| 摘要 |
FIELD: medicine. ^ SUBSTANCE: premedication by suprastin is performed in the dose of 0.25 mg/kg, in 15 minutes before anesthetic induction intravenous injection of 6-7.5 ml/kg of plasmalyte solution. Anesthesis induction is performed with 0.013 mg/kg of atropine and 1.33 mcg/kg of fentanil, then 2.5-3 mg/kg of propofol followed by 0.6 mg/kg of atracurium is injected. In 2 minutes after achievement of adequate mioplegia laryngoscopy and trachea intubation are performed. Anesthesia is sustained by low-flow anesthesia based on sevoflurane with minimum alveolar concentration of 1.2-0.6 in air and oxygen mix flow of 1.2-1.4 l/min via half-closed circuit in the IPPV mode, with tidal volume (TV)=7-8 ml/kg and minute tidal volume (MTV)=78-85 ml/kg, FiO2=40% under control of SpO2 and EtCO2. During anesthesia mioplegia is sustained by infusion of 0.36 mg/kg/hour of atracurium. If the operation should involve collapsed lung expansion, then sevoflurane feed is stopped at the moment of toracal drainage installation, in 8-10 min before the expansion, and fresh air and oxygen mix feed reaches 1.2-1.4 l/min in half-closed circuit with FiO2=40% with previous breath parametres. In 2 minutes before the collapse lung expansion anesthesia is deepened by injection of 1.25-1.5 mcg/kg of fentanil. If the operation is performed for a patient with complicated spine trauma, additionally 30 dose units of ingitryl is applied. ^ EFFECT: reduced surgical stress for patient and prevention of stress-induced response to surgical aggression. ^ 1 ex, 3 cl |
