breast 4 hours before the upcoming operation.

A child receiving formula milk should not be fed 6 hours before anesthesia.

Before the operation, the small patient’s intestines are cleaned with an enema to prevent involuntary stool passing during the operation. This is very important when abdominal operations(on the abdominal organs).

In children's clinics, doctors have many devices in their arsenal to distract children's attention from upcoming procedures. These include breathing bags (masks) with images of various animals, and scented face masks, for example, with the scent of strawberries.

There are also special children's ECG machines, in which the electrodes are decorated with images of the faces of different animals.

All this helps to distract and interest the child, conduct an examination in the form of a game, and even give the child the right to choose, for example, a mask for himself.

Consequences of anesthesia for a child’s body

In fact, a lot depends on the professionalism of the anesthesiologist. After all, it is he who selects the method of administering anesthesia, necessary drug and its dosage.

In pediatric practice, preference is given to proven drugs that are well tolerated, that is, with minimal side effects, and which are quickly eliminated from the child’s body.

There is always a risk of intolerance to drugs or their components, especially in children prone to allergies.

It is possible to predict this situation only if the child’s close relatives had a similar reaction. Therefore, this information is always clarified before the operation.

Below are the consequences of anesthesia, which can arise not only due to intolerance to medications.

• Anaphylactic shock (immediate allergic reaction).
• Malignant hyperemia (temperature rise above 40 degrees).
• Cardiovascular or respiratory failure.
• Aspiration (reflux of stomach contents into the respiratory tract).
• Mechanical trauma cannot be excluded during catheterization of veins or bladder, tracheal intubation, or insertion of a probe into the stomach.

The likelihood of such consequences exists, although it is extremely small (1-2%).

IN Lately Information has emerged that anesthesia can damage the neurons of a child’s brain and affect the rate of development of the baby.

In particular, it is assumed that anesthesia disrupts the processes of memorizing new information. It is difficult for the child to concentrate and learn new material.

This pattern was suggested after the use of injection drugs such as Ketamine for intramuscular anesthesia, which is practically not used in pediatric practice today. But the validity of such conclusions still remains unproven.

Moreover, if such changes exist, they are not lifelong. Cognitive abilities usually recover within a few days after anesthesia.

Children recover from anesthesia much faster than adults, since metabolic processes occur faster and the adaptive capabilities of a young body are higher than in adults.

And here a lot depends not only on the professionalism of the anesthesiologist, but also on the individual characteristics of the child’s body.

Young children, that is, under two years of age, are at greater risk. In children at this age, the nervous system is actively maturing, and new neural connections are being formed in the brain.

Therefore, operations under anesthesia are, if possible, postponed until after 2 years.

Myths about anesthesia

“What if the child doesn’t wake up after the operation?”

World statistics say that this is extremely rare (1 in 100,000 operations). Moreover, more often than not, this outcome of the operation is associated not with the reaction to anesthesia, but with the risks of the surgical intervention itself.

It is in order to minimize such risks that during planned operations the patient undergoes thorough examination. If any disorders or diseases are detected, the operation is postponed until the little patient has fully recovered.

“What if the child feels everything?”

Firstly, no one calculates the dosage of anesthetics for anesthesia “by eye”. Everything is calculated based on the individual parameters of the small patient (weight, height).

Secondly, during the operation the child’s condition is constantly monitored.

They monitor the patient's pulse, respiratory rate, blood pressure and body temperature, oxygen/carbon dioxide levels in the blood (saturation).

In modern clinics with good operating equipment, it is possible to monitor even the depth of anesthesia and the degree of relaxation of the patient’s skeletal muscles. This allows you to high accuracy monitor minimal deviations in the child’s condition during surgery.

“Mask anesthesia is an outdated technique. A safer type of intravenous anesthesia"

Most operations (more than 50%) in pediatric practice are performed using inhalation (mask) anesthesia.

This type of anesthesia eliminates the need to use potent drugs and their complex combinations, unlike intravenous anesthesia.

At the same time, inhalation anesthesia gives the anesthesiologist greater opportunity for maneuver and allows better management and control of the depth of anesthesia.

In any case, regardless of the reasons for which a child is indicated for surgery with anesthesia, anesthesia is a necessity.

This is a savior, an assistant who will help you get rid of the disease in a painless way.

