Fast track in the treatment of newborns with necrotizing enterocolitis

Sergey Minaev, Alexandr Obedin, Alexandr Kachanov, Mikhail Annenkov, Elena Tovkan, Igor Gerasimenko
  • Medical news of the North Caucasus, January 2016, Stavropol State Medical University
  • DOI: 10.14300/mnnc.2016.11023

FAST TRACK IN THE TREATMENT OF NEC

What is it about?

In the article consider the actual problem of fast track in newborns with necrotizing enterocolitis. Patients were divided into two groups matched for gestational age, weight and sex of patients. The Group1 consisted of 18 infants with NEC stage 2 to 3, in which the complex treatment was provided using presacral blockade with ropivacaine. The Group 2 was represented by 17 patients with NEC stage 2–3 undergoing standard treatment program. After 16 hours from the start of treatment in the Group 1 with respect to the Group 2 there was a significant decrease in the level of pain on a CHEOPS scale (6.0±0.5 points and 9.5±0.3 points, respectively, p = 0.001). Was shown substantial and significant reduction in the dose of fentanyl in the case of surgical intervention (62±2.5 mcg and 120±3.2 mcg, respectively, p = 0.002), respectively. Staying at mechanical ventilation after surgery was also reduced (1.5±0.8 days and 3.4±1.1 days, respectively). Significantly lower level of systemic and local inflectional complications was found in the Group1.

Why is it important?

Treatment of necrotizing enterocolitis (NEC) in newborns remains an urgent problem in modern pediatric surgery and intensive care. The main reason is a large amount of septic complications and high mortality in this group of patients. In this connection, it is important to search for technologies that allow minimize quantity and severity mentioned above complications. One way of solving this problem is use of modern technologies in perioperative care «fast-track» technology. Our study showed that holding presacral blockades with ropivacaine is an effective method of accelerating the recovery of infants with NEC, bringing the methodology of conducting to the fast track technology.

Perspectives

Professor Sergey Viktorovich Minaev
Stavropol State Medical University

We believe that the fast track for patients with NEC can greatly reduce the number of complications and thus improve survival rate in newborns with intestinal pathology indicated above.

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http://dx.doi.org/10.14300/mnnc.2016.11023

The following have contributed to this page: Professor Sergey Viktorovich Minaev