Вплив різних способів загальної анестезії на варіабельність ритму серця при аденотомії у дітей з різними типами автономної нервової регуляції

Objective – to investigate the perioperative period during adenotomy in children under different methods of general anesthesia by studying heart rate variability, depending on the type of autonomic nervous regulation. Material and methods . It included 70 children aged 6 to 8 years, who had adenotomy. The patients were divided into 3 groups: The group I (n=28) included patients operated under intravenous anesthesia based on propofol combined with fentanyl, the group II (n=23) included patients operated under inhalation anesthesia with sevoflurane in combination with fentanyl and metamizolum natricum, the group III (n=19) included patients operated under intravenous anesthesia based on thiopental sodium combined with fentanyl. Results . It was found that the greatest changes of the stress-index Baevsky occured in children with sympathicotonic type of autonomic nervous regulation and the lowest ones in children with vagotonic type. Children-normotonics, who were operated on under intravenous anesthesia based on propofol combined with fentanyl, requires hemodynamic monitoring starting from the 1st to 6th hour after the operation. Regardless of the general anesthesia method, it was discovered that the normalization of the balance between both branches of the ANS occured among children-vagotonics in the first 6 hours after adenotomy. Children-sympathicotonics, who were operated on under intravenous anesthesia based on propofol and thiopental sodium combined with fentanyl in the following morning after the operation they had a state of temporary exhaustion of the sympathetic branch with prevalence of parasympathetic branch of the ANS. The balance between both branches of the ANS normalized with in the 1st hour after the operation in children – sympathicotonics who were operated on under general anesthesia with sevoflurane combined with fentanyl and metamizolum natricum.