Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Criteria of the comfort level of interventional surgeon with children with congenital heart defects under the conditions of general anesthesia

Authors: Gorbunov G.E., Rybka M.M., Volodina M.S., Karakhan N.V., Petrosyan K.V., Dadabaev G.M.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2022-19-2-154-159

UDC: 616.12-007-053.1-089

Link: Clinical Physiology of Blood Circulaiton. 2022; 2 (19): 154-159

Quote as: Gorbunov G.E., Rybka M.M., Volodina M.S., Karakhan N.V., Petrosyan K.V., Dadabaev G.M. Criteria of the comfort level of interventional surgeon with children with congenital heart defects under the conditions of general anesthesia. Clinical Physiology of Circulation. 2022; 19 (2): 154–9 (in Russ.). DOI: 10.24022/1814-6910-2022-19-2-154-159

Received / Accepted:  07.02.2022 / 31.03.2022

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Abstract

Objective – in the conditions of an X-ray operating room, to organize a safe endovascular procedure in children with congenital heart defects (CHD), while improving the quality of anesthesiological support and optimizing the relationship of the anesthesiologist with the surgeon.

Material and methods. A single-center prospective randomized study included 200 patients with CHD aged 7 to 17 years, who underwent endovascular diagnostic and treatment procedures. All patients were divided into two groups: total intravenous anesthesia (TIVA; n = 100), and inhalation anesthesia (IA; n = 100). After interviewing surgeons (n = 14), the criteria that are important to them for stable work were identified. A list of factors affecting the comfort of the procedure is compiled from these criteria. A comparative analysis of the convenience of manipulations in TIVA and IA is carried out.

Results. The model of ideal anesthesia from the point of view of the surgeon became the basis for the formation of the COMFORT scale, which reflects the degree of satisfaction with the anesthetic provision. 200 endovascular interventions were analyzed. Basically, the satisfaction of surgeons was at a high level, the average score was 7.565 ± 0.58, of which 96.5% of procedures received a score of 7–8, which is defined as comfortable and stable anesthesia, and 3.5% of procedures were uncomfortable for surgeons. Anesthesia with a score of 4 or lower was not noted. With intravenous anesthesia, cases of satisfactory (uncomfortable) anesthesia were more common and amounted to 6% than in the group where sevoflurane was used, in which uncomfortable anesthesia was in 1% of cases (p < 0.05).

Сonclusion. Reliable and reliable satisfaction survey data can help identify important shortcomings in the treatment process. A surgeon's assessment can be a tool for improving the quality of anesthesiological support. Inhalation anesthesia takes place with great convenience, since it minimally creates negative conditions for the surgeon's work, the frequency was 1%, despite the fact that with intravenous anesthesia such episodes occurred in 6% of cases.

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  1. Eagle C.J., Davies J.M. Current models of “quality” – an introduction for anaesthetists. Can. J. Anaesth. 1993; 40 (9): 851–62. DOI: 10.1007/BF03009257
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  3. Guhabiswas R., Chowdhury S., Narayan P. Validated tool for quality assessment of anesthesia services by cardiac surgeons. Ann. Card. Anaesth. 2021; 24 (2): 190. DOI: 10.4103/aca.ACA_108_20
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About Authors

  • Gleb E. Gorbunov, Anesthesiologist-Intensivist; ORCID
  • Mikhail M. Rybka, Dr. Med. Sci., Head of Department of Anesthesiology; ORCID
  • Mariya S. Volodina, Anesthesiologist-Intensivist; ORCID
  • Natal’ya V. Karakhan, Anesthesiologist-Intensivist; ORCID
  • Karen V. Petrosyan, Dr. Med. Sci., Endovascular Surgeon; ORCID
  • Gulumzhan M. Dadabaev, Cand. Med. Sci., Endovascular Surgeon; ORCID

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