Method for retrobulbar anaesthesia in oncological eye diseases with use of b-ray applicator

FIELD: medicine.

SUBSTANCE: catheter is inserted into the retrobulbar space and used to introduce 2% lidocaine 1 ml and 0.5% marcaine 1 ml 15-20 minutes before applicator anchoring. The catheter is left in the retrobulbar space for 1-7 days. 10-15 minutes before removing the applicator, 2% lidocaine 0.5-1 ml and 0.5% marcaine 0.5-1 ml are introduced through the catheter. 4-6 hours after anchoring and removing the applicator, 2% lidocaine 1 ml and 0.5% marcaine 1 ml are introduced respectively additionally.

EFFECT: achieving adequate and prolonged anaesthesia in a combination with reducing a risk of a retrobulbar haematoma, eyeball puncture and visual nerve damage by eliminating the retrobulbar space re-puncture.

2 ex

 

The invention relates to medicine, namely to ophthalmology, and can be used for pain relief ophthalmic surgical interventions, especially in patients requiring prolonged anesthesia or repeated anesthesia for several days after the first surgical intervention, namely in cancer of the eye conducted using radioisotope beta applicator.

The closest analogue is a method of performing retrobulbar anesthesia for abdominal operations on the eyeball (patent RF №2400260), however, the known method has the following disadvantages, which are that to ensure a longer duration of anesthesia, the authors suggest retrobulbarno to enter an increased volume of anesthetic (lidocaine 2% and bupivacaine 0.5% to 5 ml cubic). The introduction of a large volume in the retrobulbar space requires a long exposure time, 45 to 60 minutes before the operation, so that the liquid portion of the anesthetic resorbed, eliminating excessive pressure in the orbit on the eyeball. Despite increased during anesthesia, in some cases, prolonged surgery and inadequacy of anesthesia add anesthetic during the operation is not possible.

If necessary, the operation in two stages, such as suturing and removal radioisotope�about the applicator, retrobulbar anesthesia is required at two times, which increases the risk of anesthesia, and it can happen retrobulbar hematoma, and puncture of the eyeball and optic nerve damage.

The object of the invention is to provide a method of conducting retrobulbar anesthesia in cancer of the eye conducted using radioisotope is a beta of an applicator, achieving adequate and prolonged anesthesia.

The technical result is to achieve a sustained and adequate anesthesia, reducing the risk of complications such as retrobulbar hematoma, puncture of the eyeball, damage to the optic nerve due to an exception repeated puncture retrobulbar space.

The technical result is achieved in that in the method of conducting retrobulbar anesthesia in cancer of the eye conducted using radioisotope beta applicator including retrobulbar injection of local anesthetic, according to the invention pre-installed in the retrobulbar space of the catheter, that for 15-20 minutes to stitch applicator administered 1 ml of 2% lidocaine and 1 ml of 0.5% marcaine, leave the catheter in the retrobulbar space for 1-7 days, for 10-15 minutes before removing the applicator is inserted through the leg�R 0.5-1 ml of 2% lidocaine and 0.5-1 ml of 0.5% marcaine, and 4-6 hours after stitch and removing the applicator is further added 1 ml of 2% lidocaine or 1 ml of 0.5% marcaine.

The novelty of this method is the possibility of introducing anesthetic into the retrobulbar space through the catheter that will allow to prolong the duration of anesthesia to anesthesia when running deferred operations, abandonment of the catheter and, accordingly, to reduce the risk of recurrent retrobulbar puncture.

The time of administration of the anesthetic in the indicated dosages for 15-20 minutes before first stage - stitch applicator, chosen because during this time the anesthetic is distributed in the retrobulbar space and provides adequate anesthesia.

Given that the second phase of the operation - the removal of the applicator, less traumatic and prolonged than the first, the anesthetic in the indicated dosages administered in 10-15 minutes before the start of the second phase.

