STUDYING THE PROBLEMS OF DOSING INJECTABLE DRUGS DRUGS FOR GENERAL ANESTHESIA IN SURGICAL INTERVENTIONS IN CHILDREN

Abstract

The purpose of the study was to analyze the problems of dosing injectable drugs for general anesthesia in a pediatric surgical hospital. Methods: questioning, logical analysis, economic modeling. Results: As a result of a survey of anesthesiologists at a pediatric surgical hospital, problems with dosing drugs for general anesthesia for children in a pediatric surgical hospital were identified, due to the lack of special pediatric dosages and concentrations of injectable drugs. Injectable drugs have been identified that cause difficulties in individual dosing for children due to the lack of the required form of release: INN fentanyl (ampoules), propofol, ketamine, rocuronium bromide (ampoules and vials). Losses in the primary packaging of these medicines with a single use in young children are up to 50%-90%, which leads to both material losses and environmental risks when disposing of residues. An analysis of instructions for medical use showed that pharmaceutical manufacturers do not provide for an indication of the period and conditions for storing these medicinal products after the first opening of the vial. Conclusion: A set of proposals has been developed to optimize the circulation of injectable drugs for general anesthesia used in children: the advantages of using drugs in vials compared to ampoules are shown, and the primary packaging “vial” for fentanyl solution for injections is recommended; recommended the introduction of a requirement for registration of injectable drugs for general anesthesia in vials to indicate the period and storage conditions after the first opening of the primary packaging; on the label applied to the primary packaging, it is necessary to indicate the date and time of opening the vial;in the registration dossier of injectable medicinal products for general anesthesia, it is necessary to provide data confirming the stability after the first puncture of the capping of the vial during the recommended period and storage conditions of the medicinal product.