Method of anaesthetic management of surgical interventions in patients with terminal tracheostoma
SUBSTANCE: invention refers to medicine, namely to anaesthesiology, resuscitation and otorhinolaryngology, and can be used if it is necessary to provide the anaesthetic management in the patients with terminal tracheostomy. For this purpose, pre-oxygenation, assisted and forced lung ventilation are conducted before tracheal intubation through a laryngeal mask with an inflated cuff tightly adjoining a tracheostomy opening. Then, an intubation tube is inserted into the tracheostomy, and volumetric induced ventilation is conducted through the above tube.
EFFECT: method provides the prevention of hypoxia in such patients at the stages of intravenous premedication, the induction of anaesthesia and the introduction of muscle relaxants due to the stability of hemodynamics and gas exchange due to the continuous ventilation through a terminal tracheostomy.
The method of anesthetic management during surgical interventions in patients with end tracheostomy relates to medicine, primarily to anesthesia Handbook for surgical interventions in tracheostomised sick.
In surgery there is a method of General anesthesia with the use of laryngeal mask (V.V. Liventsev (as amended) "a Practical guide anesthesiology", M: LLC "Medical information Agency, 2011, pp.178-179) (similar). It is as follows: after the introduction of anesthesia with laryngeal mask slid down his throat and promote deeper, until it takes its "anatomical" the position of the larynx. While the glottis remains open epiglottis. Ventilation of the lungs begin after inflating the cuff. Laryngeal mask allows artificial lung ventilation (ALV), supports the airway.
The closest in technical essence is a way of anesthesia with endotracheal intubation via tracheostomy and three-dimensional artificial ventilation of the lungs (Olshansky V.O. "Laryngectomy with tracheoesophageal the bypass surgery and prosthetics in laryngeal cancer (clinical, methodological and functional aspects)" / V.O. Olshansky, V.I. Chissov, I.V. Reshetov, V. Dvornichenko, NR. Novoi the ova, M., printing center "real", 2004, p.65) (prototype). Anesthetic management by this method, perform the following way. The patient before surgery after the introduction of anesthesia in the background myorelaxation inkubiruut the trachea through the tracheostomy endotracheal tube through which spend the bulk mechanical ventilation during the operation.
With this method of anesthetic management no respiratory support of the patient on the stages of intravenous sedation, induction of anesthesia and insertion of the muscle until the intubation through the tracheostomy. This is usually accompanied by the development of hypoxia, is associated with the emergence period of apnea due to the use of intravenous anesthetics, analgesics and muscle relaxants with the introduction of the patient to the anesthesia. Episodes of hypoxia on the stages of apoptosis, induction of General anesthesia and intubation of the trachea leads to the development of undesirable hemodynamic reactions (arterial hypertension, tachycardia, arrhythmias and conduction of the heart). Also it is well known negative effect of hypoxia on the functioning of the Central nervous system, depending on its severity may clinically manifest as delayed post anesthesia awakening of the patient with transient cognitive impairment and persistent neurological symptoms what about the deficit.
The objective of the invention is the prevention of hypoxia on the stages of intravenous sedation, induction of anesthesia and insertion of the muscle, making provided a satisfactory and stable performance of gas exchange and hemodynamics during General anesthesia for surgical interventions in patients with end tracheostomy. In addition, in this category of patients with this method of anesthetic management is possible induction of General anesthesia with inhaled anesthetics.
The novelty of the proposed method is to conduct before operation preoxygenation, auxiliary and forced ventilation through the laryngeal mask tightly adjacent to the tracheostomy hole, surgical interventions in patients with end tracheostomy.
Technical solutions that have the signs consistent with the distinguishing characteristics of our proposed method, it is not revealed, which allows to make a conclusion on the conformity of the proposed method the criterion of "inventive step".
The proposed method is as follows. Before the operation the patient are preoxygenation 100% oxygen for 3-10 minutes through a laryngeal mask with an inflated cuff, tightly adjacent to the tracheostomy opening. After promedica the AI and induction of anesthesia via laryngeal mask carry out auxiliary volume ventilator and after the introduction of muscle relaxants is forced hardware volume mechanical ventilation before intubation (photo 1). After reaching total myorelaxation in tracheostomy hole to introduce an endotracheal tube, through which during all operations are performed in hardware IVL.
An example of implementation of the proposed method.
