Koval O. I.

DENTISTRY

Scentific article

The article presents the results of the evaluation of cerebral metabolism in children aged 0-3 years (n = 38) during the rehabilitation of the oral cavity in conditions of general anesthesia at the outpatient reception and their correlation with pulse oximetry. To predict cognitive changes due to organic brain disorders that can occur during surgery (with hyperemia, hypoxia, ischemia) when fluctuating SpO2 beyond its mean, we used data of J. Meixensberger et al. 1998: an expressed ↓ SpO2≥20% indicates oxygen starvation due to brain perfusion; ↓ SpO2≥20% indicates an increase in brain tissue metabolism; ↓ SpO2≥25% (15-30 min) reflects an increase in tissue extraction of oxygen from the flowing blood and indicates the presence of brain tissue hypoxia; ↓ SpO2≥25% (≥30 min) or ↓ SpO2 ≥40% indicates brain ischemia; ↓ SpO2≥40% indicates gross neurological disorders or epileptic activity. Marked linear ↓ rSO2 of 30 min. At 41 minutes rSO2 has the lowest value and is 62.5% ± 6.36, with a possible minimum value of 61.45%. On average, in 1 minute rSO2 ↓ by 1.21%. When predicted, the minimum permissible rSO2 value will reach at 42 minutes. Therefore, dental treatment under general anesthesia in an outpatient setting in children 0-3 years of age is safe to carry out within 30 ± 10 minutes. The rSO2 max (80.23% ± 0.59) was observed for 9 min. but it does not go beyond the norm, which is 92.17%. Complications in the form of laryngospasm were noted in 7.89% of cases. rSO2 = 70.74% ± 8.86, which is 6.29% relative to the mean rSO2 of the respective age group (rSO2 = 75.49% ± 2.88). ↓ rSO2 from 11 min. 25 min each (˂20 min) by 12.67% (rSO2 = 70.74% ± 8.86). Max SO rSO2 for 15 min. (rSO2 = 54.33% ± 3.21), which is 23.19% of the total value and 12.06% of the rSO2 index directly in laryngospasm. Among children who had laryngospasm complications, a history of 66.67% had a history of less than 2 weeks after a full recovery for ARD. The rSO2 indicators were analyzed in 2 groups: Group I – who had a history of ARD of ≥ 2 weeks, group II – children who had a history of ARD of ≥ 2 weeks but ≤ 4 weeks (10.52% ) in relation to indicators of the general group of children aged 0-3 years. Found: rSO2 in children of group I – 70.75% ± 8,92. ↓ rSO2 from 11 min. to 27 min is (≤20 min) 9.88% (rSO2 = 63.76% ± 6.96). The peak decrease lasted 3 min. (13 min – 15 min). rSO2 = 55.5% ± 2.5, representing 21.55% of the total value and 12.95% of the rSO2 index directly in laryngospasm. In group II, the rSO2 indicator line reproduces the line of the same name in group III. rSO2 of group II (75.91% ± 4.82) is within the normal range and does not differ from rSO2 (75.49% ± 2.88) of group III. Conclusions. SpO2 scores do not correlate with rSO2 scores. The method of cerebral oximetry is a more informative method of neuromonitoring, which allows early detection of changes in oxygen saturation of the brain in order to prevent organic changes, and, as a consequence, to prevent functional disorders in intensive development. Dental rehabilitation of the oral cavity in an outpatient setting under general anesthesia for children aged 0-3 years should be carried out within 30 ± 10 minutes. The indication for planned rehabilitation of the oral cavity under general anesthesia in an outpatient setting is the absence of a history of acute respiratory diseases for at least 2 weeks. In the presence of such, ambulance under general anesthesia in an outpatient setting is possible within ≤10 min.

cerebral oximetry, SpO2, rSO2, general anesthesia

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«Bulletin of problems biology and medicine» Issue 3 (152), 2019 year, 359-363 pages, index UDK 616.311-089.5:616.831-07-084]-053.3

10.29254/2077-4214-2019-3-152-359-363