Automated External Defibrillator Use: a Clinical Note

Abstract

Objective: to evaluate the safety of postoperative analgesia via continuous intravenous infusion of promedol versus its traditional intramuscular injection. Subjects and methods. In the postoperative period, analgesia via continuous intravenous infusions of different promedol doses was performed in 20 children aged 5 months to 3 years, who had undergone elective surgical interventions. A control group consisted of 20 children in whom 1% promedol solution was intramuscularly injected in a dose of 0.5 mg/kg every 6 hours. The authors analyzed hemodynamic parameters, the duration of mechanical ventilation (MV) in the patients, the possibility of their transition to spontaneous breathing, and the need for additional sedatives for synchronization with an MV apparatus. Results. The trend in recovery of spontaneous breathing was not found to depend on the modality of analgesia. Episodes of bradypnea occurred more frequently in the patients receiving continuous intravenous infusions of promedol. However, there were no statistically significant differences between the groups. The values of blood gas composition remained in the normal range in both groups. The control group more frequently needed sedatives for synchronization with a ventilator (p<0.05) Hemodynamics was stable in the children of both groups, but tachycardia and essential hypertension were more common in the control group, which was regarded as inadequate analgesia. Conclusion. Continuous intravenous infusion of promedol in a dose of 0.1—0.2 mg/kg/hour failed to exert a pronounced inhibitory effect on respiration. The prolonged administration of the opioid analgesic allows the amount of sedatives to be reduced for synchronization with the ventilator. Moreover, the quality of adaptation to a MV apparatus does not become worse. Key words: continuous infusion of promedol, postoperative period, mechanical ventilation.