THE INFLUENCE OF POSTOPERATIVE ANALGESIA TECHNIQUES ON SPLANCHIC BLOOD FLOW IN CHILDREN WITH INTRAABDOMINAL HYPERTENSION

Introduction. Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) often develop in critically ill patients can lead to affected splanchnic blood flow, intestinal mucosal ischemia, bacterial translocation, sepsis, multiorgan dys-function. There is limited literature data on the effect of analgesic methods flow IAG / AСS. The aim study was define different postoperative analgesia techniques children with appendicular peritonitis IAH. Materials methods. included 115 who underwent surgery for peritonitis. Children were randomized into three groups depending method analgesia: “Opioids” (n = 36; intravenous infusion morphine 10 μg/kg/h); “Lidocaine” 40; lidocaine 1.5 mg/kg/h); “EDA” 39; epidural 0.25% bupivacaine 0.4 mg/kg/h). Postoperatively intraabdominal pressure (IAP) measured 4 times a day using standard in-direct through Foley catheter bladder. According IAP level presence organ dysfunction each group divided subgroups: “Without IAH”, “IAH” “ACS”. diameters linear velocities superior mesenteric artery (SMA) portal vein (PV) detected US. indices SMA PV (BFISMA, BFIPV, ml/min/m2) calculated. Results. BFISMA BFIPV significantly higher without IAH than (p <0.0001) ACS <0.0001). Among all subgroups, <0.05) compared “Opioids”. subgroups statistically significant negative correlation between observed only (rs -0.5; p <0.001). ACS, groups, but it weakest -0.24; <0.04 rs -0.39; <0.05, respectively). In (rs=-0.31; p<0.01) (rs=-0.4; p<0.0001). Conclusions. Epidural most optimal impaired complicated intra-abdominal hypertension. Intravenous may be an alternative anesthesia.