Xenon-oxygen analgesia in multiple bandages for patients with a burn injury

This article analyzes the successful experience of using xenon anesthesia in traumatizing bandages for burn patients. The developed methodology (approved by the legal and regulatory basis) and the equipment park, that is necessary for xenon inhaling, were approbated and introduced by the staff members based on CJSC “ATOM-MED CENTER” and Dollezhal R&D Institute of Power Engineering.

Materials and methods: The patients were divided into two groups: basic one and control one. The main group used masked anapnotherapy of the xenon-oxygen admixture. In the control group burn patients were applied daily bandages under intravenous anesthesia. Altogether there were 12 monoanesthesias with 70 % xenon in the department, and there were no narcotic or non-narcotic analgesics.

Before the beginning of inhalation the patients of the main group had denitrogenisation by two intakes of breath of pure oxygen through the earloop face mask. The duration of bandaging and inhalation was 33 ± 4.2 minutes in average. The given gas admixture consisted of xenon / oxygen in a proportion of 70:30; the flow rate varied from 3.5 to 5.5 liters per minute. The xenon flow was 6.5-10.5 liters per inhalation. All the respondents keep verbal contact with the surgeon during the treatment session. The patients of the control group had the total intravenous anesthesia by the standard method that is used in our clinic and involved intaking 0.4 mg of 0.005 % fentanyl liquid, 50 mg of 5 % ketamine liquid and 150 mg of 1 % propofol liquid.

Results: he information about changes of characteristics of central and peripheral hemodynamic indicators, achieved in the work, testifies that during xenon-oxygen anesthesia while traumatizing bandaging the greater stability of systolic blood pressure, diastolic blood pressure, mean airway pressure, heart rate and peripheral resistance were in the main group of patients compared to patients in the control group.

Conclusions: Anesthesia with the xenon-oxygen admixture is an effective method for surgical procedures for burn patients. This kind of analgesia allows reducing doses of psychotropic and sedating medications considerably, and that has a positive effect on the quality of treatment and reduces the risk of possible complications. The gained effect of analgesia prolongation up to 4 hours allowed refusing of narcotic analgesics using and non-steroidal anti-inflammatory drugs using among patients of the main group. 

1. Белов А. В. Ксеноновая анестезия. Достижения и перспективы. Ксенон и инертные газы в медицине. Материалы 3 конференции анестезиологов – реаниматологов в медицинских учреждениях МО РФ, Москва. 2012:17-22. [Belov A. V. Xenon anesthesia. Achievements and prospects. Xenon and inert gases in medicine. Materials from 3rd conference of anaesthesiologists and resuscitators in healthcare organizations of Moscow Region in the Russian Federation, Moscow. 2012. 17-22 p. (In Russ.)].

2. Буров Н. Е., Потапов В. Н., Макеев Г. Н. Ксенон в анестезиологии (клинико-экспериментальные исследования). М.: Пульс, 2000. 300 с. [Burov N. E., Potapov V. N., Makeev G. N. Xenon in anesthesiology (clinical and experimental researches). -Moscow: Pulse, 2000. 300 p. (In Russ.)].

3. Буров Н. Е. и др. Клинические стадии и субъективные ощущения при ксеноновой анестезии. Анестезиология и реаниматология 1993;(4):7-31. [Burov N. E. et al. Clinical stages and subjective sensations during xenon anesthesia. Anesthesiology and reanimatology = Anesteziologija i reanimatologija 1993;(4):7-31. (In Russ.)].

4. Буров Н. Е., Потапов В. А., Макеев Г. Н. Ксенон в анестезиологии, М.: Пульс, 2000. 356 с. [Burov N. E., Potapov V. A., Makeev G. N. Xenon in anesthesiology. Moscow: Pulse, 2000. 356 p. (In Russ.)].

5. Цыганков Б. Д., Шамов С. А., Брюр Е. А. и др. Учебно-методическое пособие «Ингаляционная терапия медицинским ксеноном в наркологической клинике». [Tsygankov B. D., Shamov S. A., Bryur E. A. et al. Guidance manual "Inhalation therapy by medical xenon in the detoxication clinic" (In Russ.)].

6. Rajakumaraswamy N. Neuroprotective interaction produced by xenon and dexmedetomidine on in vitro and in vivo neuronal injury models. Neurosci Lett 2006;(409):128-133.

7. Stoppe C., Cremer J.,Rex S et al. Xenon anaestesia for laparascopic cholecystectomy in a patient with multiple chemical sensitivity. Anaesth 2011;7(4):645 p.