EC Paediatrics

Introduction: Necrotizing enterocolitis (NEC) is one of the most common serious acquired diseases of the gastrointestinal tract, both in full-term and premature infants, and is associated with a high risk of complications and high mortality. Anesthetic management for necrotizing enterocolitis in newborns during surgery is a complex task and is still relevant, since the future fate of the patient depends on adequately administered anesthesia.

Purpose of the Study: Optimization of anesthesia during surgery in newborns for necrotizing enterocolitis.

Material and Research Methods: The study was conducted in surgical clinics of the Azerbaijan Medical University. The paper presents the results of treatment of 96 patients based on the assessment of clinical indicators of preoperative preparation, anesthesiological care, and the study of central hemodynamics in newborns operated on for necrotizing enterocolitis. Newborns were divided into 2 groups depending on the method of anesthesia used: group I with general anesthesia and group II with general anesthesia using caudal anesthesia.

Results: The results of this study showed that effective interruption of nociceptive impulses from the surgical site through caudal blockade and sufficient sedation can prevent pronounced activation of the body's neurohumoral reactions to surgical stress under conditions of balanced regional anesthesia, and it was also revealed that the modern muscle relaxant rocuronium bromide allows the concept of multicomponent anesthesia to be implemented, causing complete relaxation of the striated muscles during surgery, which helps to effectively block pathological reactions in response to surgical stress.

Keywords: Newborns; Necrotizing Enterocolitis; Caudal Anesthesia

1. Aukes DI., et al. “Pain management in neonatal intensive care: evaluation of the compliance with guidelines”. Clinical Journal of Pain 9 (2015): 830-835.
2. Allin BSR., et al. “One-year outcomes following surgery for necrotising enterocolitis: a UK-wide cohort study”. Archives of Disease in Childhood. Fetal and Neonatal Edition 5 (2018): F461-F466.
3. Alsaied A., et al. “Global incidence of necrotizing enterocolitis: a systematic review and meta-analysis”. BMC Pediatrics 1 (2020): 344.
4. De Bernardo G., et al. “Management of NEC: Surgical treatment and role of traditional x-ray versus ultrasound imaging, experience of a single centre”. Current Pediatric Reviews2 (2019): 125-130.
5. Carr B D and Gadepalli S K. “Does surgical management alter outcome in necrotizing enterocolitis?”. Clinics in Perinatology1 (2019): 89-100.
6. Cai X., et al. “A review of the diagnosis and treatment of necrotizing enterocolitis”. Current Pediatric Reviews3 (2023): 285-295.
7. Group E B M. “Clinical guidelines for the diagnosis and treatment of neonatal necrotizing enterocolitis (2020)”. Zhongguo Dang dai er ke za zhi Chinese Journal of Contemporary Pediatrics1 (2021): 1-11.
8. Jones IH and Hall NJ. “Contemporary outcomes for infants with necrotizing enterocolitis-a systematic review”. Journal of Pediatric 220 (2020): 86-92.
9. Kuik SJ., et al. “Predicting intestinal recovery after necrotizing enterocolitis in preterm infants”. Pediatric Research 5 (2020): 903-909.
10. Meesters NJ., et al. “Infants operated on for necrotizing enterocolitis: towards evidence-based pain guidelines”. Neonatology3 (2016): 190-197.
11. Miller A G., et al. “High-frequency jet ventilation in neonatal and pediatric subjects: a narrative review”. Respiratory Care5 (2021): 845-856.
12. Wendy HY., et al. “Incidence and timing of presentation of necrotizing enterocolitis in preterm infants”. Pediatrics2 (2012): 298-304.
13. Van Heesewijk A E., et al. “Agreement between study designs: a systematic review comparing observational studies and randomized trials of surgical treatments for necrotizing enterocolitis”. The Journal of Maternal-Fetal and Neonatal Medicine12 (2020): 1965-1973.
14. Valpacos M., et al. “Diagnosis and management of necrotizing enterocolitis: an international survey of neonatologists and pediatric surgeons”. Neonatology2 (2018): 170-176.