| 摘要 |
A method for general anesthesia during laparoscopic surgery in infants comprises the oxygen inhalation anesthesia with oxygen and sevofluran mixture, induction of "painful" method through a face mask with concentration of anesthetic during inspiration 8 vol. %. The breathing circuit is blown with oxygen-sevofluran mixture with triple filling and depletion of breathing bag of and anesthesia respiratory system and the loss of the child's consciousness after 3-5 breaths of oxygen-sevofluran mixture and upon reaching of bispectral index of 40 units. Phentanyl is administered painfully 5 mg/kg, esmeron 0.4 mg/kg, and then tracheal intubation is made and mechanical lung ventilation to support breathing volume of 6 ml of respiratory mixture per kilogram of body mass. During maintenance of anesthesia BIS-index has the value of 30-42 units at concentration of sevofluran on exhalation 3.2 ± 0.2 vol. % of continuous infusion of phentanyl 5 mg/kg body mass per hour. The gas flow is reduced to 0.5 l/min, transition to inhalation anesthesia with minimal gas flow is carried out no earlier than 10 minutes from the beginning of induction, provided dynamic equilibrium concentration of anesthetic for inhalation and exhalation. At lack of fresh gas the gas flow is increased again for 5 min. At the moment of reduction gas flow the correction of oxygen and air is carried out, and at the end of surgery after the removal of carbon dioxide from abdominal the transfer the patient to spontaneous breathing is performed, followed by the extubation of the trachea. When BIS-index ≥ 75 units which corresponds to adequate recovery and proper breathing with blood oxygen saturation, carbon dioxide tensions on the exhale and upon reaching BIS-index> 90 units the patient is transported in the chamber. |