Patient T. 64 years, case history No. 1005. Clinical diagnosis: Cancer of the larynx T4N0M0, III clinical group status after laryngectomy, tracheostomy in 2011. To rehabilitate voice 12.01.12, the patient underwent the operation of forming tracheoesophageal fistula under General anesthesia with myorelaxation and volume ventilation. Before the operation the patient was performed preoxygenation 100% oxygen for 5 minutes through a laryngeal mask with an inflated cuff, tightly adjacent to the tracheostomy opening. After premedication and induction of anesthesia via laryngeal mask was carried out by the auxiliary volume ventilator, and after the introduction of muscle relaxants is forced hardware volume mechanical ventilation before intubation. After reaching total myorelaxation in tracheostomy hole has introduced an endotracheal tube, through which during the whole operation was performed hardware IVL. During anesthesia smooth, without features. Throughout the perioperative period is as marked satisfactory performance of gas exchange and hemodynamics. Later in the fistula has tracheoesophageal valve. The patient was discharged on the second day after surgery. Tracheoesophageal voice sonorous. It legible.
The proposed method of anesthetic management is used during surgical interventions in the hospital for ENT cancer patients with end tracheostomy.
The method of anesthetic management during surgical interventions in patients with end tracheostomy, namely, that during the surgery under General anesthesia spend the bulk of artificial lung ventilation through an endotracheal tube inserted in the end tracheostomy, characterized in that prior to intubation are preoxygenation, auxiliary and forced ventilation through a laryngeal mask with an inflated cuff, tightly adjacent to the tracheostomy opening.
SUBSTANCE: invention refers to medicine, namely physiology and experimental medicine, and may be used for preventing and relieving a chemical liver injury in a living body. That is ensured by an atmospheric hypoxic exposure which is started with standard 21% air oxygen to be gradually reduced to 12% at 3±0.25% a minute. That is followed by a -minute pause at 12% oxygen to be gradually increased to 30% at 3±0.25% a minute. That is followed by another 5-minute pause at 30% oxygen. Then, the oxygen content is gradually reduced to 21% at 3±0.25% a minute. The procedure is daily for 10-14 days.
EFFECT: method provides higher body adaptation ensured by the gradual variations of gas mixture oxygen.
SUBSTANCE: group of inventions refers to medicine. A respiratory mask has a receiving nose chamber, and at least three fastening loops to fasten the mask to the user's head. Each of the first and second fastening loops is located in the appropriate section of the nose chamber corresponding to a wing of nose, and the third fastening loop is placed in the area of the nose chamber corresponding to a base of nose. What is also presented is a respiratory device consisting of a mask, a cap and fasteners which are interfaced with fastening loops and the cap thereby fastening the mask on the patient's head. What is also presented is a respiratory system comprising the respiratory device with the mask and a respiratory unit that generates constant high air pressure. What is also presented is a packaging unit accommodating the respiratory mask having a fringe with a peripheral groove, a sealant placed in the groove (21) to seal a border between the mask and the patient's face, as well as a protective film covering the sealant prior to the use of the mask.
EFFECT: group of inventions enables avoiding the mask leakage when in use.
13 cl, 6 dwg
SUBSTANCE: group of inventions refers to medicine. A mask comprises a body with a nose space; an interface portion attached to the body by a connection system having a side channel formed across an upper wall. The connection system is flexible. The interface portion is movable with respect to the body, and comprises a patient's port and an elongated hollow rod inserted in nostrils, projecting from the nose space and forming a gas passage for gas delivery into the patient's nose. The rod is rigidly connected to the patient's port of the interface portion. The interface portion is connected to a universal interface comprising a feed passage, a pressure passage and an inhalation port. The rod has proximal and distal ends. The proximal end is inserted into the nose space, while the distal end has a female end hermetically inserted into one of the patient's nostrils. The rod comprises a pear-shaped portion; it is fixed inside the patient's nose thereby attaching a nasal mask with using no head belt. What is also disclosed is the version of the nasal mask differing by the implementation.
EFFECT: lower risk of leakage.
17 cl, 10 dwg
SUBSTANCE: invention refers to medicine, namely paediatrics, cardiology, somnology, and may be used for treating adolescents with essential arterial hypertension with obstructive sleep apnoea/hypnoea syndrome. For this purpose, nasal non-invasive lung ventilation by nocturnal nasal continuous positive airway pressure (nCPAP-therapy) and light therapy with a therapeutic health-improving lamp with underlying standard therapeutic regimens. The nCPAP-therapy involves 10 monthly procedures for three months with a session length of 8 hours. The light therapy are performed once a day during a first hour after wakening up, a length of procedure is 30 minutes; the therapeutic course is 10 days for a first month of therapy.