After all, even with minimal intervention under local anesthesia, when the child sees everything but does not feel, not every child’s psyche can withstand this “spectacle.”

Anesthesia allows treatment of non-contact and low-contact children. Provides comfortable conditions for the patient and the doctor, reduces treatment time and improves its quality.

Moreover, not in all cases we have the opportunity to wait, even if the child is small.

In this case, doctors try to explain to parents that leaving the child’s illness without surgical treatment, can provoke greater consequences than the likelihood of developing temporary consequences of general anesthesia.

Practicing pediatrician and twice-mother Elena Borisova-Tsarenok told you how dangerous general anesthesia is for a child.

The use of general anesthesia is accompanied by adverse reactions - impaired breathing, circulation, work nervous system. Anesthesia during cesarean section can also cause long-term consequences - attention deficit hyperactivity disorder in the child. Prevention requires a full examination (with planned intervention), recording possible factors risk. Read more about them in this article.

Read in this article

What is anesthesia and its consequences

Anesthesia is a human condition in which a loss of consciousness occurs, created artificially. Introduction to narcotic sleep is a necessity when performing any surgical operations; this allows you to avoid painful shock, which causes negative changes in the body, including cardiac arrest. There are three types of anesthesia used in medicine:

• intramuscular injection;
• intravenous injection;
• inhalation

The choice of type is carried out on an individual basis and depends on the volume of surgical intervention, the general health of the patient, his age and other factors.

The consequences of anesthesia can be very different - from short-term to permanent disorders. The first include:

• partial/complete memory impairment – ​​restored literally after 3-5 days;
• sleep disturbance - insomnia or, conversely, constant desire get enough sleep, it will return to normal within a week;
• severe headaches, problems with vision (decreased visual acuity) and hearing - the condition stabilizes within 5-10 days.

Often appear:

• muscle pain;
• nausea, which may be accompanied by vomiting;
• dizziness;
• speech problems, general lethargy;
• back pain.

Back pain may occur after epidural anesthesia.

Complications after anesthesia of a more severe nature:

• disorders of the respiratory system;
• problems in the functionality of the heart and vascular system;
• acute renal, adrenal failure;
• problems in the process of thermoregulation of the body.

Consequences of anesthesia, which are recorded extremely rarely, but do occur:

• Injury to tongues, lips and teeth is diagnosed in 1 case per 45,000 anesthesia use. Linked like this " by-effect» with damage oral cavity breathing tube. It is recommended to visit a dentist and undergo sanitation before undergoing surgery.
• Postoperative pulmonary infection - most often diagnosed after organ surgery chest and in smoking patients. According to statistics, it can be successfully treated, but it lengthens the recovery period.
• Damage to the eyes - the cornea is most often affected, does not lead to loss of vision, but causes a dark spot to appear in front of the eyes. The reason for this complication is incomplete closure of the eyelids during anesthesia: eyeball dries out and is injured on the inside of the eyelid.

What does general anesthesia do?

Here is what and how general anesthesia affects:

• Nervous system (central)– it is important to “turn off” the main center for the perception of pain sensitivity. If applicable inhalation drugs, then vasodilation occurs and oxygen consumption decreases. Intravenous drugs directly affect blood circulation - they reduce its speed by almost 2 times.
• Respiratory system– in the process, the nature and quality of breathing changes: the respiratory muscles work slowly, the depth and rhythm of inhalations/exhalations changes, and the level of serotonin decreases. If anesthesia is used simultaneously with ventilation, blood flow is distributed in the vessels of the respiratory system.
• The cardiovascular system– depression occurs when using any drugs, the myocardium begins to work at a slow pace. Simultaneously with the negative effect on the heart, the sympathetic-adrenal system is stimulated, which ensures rapid restoration of the functioning of the heart and blood vessels after surgery.

Common effects of anesthesia on the body

Often, patients after general anesthesia experience nausea, which can intensify with a sudden change in body position, eating or drinking water. To eliminate it, sometimes it is necessary to administer antiemetics (Cerucal, Etaperazine, Tavegil), in most cases it goes away on its own within 1 - 2 days. Recommended quiet deep breathing with slowing inhalation to relieve discomfort.