Given that the action is carried out during each phase of the operation the anesthesia ends after 4-6 hours in the postoperative period is further added 1 ml of 2% lidocaine or 1 ml of 0.5% marcaine. Initially 15-20 minutes before surgery patients performed intramuscularly standard premedication, including sedatives (seduksen 0.14 mg/kg), antihistamines (diphenhydramine 0.14 mg/kg or suprastin 0.3 mg/kg) and anticholinesterase (atropine 0,007 mg/kg) drugs. �] is as follows: with the patient supine before the operation is performed, the catheter was installed in the retrobulbar space. Used subclavian catheter with a diameter of 0.6 ml (JSC "Sintez", Kurgan). Once the needle is in the retrobulbar space in the lumen of the scaffold is introduced on a scaffold and catheter to a depth of 25 mm, which previously on the catheter to apply the label dye, for example alcoholic solution of brilliant green. The catheter is fixed and through him is introduced 1 ml of 2% lidocaine and 1 ml of 0.5% marcaine. After 15-20 minutes can be initiated the first stage of surgical intervention, namely suturing the applicator. The catheter may be retained for a period of from 1 to 7 days in advance for planned second stage surgery, namely the withdrawal of the applicator. 10-15 minutes before it is administered in 0.5-1 ml of 2% lidocaine and 0.5-1 ml of 0.5% marcaine, which eliminates repeated puncture of the retrobulbar space and reduces the risk of complications such as retrobulbar hematoma, puncture of the eyeball, damaging the optic nerve. In the postoperative period after 4-6 hours after each phase of the operation is further added 1 ml of 2% lidocaine or 1 ml of 0.5% marcaine.

Example 1

Patient S., aged 57, was admitted to IRTC "eye microsurgery" with a diagnosis of tumor of the choroid.

Operation stitch radioisotope applicator held on 18.12.2013 Previously in the retrobulbar space put a catheter that is introduced 1 m� 2% lidocaine+1 ml of 0.5% marcaine. The operation began after 15 minutes and was successful, anesthesia was adequate. The catheter is fixed to the skin by adhesive plaster left in the retrobulbar space. 6 hours after stitch applicator for postoperative analgesia additionally introduced 1 ml of 2% lidocaine.

The operation to remove the applicator held on 23.12.2013 preloaded into the catheter for 15 minutes before operation introduced 1.0 ml 2% lidocaine+0.5 ml of 0.5%. Marcaine. The operation was successful, anesthesia was adequate. The risk of anesthesia was reduced, given that the repeated puncture of the retrobulbar space was not required. 4 hours after removal of the applicator for postoperative analgesia additionally introduced 1 ml of 0.5% marcaine.

The catheter from retrobulbar space at the end of the first day after postoperative analgesia deleted.

Example 2

Patient A., age 59, entered the IRTC "eye microsurgery" with a diagnosis of tumor of the choroid.

Operation stitch radioisotope held applicator Pre-23.12.2013 in the retrobulbar space delivered to the catheter. In the catheter for 20 minutes to stitch the applicator is introduced 1 ml of 2% lidocaine+0.5 ml of 0.5%. marcaine. The operation was successful, anesthesia was adequate. The catheter is fixed to the skin by adhesive plaster left in the retrobulbar space�TVE. 4 hours after stitch applicator for postoperative analgesia additionally introduced 1 ml of 0.5% marcaine.

The operation to remove the applicator held 24.12.2013 G. preloaded into the catheter for 10 minutes before removing the applicator is introduced 0.5 ml of 2% lidocaine+1 ml of 0.5%. marcaine. The operation was successful, anesthesia was adequate. The risk of anesthesia was reduced, given that the repeated puncture of the retrobulbar space was not required. 6 hours after operations for the removal of the applicator for postoperative analgesia additionally introduced 1 ml of 2% lidocaine. The catheter from retrobulbar space after postoperative analgesia deleted.

The method retrobulbar anesthesia in cancer of the eye conducted using radioisotope beta applicator including retrobulbar injection of local anesthetic, wherein the pre-set in the retrobulbar space of the catheter, that for 15-20 minutes to stitch applicator administered 1 ml of 2% lidocaine and 1 ml of 0.5% marcaine, leave the catheter in the retrobulbar space for 1-7 days, for 10-15 minutes before removing the applicator is inserted through the catheter with 0.5-1 ml of 2% lidocaine and 0.5-1 ml of 0.5% marcaine, and 4-6 hours after stitch and removing the applicator further added respectively 1 �l of 2% lidocaine or 1 ml of 0.5% marcaine.



 

Same patents:

FIELD: medicine.