EFFECT: method provides normalising the blood pressure level ensured by correcting obstructive respiratory sleeping disorders and normalising the circadian rhythm system.
FIELD: textiles, paper.
SUBSTANCE: material comprises fibrous layers of a mixture of viscose, polypropylene and bicomponent fibers, bonded with the back-up substrate, in the following ratio of components: viscose fibers (0.17-0.33) tex - (20-40) wt.% polypropylene fibers (0.33-0.67) tex - (30-45) wt %, polypropylene fibers 1.7 tex - (5-10) wt.%, bicomponent fibers (0.22-0.40) tex (20 - 30) wt %, calcium chloride (15-50) wt %. The surface density of the obtained filter material is (100-500) g/m2, air permeability (550-850) dm3/m2s, hygroscopicity (25.0-47.5)%. The objects of the invention are also variants of the method of manufacturing non-woven filter material, the first of which involves the processing of viscose and polypropylene fibers with an aqueous solution of calcium chloride with the mass concentration (100-500) g/dm3 at processing module (1:2÷1:5) of weight parts for viscose fibers, at processing module (1:1.5÷1:3) of weight parts for polypropylene fibers. The version 2 of the claimed method provides for the processing of the whole filtering material with a solution of calcium chloride, which mass concentration is (100-500) g/dm3 at processing module (1:1.15÷1:3) of weight parts. In both versions, drying of the treated material is carried out at a temperature not exceeding 80°C and heat treatment with hot air at a temperature of (120-145)°C.
EFFECT: obtaining a porous hydrophilic filter material with a high air permeability and stability of shape, providing moisture and warming of air entering the patient's lungs through a breathing filter when endotracheal anesthesia and mechanical lungs ventilation.
18 cl, 1 dwg, 5 ex
SUBSTANCE: group of inventions refers to medicine. An inflatable face seal comprises a ring air-tight hollow portion. The face seal in its cross-section section of the ring hollow portion comprises an adhesive joint which connects two overlapped boards glued together so that a surface of the first board facing inside from the two overlapped boards contact with a surface of the second board facing outside from said overlapped boards. The surface of the first board facing inside is pressed to surface of the second board facing outside due to initial stress in the inflatable face seal. There are disclosed a method for making the inflatable face seal with using a mould and extending a part of the section, and a workpiece for making the face seal.
EFFECT: cutting production costs.
9 cl, 9 dwg
SUBSTANCE: invention refers to medicine, namely therapy and surgery, and can be used for treating metabolic syndrome, including in patients suffering cardiovascular and respiratory insufficiency, and also obstructive sleep apnea. That is ensured by brief noninvasive continuous positive pressure assisted ventilation for 3 days (CPAP-therapy). The compensation is followed by inserting an intragastric cylinder and continuing the long-term CPAP-therapy to eliminate sleep apnea completely.
EFFECT: method provides compensating metabolic syndrome by manifested body weight reduction ensured by enabled insertion of the intragastric cylinder together with a reduced risk of developing complications accompanying the insertion due to the advance compensation of the detected disorders.
1 ex, 4 dwg
SUBSTANCE: invention refers to medicine, namely to anaesthesiology and resuscitation, and can be used if placing of a flexible reinforced laryngeal mask airway required. That is ensured by preoxygenation through a face mask for two minutes. Then a patient is placed in a "sniffing" position with a head supported by a cotton roll. The laryngeal mask airway is placed with its aperture upwards and arranging a mask tip on the centre of front incisors on an internal surface of a patient's mouth with pressing it to a hard palate with a third finger. After that, the mouth cavity is examined, and the LMA is moved downwards with pressing within a tube and mask junction to enable the mask passing near a tongue and falling in a pharynx. If observing resistance behind the tongue, the mask is turned around 90° with the aperture to the left and placed back into the initial position after passing the obstacle. Mask cuff is inflated with making sure that a black line is directed backwards and found in the middle.
EFFECT: method allows providing easy placing of the laryngeal mask airway with simultaneously reduced risk of hypoxia and laryngopharynx damages during mask placing.
7 tbl, 2 ex
SUBSTANCE: invention relates to medicine, specifically to influenza medicine, and can be used as individual protection of respiratory organs of humans and animals against airborne viral and bacterial infections. Personal protection from viral infection includes the input layer of the filter, the light-emitting diodes located outside inhalation area behind the front surface of the input layer of the filter; the light-emitting diodes light is directed toward the location of the inhalation area. The selected emission spectrum is fatal to the virus. LEDs Housing has a shaped location plate made with the lodgment, the concave shape of which is oriented toward the inhalation area. On the opposite side of the LEDs (opposite to inhalation area) outside the inhalation area there are reflectors each facing their concave surface towards its radiator, LED. The interior surfaces of lodgments and reflectors have high reflectance in the radiation area.