Dryness, a feeling of rawness or a burning sensation in the throat may occur immediately after waking up, some patients experience quite severe pain in the throat when swallowing or talking, hoarseness of the voice. This consequence of anesthesia is not dangerous; in case of intense pain, a soothing warm chamomile tea with a little honey and rose petal jam. Among the medications, Strepsils Intensive is indicated.

Tongue - tongue; epiglottis - epiglottis; balloon - balloon; trachea - trachea; endotracheal tube - endotracheal tube; palate - sky.

Trembling hands or severe chills are not always associated with the administration of painkillers or infusion solutions. They can also be explained by a sharp activation of sympathetic impulses in response to stress, which is surgery. Warming with a warm blanket and maintaining a comfortable air temperature in the room will help reduce tremors in the body. If there is no fever, then drug therapy is not used.

Changes in blood pressure, pulse rate and respiration are a natural response to the suppression of vasomotor and respiratory centers brain. After a period of braking, they may become unstable for some time. Therefore, all patients are advised to monitor hemodynamic parameters, control the rhythm and depth of breathing in the postoperative period.

At the same time, the likelihood increases various violations heart rhythm - extrasystole, tachycardia and bradycardia. The most dangerous are:

• group extrasystoles;
• complete block of atrioventricular conduction;
• seizures ventricular tachycardia which can progress to ventricular fibrillation and asystole.

They are more common in older people with associated disorders excitability and conductivity of the myocardium, cardiomyopathy, coronary heart disease. For treatment, antiarrhythmic drugs are prescribed, and constant ECG monitoring is required.

Effects of anesthesia on the brain

The most common neurological complications include:

• headache;
• dizziness;
• collaptoid (fainting) state;
• weakness;
• disturbance of the sleep-wake rhythm;
• difficulty coordinating movements (unsteadiness of gait, awkwardness during purposeful actions).

They are associated with dehydration, blood loss, impaired vascular tone, and the inhibitory effect of anesthesia drugs on brain function. As a rule, such signs disappear within 2-4 days.

A more significant impairment is postoperative cognitive dysfunction. It can appear both in the first days and 2-3 months after general anesthesia. Patients complain that it is difficult to find the right word, remember information, fatigue quickly occurs during mental stress, and it is difficult to concentrate.

Memory and learning ability may decrease by 10-20%. Symptoms may subside over time, but some patients drug therapy they are intensifying.

The causes of this complication may be cerebral ischemia due to a decrease in blood pressure during surgery, disruption of the interaction of neurons under the influence of drugs and their partial destruction. It is possible that stimulation of the immune response and inflammatory process with prolonged or extensive surgery, as well as insufficient pain relief, damage brain cells.

Insufficient nutrition of the brain at the cellular level, which is not quickly corrected, can provoke hallucinations, problems with attention and memory.

If the brain was injured before general anesthesia was used, then it is impossible to predict the consequences of the drugs.

For treatment the following is prescribed:

• neuroprotectors – Mexidol, Nimotop;
• nootropics – Glycine, Ceraxon;
• metabolic stimulants – Cerebrolysin, Somazina;
• antioxidants – Emoxipin, Bilobil.

To prevent memory impairment, it is necessary to minimize factors that damage brain tissue - smoking, drinking alcohol, eating fatty animal products, low or high blood pressure, increased blood sugar and cholesterol. You can train your memorization by solving crossword puzzles, reading, listening to audio books, or playing chess.

What anesthesia rarely leads to

Less common effects of general anesthesia are:

• increased secretion of bronchial mucus, spasm of the bronchi and larynx, impaired ventilation of the lungs, depression or increased breathing until it stops, pneumonia, respiratory failure, shortness of breath, cough;

Pneumonia postoperative

• increased salivation, transient jaundice, increased activity liver tests, decreased motility (motor function) of the stomach and intestines;
• psychomotor agitation, convulsive syndrome, drowsiness, depressive reactions, psychosis, disorientation;
• disturbance of acid-base balance and electrolyte balance, decrease in protein content in the blood due to their excretion by the kidneys, fluctuations in blood sugar levels, leukocytosis, hemolysis of red blood cells;
• sweating, fever;
• allergic reactions- bronchospasm, urticaria, itching, anaphylactic shock, Quincke's edema, chills;
• renal failure;
• change in consciousness – stupor, delirium, hallucinations;
• decreased myocardial contractility, cardiac decompensation.