SUBSTANCE: after performing median sternotomy pericardial and mediastinal drainages are installed and sternum is sutured. After suturing sternum for length of its entire front surface, catheter is installed through skin counterpuncture, with 1.0-2.0 cm indent from lower wound edge. proximal end of catheter is fixed to subcutaneous-adipose cellular tissue with absorbable suture material, and distal part of catheter with cannula is fixed by suturing to skin with non-absorbable suture material. Local anaesthetic is introduced through installed catheter every 6 hours, with antibiotic being introduced every 8 hours. Introduction of medications is performed for 3-5 days.

EFFECT: method provides effective anaesthetics with simultaneous drainage of front sternum surface and skin wound due to introduction of anaesthetics and antibiotics via catheter into said zone, which additionally reduces quantity of exudative inflammatory complications in post-operative period.

2 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: spinal anaesthesia is followed by catheterisation of an epidural space at the level of L1-L2. The spinal anaesthesia is performed at the level of L4-L5 by administering 0.5% bupivacaine. Bupivacaine is administered in a dose of 5-6 mg if the pregnant woman's height is less than 165 cm, and the dose is 6-7 mg if the pregnant woman is from 165 to 175 cm high. After the local anaesthetic is administered into the epidural space, normal saline is introduced. If the intra-abdominal pressure is ≤16 cm H2O, normal saline 15 ml is administered; if the intra-abdominal pressure is 17-21 cm H2O, an amount of normal saline is 10 ml, whereas the intra-abdominal pressure of 22-28 cm H2O requires an amount of 5 ml.

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1 tbl, 1 dwg, 2 ex

FIELD: chemistry.

SUBSTANCE: as active component pharmaceutical composition contains dihydrochloride of 9-(2-morpholine ethyl)-2-(4-fluorophenyl)imidazo[1,2-α]benzimidasol, and as additional substances - fillers, binding, sliding and film coatings, in quantities, given in the invention formula. Composition can be made in form of solid medication form, mainly in form of tablets and capsules.

EFFECT: obtained solid medication forms satisfy the requirements of the State Pharmacopoeia.

7 cl, 2 dwg, 3 tbl, 14 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to a percutaneously absorbable layer having a base and an adhesive layer which is placed on the base and which comprises an adhesive agent and a therapeutic ingredient. The adhesive agent contains a mixture of resins containing 100 portions by weight of an acrylic copolymer (A) and 0.1 to 30 portions by weight of an acrylic copolymer (B) or 0.05 to 2 portions by weight of a low-molecular polyamine compound having at least two amino groups in one molecule and non-polymerising with a polymer or an oligomer formed. The adhesive layer additionally contains an organic acid. The acrylic copolymer (A) represents an acrylic copolymer, which contains acrylic ester of (meth)acrylic acid as a main monomer ingredient and contains 3 to 45 wt % of diacetone acrylamide as a target monomer ingredient, but free from a free carboxylic group. The acrylic copolymer (B) represents an acrylic copolymer, which contains acrylic ester of (meth)acrylic acid as a main monomer ingredient and contains a primary amino group and/or carboxyhydrazidase group on side chains, but free from a free carboxylic group.

EFFECT: reducing the aging period of the adhesive layer considerably.

7 cl, 8 tbl, 39 ex

FIELD: medicine.

SUBSTANCE: therapeutic agent contains hypromellose, boric acid and a consistency base; it additionally contains anesthesin or lidocaine as an analgesic in an amount of 0.00001-0.5 g.

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3 cl, 6 ex

FIELD: medicine.

SUBSTANCE: anterior chamber anaesthesia and pupil dilatation accompanying anterior eye segment surgeries experimentally involve a preoperative administration of a composition in an amount of 0.1-0.2 ml representing 0.005% 1-(3-pyrrolidinopropyl)-2-phenylimidazo[1,2-a]benzimidazole dihydrochloride into the anterior eye segment. The composition is prepared in 1% viscoelastic solution, visiton PEG.

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2 ex

FIELD: veterinary medicine.

SUBSTANCE: intramesovarian blockade of ovarian and cranial uterine nerves is carried out by laparotomy and administration in the mesovarium of 0.5-1% solution of novocaine or lidocaine. Blockade is carried out by inserting the needle of the syringe into the mesovarium in the vicinity of the ovarian bursa and uterine horn at an acute angle to the surface of the ovarian mesenterium to a depth of 3-4 cm. At that 3 ml of anaesthetic is administered to small breeds of dogs and fur-bearing animals, and from 3 to 9 ml of anaesthetic is administered to large and giant breeds of dogs as from one and from the opposite side of the body.

EFFECT: effective implementation of intramesovarian blockade by taking into account the anatomical and the breed features of the animal category.

1 tbl

FIELD: medicine.

SUBSTANCE: patient is laid on his/her side opposite a block region. A guide mark is a vertical line in a projection of Petit's triangle from the twelfth rib to a wing of ilium. A needle is pricked into the skin on the vertical line at 1.5-2.5cm above the wing of ilium. 0.25% Novocaine is administered in layers into the skin and subcutaneous fat. The needle is advanced into the lumbar region from back to front in the medial direction along the lateral edge of broadest muscle of back at 6-8cm. Novocaine 120ml is administered into the lower order of the lumboiliac fossa formed in this region.

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1 dwg, 1 ex

FIELD: biotechnology.

SUBSTANCE: aqueous composition for anaesthesia is proposed, which comprises propofol as an active agent, the PEG-660-12-hydroxystearate as a solubiliser, benzyl alcohol, or chloroethanol or parabens as preservative, the tocopherol and arginine or glycine at a specific content of components wt %. The GABA agonists can be additionally added to the composition, e.g. aminophenyl-butyric acid, local anesthetics such as lidocaine, alpha-2-adrenoceptor agonists such as xylazine. The method is proposed for implementing anaesthesia comprising administering to a patient of an effective amount of the claimed composition.

EFFECT: invention provides low toxicity of dosage form and high efficiency.

5 cl, 3 tbl, 1 ex

FIELD: medicine.

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2 dwg, 2 ex

FIELD: medicine.

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2 dwg, 2 ex

FIELD: medicine.

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5 cl, 2 ex

FIELD: medicine, pharmaceutics.

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12 cl, 4 dwg, 4 ex

FIELD: medicine.

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6 cl, 2 tbl, 3 ex

FIELD: medicine.

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2 cl, 3 dwg, 3 ex

FIELD: medicine.

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27 cl, 13 dwg

Reverse evaporator // 2532502

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to medical equipment. It can be used for surgeries and postoperative care of wounds (including injuries, burns, freezing injuries and trophic ulcers), as well as soft tissues and mucous membranes for bleeding control, prevention and treatment of suppurative complications, infectious and dermatologic diseases. The object of the presented device is providing the local, targeted haemostatic and/or antiseptic preparation of biological tissues with an ozone-oxygen mixture in a combination with the effective aspiration and deactivation of ozone from the used gas mixture, staying within the maximum permissible ambient ozone concentration. The assigned object is solved by the fact that the device additionally comprises a motor and storage portions combined together into a one-piece working circuit. A tip in the form of an ozone handle and peripheral aspiration and release pumps connected by a plastic retainer; pump inlets and outlets are presented in the form of junction pipes provided with conical nozzles with adapters, are parts of the motor portion. The storage portion comprises a chain of cross-pieces coupled in the same direction by supplying pipes and provided on each side from each cross-piece with a pair of hermetic ozone-oxygen packages on the opposite crossarms.

EFFECT: presented reverse evaporator enables avoiding sophisticated, bulky, immobile treatment apparatuses and using the aggressive gas media, like ozone-oxygen mixtures.

3 cl, 4 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment. Device contains cylindrical case element, plunger and cover, made with possibility f travel between closing position and dispensing position. Cover includes hole, which has specified dimensions to provide leaking of medication through cover, when cover is in dispensing position. Cylindrical case element has multitude of internal thread coils. Connection of cover and case is realised due to the fact that cover includes external wall and column, extending towards cylindrical case element, column includes external thread coils, or cylindrical case element includes multitude of external thread coils, and cover includes multitude of internal thread coils, which have such dimensions that they are capable of mating in thread coils of external thread of cylindrical case element, and/or cylindrical case element includes multitude of internal thread coils, and cover includes multitude of cogs, which have multitude of external thread coils, which have such dimensions that it is capable of mating in thread said coils of internal thread of cylindrical case element (12), or cylindrical case element includes flange part, passing from distal end, projection, formed near distal end, first groove and second groove, with cover including first holding bead, which has such dimensions that it is capable of interaction with flange part, and second holding bead, which has such dimensions that is capable of snapping shut in first groove, when cylindrical case element is in closing position, and has such dimensions that it is capable of snapping shut in second groove, when first holding bead interacts with flange part, in order to place cover in dispensing position. Device additionally contains holding means to hold cover on cylindrical case element, when cover is in dispensing position.

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13 cl, 14 dwg

FIELD: medicine.

SUBSTANCE: group of inventions refers to medicine, namely to gynaecology, and can be used in treating such diseases as dysfunctional uterine bleeding, menorrhagia, dysmenorrhoea, endometriosis, uterine fibroid, menopausal disorders, osteoporosis and urogenital atrophy. That is ensured by presenting an urogenital system comprising a frame forming an internal cavity enclosing an insert with a therapeutically effective dose of a biologically active compound. The insert is form-stable and damage-resistant when in use. The frame has an open structure providing access to a main portion of an external portion of the insert. The frame comprises one or more retaining element for frame holding in the uterine. What is also presented is a method for making the above intrauterine system.

EFFECT: group of inventions provides an effective controlled release drug delivery for a long period of time, as well as easy and safe administration and proper removal of the preparation.

14 cl, 9 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely traumatology, orthopaedics, and can be used for supporting treatment in large joint replacement. That is ensured by determining a volume of involved joint contracture six months before the operation. That is followed by X-ray and magnetic resonant examination of the involved and collateral joints to specify their state. Besides, a quality of the bone tissue is assessed by osteodensitometry. If observing changes in the bone tissue quality, the complex of the drug therapy is added with the preparations Bivalos and Calcemin. A pain syndrome intensity is assessed by the visual analogue scale three months before the operation. That is followed by the complex therapy aiming at optimising the state of extremity joints with added local injection therapy (LIT). That is ensured by preliminary exposing the biologically active periarticular zones in the proximal and distal direction from the involved joint to the focused infrared laser light. A mixture containing solutions of the therapeutic preparations: chondroprotectors, Contrykal, Lidocaine, vitamin B12 is injected into the same zones. Besides, Arthrofoon is administered for the whole preoperative period. If the pain syndrome intensity is less than 4 points, Arthrofoon is administered in a dose of 4 tablets a day. If the intensity value is more than 4 points, the preparation is administered in a dose of 8 tablets a day in a complex with a short course of a non-steroidal anti-inflammatory preparations and a chondroprotector. The replacement operation is immediately followed by fixing a collateral joint with an orthesis for the period of 3 months. The complex of the postoperative supporting therapy started three weeks after the operation is added with a single intravenous introduction of the preparation Aklasta, the preparation Arthrofoon in a dose of 4 tablets a day for three months, alpha calcidole and Calcemin continuously. A pectoral girdle of the extremities is reinforced by means of an individually specified set of therapeutic exercises and electric walking myostimulation. The LIT of the collateral joint is performed three months after the operation. If observing a degenerative process in the adjacent joints, the LIT is performed alternatively in these regions. Vasodilators, chondroprotectors, and the preparation Milgamma are administered with underlying LIT. If observing psychoemotional changes in the patient, the preparation Tenoten is additionally administered. A postoperative medication regimen, including the LIT is repeated 3-4 times every 6 months.

EFFECT: method provides optimising the effect of the surgical management and preventing developing complications both in the operated joint, and in the adjacent and symmetrical joints after the replacement, preventing developing instability of the endoprosthesis components, preventing developing or aggravating degenerative process in the symmetrical and adjacent joints that reduces a risk of the recurrent operations.

1 ex

FIELD: medicine.

SUBSTANCE: after performing median sternotomy pericardial and mediastinal drainages are installed and sternum is sutured. After suturing sternum for length of its entire front surface, catheter is installed through skin counterpuncture, with 1.0-2.0 cm indent from lower wound edge. proximal end of catheter is fixed to subcutaneous-adipose cellular tissue with absorbable suture material, and distal part of catheter with cannula is fixed by suturing to skin with non-absorbable suture material. Local anaesthetic is introduced through installed catheter every 6 hours, with antibiotic being introduced every 8 hours. Introduction of medications is performed for 3-5 days.

EFFECT: method provides effective anaesthetics with simultaneous drainage of front sternum surface and skin wound due to introduction of anaesthetics and antibiotics via catheter into said zone, which additionally reduces quantity of exudative inflammatory complications in post-operative period.

2 dwg, 1 ex

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