EFFECT: invention provides a high degree of protection from disease-causing viruses that cause influenza, such as swine influenza H1N1, by destroying these viruses.
15 cl, 2 dwg
SUBSTANCE: invention relates to medicine, namely to rehabilitology, and can be applied for non-drug treatment of metabolic syndrome. For this purpose patients are given 10-12 complex procedures with 40-50 minute duration. Procedures include simultaneous impact with dosed systemic body hyperthermia in conditions of dry sauna with gradual temperature increase to 50-80°C with its further decrease to 35°C by the end of procedure, apparatus vibration massage of back and lower extremities, aromatherapy and hypoxic- hyperoxic inhalations through the mask. Each inhalation consists of 5-7 cycles which include period of breathing with hypoxic mixture with 11% O2, followed by breathing with hyperoxic mixture with 30% O2, whose duration is selected individually. Inhalations with hypoxic gas mixture are continued until individual minimal value of level of blood saturation with oxygen or individual maximal value of heart beat rate is reached, 1 minute after it hypoxic mixture is replaced with hyperoxic mixture until initial values of parametres are restored.
EFFECT: said mode of complex physiotherapeutic procedures including individual selection of dosage of hypoxic and hyperoxic inhalations duration ensures increase of treatment efficiency due to synergetic action of therapy components.
SUBSTANCE: presented group of inventions refers to anaesthesiology, and may be used in performing X-ray endovascular heart, aorta and other great vessel surgeries in infants and young children. For this purpose, 10-12 hours before the surgery, a patient is pre-medicated by administering benzodiazepine, antihistamine and blocker H2. The anaesthetic administration is enabled by fast induction of sevoflurane before the first surgical stage. Then, a two-flap laryngeal mask is used, its drainage duct is used to pass a gastric probe a correct placement of which is monitored by X-ray, and the gastric contents is evacuated. The probe is removed, and the same duct is used to insert an echocardiographic probe. The anaesthesia is maintained by infusion of propofol in a dose of 6-8 mg/kg/h and bolus introduction of an opioid analgesic. The artificial pulmonary ventilation is conducted through the laryngeal mask, and the patient is transferred to unassisted respiration with a dose of propofol to be reduced to 4-5 mg/kg/h. The principal stage of the surgery and ultrasonic control, or control with introducing a contrast agent, the echocardiographic probe is removed. Infusion of propofol is terminated after suturing and compression hemostasis. In the period of escaping the anaesthesia with the laryngopharyngeal reflexes recovered, air is evacuated from a cuff of the laryngeal mask, and after adequate respiration recovered, the same mask is removed.
EFFECT: group of inventions ensures the adequate anaesthesia in these patients by means of the developed method of lung ventilation using no myorelaxants, and prevented regurgitation of the gastric contents.
8 cl, 3 ex
SUBSTANCE: group of inventions represents a respiratory apparatus and an operating procedure of a particularly combined analgesia and therapeutic artificial respirator. Said respiration apparatus comprises at least a fresh gas treatment device, a stimulant gas treatment device, a T-joint with an inhalation site and an exhalation site, as well as appropriate regulation and control units. For the purpose of regeneration and return of an excessive gas anaesthetic, the respiratory apparatus additionally comprises a regulation select valve mounted on the exhalation site and having a return flow gas line and a direct flow gas line, a gas vessel arranged on a return flow path and extending on the inhalation site, as well as a fresh gas release valve connected to the gas vessel towards the gas flow and connected with both the gas vessel, and the fresh gas treatment device. When the apparatus is in service, the direct gas flow is used to control the fresh gas discharge parameters; a filling rate indicator in the respiratory apparatus is expiratory pressure.
EFFECT: group of inventions provides higher clinical effectiveness of using the gas anaesthetic supplied to the patient.