To learn how general anesthesia affects a patient’s health, watch this video:

Negative consequences for women

There is a special situation when it is necessary to use anesthesia in women - this is a caesarean section. There are several methods of general anesthesia, each of which has certain advantages and disadvantages.

The inhalation method is convenient when urgent delivery is necessary for life-saving reasons; the depth of anesthesia is easy to regulate. Inhalation of the gas mixture is usually well tolerated - circulatory disorders rarely occur in the mother and fetus. TO negative characteristics relate:

• risk of vomiting and vomit blockage respiratory tract in a woman in labor;
• the appearance of inflammation of the bronchi and lung tissue (more often in the presence of ether in the mixture);
• The child's breathing may become weakened.

Intravenous anesthesia can damage the neurons of the fetal brain, cause instability in pressure and pulse rate, and fluctuations in respiratory activity. Therefore, it is most often replaced with spinal or epidural anesthesia. They are also not completely safe, as they provoke hypotension in the mother and oxygen starvation in the fetus.

Hypoxia in a child can manifest itself only by 2–3 years of age in the form of attention deficit disorder, hyperactivity, speech development disorders, and muscle reflexes.

Pain relief during childbirth is used according to strict indications in situations where pain can cause state of shock. To insist on anesthesia because you are psychologically unprepared for childbirth means endangering not only your health, but also the nervous system of the unborn child. The choice of anesthetic agents and methods should be made by a specialist, taking into account all risk factors.

General anesthesia: consequences for men

In medicine it is not customary to separate unpleasant consequences after general anesthesia depending on the gender of the patient, but scientists have proven that for men it can cause problems in their sexual life. It is not the sexual desire that decreases, but the potency - erectile dysfunction is diagnosed. This happens especially often in men of the older age group, when there are already signs of a natural decline in sexual activity.

After general anesthesia, problems in endocrine system– the production of male hormones decreases. True, this is considered an exception and can be recorded during frequent surgical interventions or against the background of existing endocrine diseases.

The effect of anesthesia on the human body: consequences

The consequences for the human body after anesthesia are directly related to the effect of the drugs:

• Nausea– most often observed immediately after emerging from narcotic sleep, it is short-lived, and does not require the use of medications. It may be accompanied by vomiting, but only if the preparation for the operation was carried out with violations (for example, the patient ate food immediately before the manipulation).
• Pain in the throat when swallowing and talking - can be periodic or constant, lasting from 2 hours to several days. Accompanied by severe dryness in the mouth and a strong feeling of thirst.
• Whole body tremors or limb tremors– lasts no more than 30 minutes, is associated with conduction disturbances nerve impulses. The problem is solved with warm clothes, a blanket - the patient simply needs to warm up.

• General weakness, dizziness, faintness– associated with a decrease in blood pressure after recovery from anesthesia. If such a pathological condition persists for 2 days after surgery, then you should seek help from your doctor - there may be a dehydration factor.
• Itchy skin– present throughout the body, can be strong and uncontrollable. This is how the body reacts to anesthetic drugs, but it can also be a manifestation of a powerful allergy. To avoid development serious complications in the form of anaphylactic shock, Quincke's edema, you need to report the problem to your doctor - you will need to undergo a short course of therapy with antihistamines.
• Pain in the back and muscles– a consequence of an uncomfortable posture during the operation, they are symmetrical, and may bother you for 2-3 days during the recovery period. Most often, such consequences are observed when using the anesthetic Ditilin, which is suitable for emergency surgery without first clearing the stomach of food.

Watch this video about the dangers of anesthesia:

Anesthesia overdose: consequences in adults

Modern medicine practically eliminates the risk of anesthesia overdose, but if this happens, the consequences in adults can be the following:

• Too much drug sleep– the patient begins to regain consciousness only 6-12 hours after surgery. He may be forcibly awakened, but the loss of consciousness will continue until the increased dose of anesthetic wears off.
• Headache- this is how most anesthesia drugs act on the central nervous system. If after normal anesthesia the pain syndrome disappears within a few hours, then in case of an overdose it may persist for several days.
• Respiratory depression– a temporary phenomenon that can provoke postoperative pneumonia.

Cases where an overdose of anesthesia led to the death of a patient have not been recorded in the last 50 years.

