СПОСОБ КОМБИНИРОВАННОЙ ОБЩЕЙ АНЕСТЕЗИИ В СОЧЕТАНИИ С БЛОКАДОЙ ГЛУБОКОГО И ПОВЕРХНОСТНОГО ШЕЙНЫХ СПЛЕТЕНИЙ ПРИ КАРОТИДНОЙ ЭНДАРТЕРЭКТОМИИ ИЛИ РЕЗЕКЦИИ ВНУТРЕННЕЙ СОННОЙ АРТЕРИИ ПРИ ПАТОЛОГИЧЕСКОЙ ЕЕ ДЕФОРМАЦИИ
ILIN SERGEJ ALEKSANDROVICH,Ильин Сергей Александрович,SUBBOTIN VALERIJ VJACHESLAVOVICH,Субботин Валерий Вячеславович,POKROVSKIJ ANATOLIJ VLADIMIROVICH,Покровский Анатолий Владимирович
申请号：
RU2011107208/14
公开号：
RU0002493884C2
申请日:
2011.02.28
申请国别(地区):
RU
年份:
2013
代理人:
摘要：
FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to anaesthesiology, and may be used as an anaesthesia care of a surgical intervention for carotid endaterectomy or internal carotid artery resection after pathological deformation thereof. That is ensured by general anaesthesia in a combination with deep and superficial cervical plexus blockade. Pre-medication is used the day before the operation and on the operative day in the morning. Diazepam is introduced intramuscularly 30 minutes before the operation in a combination with phentanyl the introduction is followed by ECG monitoring and heart rate count, plethysmography with arterial blood saturation, non-invasive blood pressure measurement and neuromonitring according to a bispectral index or entropy. Catheterisation of patients peripheral or central vein is followed by an infusion therapy, an ionotropic therapy, a cardiotropic therapy, peripheral resistance maintenance. If heart rate is no more than 80 beats per minute, the anaesthesia is induced to reach an anaesthetic depth according to the bispectral index or entropy within 40-60 units. Analgesia is provided by the intravenous introduction of 0.005% phentanyl myoplegia is ensured by the intravenous introduction of a myorelaxant. After tracheal intubation, the patient is transferred to forced volumentic artificial pulmonary ventilation with the CO2 level within 35-45 mm Hg according to capnography. The anaesthesia is maintained by supplying an inhalation anaesthetic to the steam level of 0.8-1.0 MAK 0.8-0.9 litre of the air and oxygen flow containing 50% oxygen with controlling the inhalation anaesthetic volume by the level of the anaesthetic depth according to the bispectral index or entropy. That is followed by deep cervical plexus blockade. A tubercle of the VI cervical vertebra (a carotid tubercle) and a mastoid process are localised thereafter a line connecting the above reference points is drawn on skin. The second line is drawn 1 cm below th