12 cl, 5 dwg
SUBSTANCE: inhalation narcosis apparatus comprises a fresh gas dosage meter 8 coupled with a stabilised low-resistance evaporator 1 equipped with a position switch 2 inside or outside a breathing system 3 comprising a carbon dioxide adsorber 4, a respiratory bag 5, an air aspiration valve 6 and a safety valve 7 provided in front of the adsorber. A shaft 10 covers the respiratory bag 5 with forming a cavity in between coupled with an output connector of an artificial pulmonary ventilation system. The evaporator 1 is provided is a calculator 15 of the expired concentration of an anaesthetic and attached to the adsorber 4. The shaft 10 is internally deflected and equipped with an adjustable maximum volume limiter 14.
EFFECT: extended range of the use of the inhalation narcosis apparatus.
7 cl, 2 dwg
SUBSTANCE: invention relates to medicine, namely to anesthesiology and resuscitation science and can be used in diagnostics of impairment of blood oxygenation in process of artificial lung ventilation (ALV). For this purpose in process of carrying out ALV partial pressure of oxygen in arterial blood (PaO2), fraction of oxygen in inhaled mixture (FiO2), partial pressure of carbon dioxide in arterial blood (PaCO2), mean pressure in airways (Pmean) are determined, patient's age (a) is taken into account, rhythm of breathing during ALV, whose impact on oxygenation is taken into account by coefficient (K) is determined. After that, level of proper partial pressure of oxygen in arterial blood (PaO2proper) is calculated by formula
PaO2proper is proper partial pressure of oxygen in arterial blood, mm Hg; a is age, years; K is coefficient of impact of breathing rhythm on oxygenation: in case of forced rhythm of ALV, K is 0.9; in case of intermittent rhythm of ALV, K is 0.95; in case of independent rhythm of ALV, K is 1. Pmean is mean pressure in airways, cm, water column, FiO2 is fraction of oxygen in inhaled mixture, fraction from 1, PaCO2 is partial pressure of carbon dioxide in arterial blood mm Hg. On the basis of obtained data, ratio PaO2proper/PaO2 (is determined. If value of obtained ratio is lower than 1.2, absence of oxygenation impairment is diagnosed, from 1.2 to 1.59, first degree of oxygenation impairment is diagnosed, from 1.6 to 2.09 - second degree of oxygenation impairment, from 2.1 to 2.69 - third degree of oxygenation impairment, from 2.7 to 4.79 - fourth degree of oxygenation impairment and from 4.8 and higher, 5 degree of oxygenation impairment is diagnosed.
EFFECT: method makes it possible to optimise treatment process due to the most accurate selection of ALV mode which results from provided possibility of estimation of functional state of lungs in response to performed therapy in patients of any age.
1 tbl, 3 ex
SUBSTANCE: invention refers to medicine, namely to anaesthesiology, and may be used as an anaesthesia care of surgical correction of severe spinal scoliosis with a high risk of developing neurological complications. For this purpose, 30 minutes prior to the operation, intramuscular pre-medication with Dormicum 0.1 mg/kg and Dimedrol 0.4 mg/kg is required. The anaesthesia is induced by Phentanyl 0.002 mg/kg, Propofol 2.5 mg/kg. The introduction of Nimbex 0.1 mg/kg is followed by the trachea intubation. After the trachea intubation and transition to artificial pulmonary ventilation, loading doses of Clopheline 0.004 mcg/kg and Ketamine 0.25 mg/kg are introduced. Sevorane in the concentration of 4 vol. % immediately follows the trachea intubation and transition to artificial pulmonary ventilation assisted by the air and oxygen flow rate of 4-5 l/min to reach the breath-out sevorane concentration min. 2.6 vol. % (1.04 minimum alveolar concentration). Then the air and oxygen flow rate is decreased to 1 l/min. Artificial pulmonary ventilation is enabled by an anaesthesia apparatus for sevorane delivery in forced pulmonary ventilation mode with the low fresh gas flow rate 1 l/min with minute tidal volume to ensure the breath-out concentration of carbon dioxide within 32-37 mm Hg, the concentration of oxygen in the mixture 40%. The mandatory safety monitoring involves blood pressure, heart rate, electrocardiogram, arterial blood oxygen saturation, mixture oxygen concentration, breath-out carbon dioxide concentration, air and oxygen sevorane concentration, breath-out sevorane concentration, breath-in air and oxygen carbon dioxide and bispectral electroencephalogram and electromyography index recordings. The anaesthesia is maintained by sevorane inhalations 3-1.5 vol. %. (1.2-0.6 minimum alveolar concentration), bolus introductions of Fentanyl 0.004±0.001 mg/kg/h, continuous infusion of Clopheline 0.004 mcg/kg/h, Ketamine 0.25 mg/kg/h and supporting Nimbex 0.05-0.03 mg/kg/h. 30 Minutes before the patient wakes up, sevorane dose is maintained at 1.0-0.8 vol. %, 20 minures before, the Nimbex introduction is completed, 15 minutes before, sevorane delivery is completed, 30 minutes before the waking up, the Fentanyl introduction is completed, while Clopheline and Ketamine are kept to be introduced. The spinal function monitoring is controlled by electroencephalogram activity and nervomuscular conduction as shown by electromyography. Patient contact is considered to be allowed if observing the bispectral electroencephalogram index min. 75-78% and the degree of residual neuromuscular blocks max. 20%. After obtaining the spinal function monitoring data, the bolus introduction of Fentanyl 0.002 mg/kg, Nimbex 0.1 mg/kg, while sevorane is started to be introduced in the concentration of 4 vol. %. Then concentration of Sevorane is reduced to 3-1.5 vol. % (1.2-0.6 minimum alveolar concentration), Clopheline and Ketamine are kept to be infused in the previous dosages.
