| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, namely, to anesthesiology and oncology, and can be used as an anaesthesia care of surgical interventions in oncological patients. For this purpose, after the entry to operating theatre, an epidural cavity is punctured at the level T4-T11 followed by introducing lidocaine 40 mg. Thereafter, the epidural cavity is catheterised with a catheter which is inserted to infuse an analgesic mixture consisting of 0.2% ropivacaine 47 ml, 0.005% phentanyl 2 ml and 0.1% adrenaline 0.1 ml at 15 ml/hour for 20 min, and then the rate of administering is reduced to 7-10 ml/hour. In 20-25 min after the beginning of the epidural administration of the mixture, 0.005% phentanyl 2 ml and 0.1% atropine 0.5-0.6 ml are introduced intravenously. It is followed by propofol induction in dose 2-2.5 mg/kg with accompanying intubation of the patient. 100% Oxygen semiopen circuit denitrogenisation is performed. The denitrogenisation procedure is attended by the intravenous propofol anaesthesia in dose 4 mg/kg/hour. After the closed circuit is enabled, a breathing bag is left filled with no more than 500 ml, and the flow is dropped to zero. A phase of fast saturation Xe 1.3-1.5 of patient's pulmonary capacity under control of FiO2 follows to reduce the oxygen concentration in the breathing circuit equal to 40%. If achieving Xe 60%, the flow is set at 250-400 ml a minute to provide a stable balance. After the stable balance is provided in the relation Xe:O2 60:40, the Xe flow is reduced to 0-160 ml/min, while oxygen is supplied to the circuit in dose 4 ml/kg. At the traumatic operative stages, boluses of phentanyl 0.1 mg is gradually introduced. ^ EFFECT: method provides more effective and safe anaesthesia in the case patients due to the lower drug-induced load with simultaneous enhancement of an analytic effect ensured by the use of a combination of certain modes of the epidural and endotracheal anaesthesias. ^ 2 ex |
