Method for anesthesia at short-term laser-surgical interferences in the field of ophthalmology

FIELD: medicine, ophthalmology.

SUBSTANCE: one should intramuscularly introduce Ketanov about 1 h before operation, not later, at the dosage of 0.4-0.45 mg/kg patient's body weight followed by local anesthetization as blockade of pterygopalatine ganglion and akinesia with 2%-lidocaine solution. The present innovation enables to prolong anesthetization in post-operational period that, in its turn, prevents iatrogenic complications, especially in senile patients.

EFFECT: higher efficiency.

 

The invention relates to medicine, namely to ophthalmology, and can be used for short laser surgery in ophthalmology, for example, when conducting transscleral cyclophotocoagulation in the treatment of primary and secondary glaucoma.

The known method of anesthesia for short laser surgery in ophthalmology, for example, when conducting transscleral cyclophotocoagulation in the treatment of primary and secondary glaucoma (see a collection of scientific papers and articles "New laser technology in ophthalmology" Kaluga, February 2002, S. 31), consisting in the implementation of local anesthesia before performing outpatient surgery. Local anesthesia involves parabulbar introduction 2%lidocaine solution, blockade wing-Palatine ganglion 2%lidocaine solution).

The disadvantage of this method is unsatisfactory analgesia requiring further introduction, as a rule, narcotic analgesics (morphine, morphine or omnopon). However, despite the fact that the additional introduction of narcotic analgesics reach the required degree of pain, their use entails a lot of side effects, such as addiction, decreased level of consciousness, increased respiration, impaired hemodynamics, enabled the emergence of nausea, vomiting, urinary retention, inhibition of intestinal peristalsis.

The present invention solves the problem of developing a new method of anesthesia when performing a short-laser-surgical procedures in ophthalmology, for example, when conducting transscleral cyclophotocoagulation in the treatment of primary and secondary glaucoma in the outpatient setting. The technical result consists in obtaining adequate anesthetic effect if the drug is devoid of the side effects of narcotic analgesics. Preservation in patients with residual anesthetic effect during the first days after surgery avoids additional analgesia in the postoperative period. This is very important given that the majority of patients, which is transscleral cyclophotocoagulation, elderly and senile age with a number of concomitant diseases, in particular cardiac and pulmonary insufficiency, diabetes mellitus, chronic kidney disease, with elements kidney failure and others. For such patients are concerned about the introduction of additional pain medication.

This technical result is achieved in that in the method of anesthesia for short laser surgery in OFTEL is mologie, for example, when performing transscleral cyclophotocoagulation, consisting in the implementation of local anesthesia before performing outpatient surgery, pre-not less than an hour before the operation intramuscularly injected Ketanov at a dose of 0.4-0.45 mg/kg weight of the patient.

The method of anesthesia for short laser surgery in ophthalmology, for example, when performing transscleral cyclophotocoagulation is as follows.

Patients who are trained to perform transscleral cyclophotocoagulation previously not less than an hour before the operation intramuscularly injected Ketanov at a dose of 0.4-0.45 mg/kg weight of the patient. Immediately before surgery is performed with local anesthesia, including the blockade wing-Palatine ganglion 2%lidocaine in a dose of 5.0 ml and holding akinesia 2%lidocaine in a dose of 3.0. Perform short laser surgery, namely, transscleral the cyclophotocoagulation in 10-20 minutes. The number of operated patients, which when executed transscleral cyclophotocoagulation - outpatient laser surgery has been applied the proposed method of anesthesia is 159 patients. When you perform all of these patients showed prolonged analgesic effect was not observed n is any side effects during operation, and in the postoperative period. Prolonged analgesic effect in the postoperative period, which has continued during the first days after the operation, did not require additional infusion of analgesic drugs, which allowed to perform this operation in an outpatient setting without the need for hospitalization of patients.

The method of anesthesia when performing transscleral cyclophotocoagulation, including directly before surgery local anesthesia in the form of a blockade wing-Palatine ganglion and akinesia 2% lidocaine solution, characterized in that the pre is not less than an hour before the operation, intramuscularly injected Ketanov at a dose of 0.4-0.45 mg/kg weight of the patient.



 

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1 ex, 2 tbl

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