EFFECT: method enables high control of the anaesthesia and an effective level of antinociceptive protection while the patient wakes up that is ensured by multidirectional action of the presented components of the anaesthesia.
SUBSTANCE: invention relates to medicine, namely to anesthesiology and thoracic surgery, and can be used as anesthetic aids in surgery on lung resection. For this purpose carried out is general anesthesia with microrelaxants and artificial lung ventilation in combination with blockades. Before anesthesis induction subpleural blockade is performed. After intubation of patient vagosympathetic blockade is carried out. As local anesthetic, in carrying out said blockades 0.2% ropivacaine solution is used.
EFFECT: method makes it possible to ensure adequate blockade of pain impulse at stages of transduction and transmission in carrying out operation on patients with reduced reserve heart possibilities.
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.
SUBSTANCE: invention refers to anaesthesiology. An anaesthetic evaporator comprises a gas distributor with a temperature compensator, an anaesthetic chamber with a number of evaporating elements made of a capillary active material and connected with an input and an output of the gas distributor, and a heat stabiliser with a liquid. The heat stabiliser comprises a number of cylinders with a liquid and is placed in the anaesthetic chamber. The evaporating elements are combined with the cylinders with their external walls being wrapped up with the capillary active material. The liquid in cylinders has hardening temperature higher than a lower limit of working temperature of the evaporator. The output anaesthetic steam concentration is equilibrium with the liquid anaesthetic at liquid temperature in the cylinders.
EFFECT: more stable anaesthetic dosing.
5 cl, 5 dwg
SUBSTANCE: invention refers to medicine, namely to anesthesiology, and can be used in sevoflurane inhalation anaesthesia. For this purpose, the general anaesthesia is induced by inhalation of an anaesthetic gas of the anaesthetic sevoflurane concentration 8%. Then, in 2 minutes the anaesthetic concentration is reduced to 4%. Thereafter, in 2 minutes, the supporting concentration 1.5 % is adjusted.
EFFECT: method allows reducing narcosis induction time and thereby reducing the adverse actions of the anaesthetic due to staged two-level decrease of the inhalation anaesthetic concentration.
SUBSTANCE: invention refers to medicine, namely to anesthesiology, and can be used in inhalation anaesthesia. That is ensured by inhalation induction with adjusting constant positive pressure 5 cm Aq in a breathing system of an anaesthesia apparatus.
EFFECT: method allows reducing narcosis induction time and thereby reducing the adverse actions of the anaesthetic with simultaneous partial inhalation anaesthetic pressure increase due to choosing an optimum value of constant positive breathing system pressure.
2 dwg, 2 ex
FIELD: medical engineering.
SUBSTANCE: device has measuring unit 1 having inlet and outlet tubes 2 and 3 and electronic unit for processing signals. The device has control valve 4 mounted on inlet tube 2. The electronic unit for processing signals has absolute pressure gage 5 mounted on xenon entry to the measuring unit, standardizing amplifier 6 of absolute pressure, the first differential pressure gage 7, the first standardizing amplifier 8 of differential pressure, the second differential pressure gage 9, the second standardizing amplifier 10 of differential pressure, switch 11, multiplier 12, analog-to-digital converter 13, digital xenon discharge flow indicator 14, voltage-to-frequency converter 15, xenon quantity counter and digital xenon quantity indicator. The measuring unit has at least two parallel capillary tubes. Capillary tubes inlet is connected to the inlet tube and the outlet is connected to the outlet tube.
EFFECT: improved operation characteristics.
7cl, 1 dwg