Consequences of frequent anesthesia

There is a myth that says the more anesthesia a patient is given ( frequent operations), the more difficult it will be for him to get out of this state, even clinical death or total loss memory, reason.

In reality this is not
happens:

• drugs act on the body in the same way with each administration;
• a recovery period is observed between surgical interventions - the effects of general anesthesia are already disappearing, the systems are ready for a new “blow”;
• There are patients who often undergo anesthesia for medical reasons (for example, multiple operations for extensive burns) - statistics are silent that this led to any serious consequences.

The only thing that doctors and scientists warn about is that there may be a disorder of the nervous system and the presence of constant pain in back. This is manifested by headaches of unknown origin, unmotivated surges in blood pressure, and aching in the lower back after habitual physical activity.

Is there a harmless anesthesia?

With a good preoperative examination, the anesthesiologist has the opportunity to choose best option pain relief, taking into account concomitant diseases, duration of surgery, indications and contraindications for specific drugs. As a result, the risks of side effects can be minimized, and the patient receives anesthesia that causes fewer complications upon awakening.

Since any anesthetic suppresses brain functions, it is absolutely safe method it can not be. To put the patient into a state of artificial sleep, a drug is needed that could reduce the activity of the nervous and cardiovascular systems for a sufficiently long time to make it possible to perform the operation. Therefore, some possible consequences for the body are regarded as a kind of “payment” for getting rid of the disease.

When choosing medications for women who are indicated for cesarean section, preference is given not to intravenous administration, but to new inhalational anesthetics - isoflurane and sevoflurane. They are significantly superior in safety to the previous ones (for example, Ftorotan). Women in labor wake up within 15 - 20 minutes, and anesthesia depression in a newborn also disappears in the first minutes after birth.

Should you be afraid of anesthesia?

The operation cannot be performed without pain relief. In this case, it is important that the patient not only does not feel pain, but also does not remember what happened to him during the treatment period (amnesia). To do this, the surgeon and anesthesiologist choose the method of anesthesia. They focus on age characteristics, presence of concomitant pathology and volume, duration of surgical intervention.

In most patients who have undergone preoperative preparation, anesthesia does not cause significant deviations in the subsequent functioning of the heart, brain, lungs, liver and kidneys.

Modern agents are used for anesthesia, which have side effects, but they can be prevented or eliminated. It should also be taken into account that any drug therapy has its own expiration date. Almost all complications with proper pain relief can be removed after the drug is removed from the body.

Therefore, you need to choose a doctor and a medical institution that you can trust, and leave all other actions (including anesthesia) at the discretion of specialists.

How to minimize risks

In preparation for elective surgery A full range of diagnostic studies is recommended. An ECG, chest x-ray, and abdominal ultrasound are prescribed. For laboratory examination it's important to go through general tests blood and urine, coagulogram, kidney and liver tests, study of blood glucose and cholesterol concentrations.

If it is possible to compare several medical institutions, then preference should be given to those that have a modern technical base, as well as a narrower specialization of doctors in the profile that is needed.

Patients need to exclude smoking, alcohol for 10 - 15 days, and from the diet - any fatty, spicy foods, pickled and canned foods, the diet should consist of low-fat varieties meat, fish, vegetables and whole grain cereals. They are prepared with a minimum of salt, spices, oil and cooking oil.

It is also useful to drink freshly squeezed juices from vegetables, fruits, and herbs. This diet improves the condition of the mucous membranes of the digestive tract and the functioning of the liver and kidneys. The removal of drugs for anesthesia depends on their function.

If your health condition allows, then every day it is recommended hiking at least 40 minutes, light gymnastics, adherence to the regime, 8 hours of sleep at night is especially important. To improve sleep, you can drink soothing teas from valerian, lemon balm, mint, and chamomile.

Any medications should be taken only after consulting the surgeon who will perform the operation. It is also necessary to discuss drug tolerance and allergic reactions in the past with him.

General anesthesia can cause Negative influence on the state of the nervous system, blood circulation, bronchial and lung function. A fairly common condition is post-anesthesia cognitive dysfunction. During surgery caesarean section Children may have long-term consequences in the form of attention deficit hyperactivity disorder.

The choice of anesthesia method should be made by anesthesiologists and surgeons after comprehensive examination. Before surgery, you need a special diet and lifestyle.

Useful video

To learn about the complications that occur after general anesthesia, watch this video: