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Fast track in the treatment of newborns with necrotizing enterocolitis

[Surgery]
Sergey Minaev; Alexandr Obedin; Alexandr Kachanov; Mikhail Annenkov; Elena Tovkan; Igor Gerasimenko;

In the article consider the actual problem of fast track in newborns with NEC. 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. Thus, 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.

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Keywords: necrotizing enterocolitis, CHEOPS scale, treatment, fast track, newborns


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