Method for anesthetic maintenance during radical surgery for cancer patients

FIELD: medicine.

SUBSTANCE: after patient admission to the operating room dexmedetomidine administration starts at a dose of 0.6-0.8 mcg/kg/h. Then epidural space catheterization is perform lying on the side. Analgesic mixture administration starts at a rate of 5 ml/hour and continued throughout the operation. During denitrogenation, intravenous dexmedetomidine sedation is performed at an dose of 0.6-0.8 mcg/kg/hr, after repeated denitrogenation and transition to closed circuit, oxygen supply is stopped. The breathing bag is completely emptied, then Xe is fed rapidly, once filling the breathing bag, ventilation by pure Xe flow of 150-300 ml per minute is begun under the control of FiO2 to reduce the oxygen concentration in the breathing circuit to 40% and Xe concentration to 60%, and then oxygen is supplied at a dose of 4 ml/kg, maintaining the balance in the ratio of Xe:O2 60:40. Xe flow is reduced to 0-100 ml/min intravenous administering of dexmedetomidine is continued throughout the operation at a dose of 0.3-0.6 mcg/kg/hr. Prior to surgical wound suturing Xe supply is stopped. After surgery, anesthesia machine is converted to a semi-open circuit, oxygen flow is increased to 5 l/min, sodium sugammadex is introduced at the rate of used bromide rocuronium. The patient extubated, in the early postoperative period analgesic mixture administration is continued at a rate of 5 ml/hr and intravenous dexmedetomidine administration is continued at a dose of 0.3-0.6 mcg/kg/h under the control of sedation level and hemodynamics.

EFFECT: method allows to obtain an efficient multimodal anesthetic protection, reduce xenon and narcotic analgesics consumption during extended and highly-traumatic cancer surgery.

2 ex

 



 

Same patents:

FIELD: medicine.

SUBSTANCE: anaesthetising patients with chronic pain syndrome undergoing a cyclophotocoagulation surgery involves the intravenous administration of the hormonal preparation dexamethasone in a dose of no more than 8 mg followed by the anxiolytic droperidol in a dose of no more than 2.5 mg 5 minutes prior to the operation before the peribulbar anaesthesia. A peripheral block in the form of the peribulbar anaesthesia involving administration of no more than 6 ml of a local anaesthetic follows. At the moment the surgical procedure starts, benzodiazepin, e.g. diazepam, is administered in a dose of no more than 5 mg.

EFFECT: achieving adequate anaesthesia in the given category of patients by blocking all the links of a pathological pain chain.

1 ex

FIELD: medicine.

SUBSTANCE: dexamethasone 8 mg and ketoprofen 100 mg is administered intravenously once prior to the operation. A lumbar plexus is blocked in a combination with a parasacral block and inserting perineural catheters to administer weak 0.2% Ropivacaine, local anaesthetic 20 ml. Paracetamol 1,000 mg is administered intravenously 30 minute before the operation is completed. After the operation is completed, the perineural catheter of the lumbar plexus is used to infuse 0.2% Ropivacaine 300 ml at 6-8 ml/hour for 4-5 days. Ketoprofen 100 mg is administered intramuscularly twice a day for 3 days. Through the perineural catheter of the parasacral plexus, 0.2% Ropivacaine 10 ml is administered twice every 12 hours.

EFFECT: method provides the adequate anaesthesia in the given category of patients by having an effect on primary pain components, as well as ensures the continuous and prolonged anaesthesia both intra-, and postoperatively, prevents the stable and chronic pain syndrome and the motor block of the extremities, reduces a rate of toxic complications.

1 ex

FIELD: medicine.

SUBSTANCE: preanaesthetic medication preceding gynaecological surgeries under general anaesthesia is ensured by prescribing diazepam 10mg, nefopam 10mg and ketoprofen 100mg intramuscularly 30-40 min before the surgery.

EFFECT: method enables reaching the sedative and analgesic effect of the preanaesthetic medication by the complementary action of preparations with no undesired side effects, requiring no time consumption and expensive equipment.

3 tbl, 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.

SUBSTANCE: at the initial stage of the intraoperative period, immediately before the local anaesthesia and the femoral artery puncture, ketorolac tromethamine is administered intravenously as an analgesic, and propofol as a sedative agent. Ketorolac tromethamine is administered in a dose of 15-75 mg, while propofol is administered in a dose of 50-250 mg.

EFFECT: method prevents developing pain and psychoemotional responses caused by the given interventions, including postoperatively by the fast development of the adequate analgesic effect accompanied by the controlled sedation level.

1 tbl, 10 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to organic chemistry, namely to benzimidazole derivatives of general formula (I) and to their pharmaceutically acceptable salts, mixed stereoisomers and enantiomers, wherein R1 is L1C(O)OL2C(O)OT; R2 is unsubstituted C1-C10alkyl; L1 is a bond; L2 is unsubstituted C2-C10alkylene; T is C1-C10alkyl. Also, the invention refers to a pharmaceutical composition of the compound of formula (I) and a method of anaesthetising on the basis of using the compound of formula (I).

EFFECT: there are prepared new imidazole derivatives effective as an anaesthetising agent.

15 cl, 9 dwg, 15 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention refers to a new compound, namely to (S)-enantiomer of 1'-{[5-(trifluoromethyl)furan-2-yl]methyl}spiro[furo[2,3-f][1,3]benzodioxol-7,3'-indole]-2'(1'H)-one of formula (I), and a method for preparing it which is effective for treating diseases and conditions, such as pain, an intensity of which can be reduced or relieved by modulating potential-dependent sodium channel gatings.

EFFECT: invention refers to the pharmaceutical composition of the above compound, methods of treating and a method of relieving an ion flux through the potassium channel gating in a cell.

10 cl, 5 tbl, 6 dwg, 11 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.

SUBSTANCE: what is involved is infusion therapy with crystalloid solutions at 15 ml/kg of a patient's body weight. That is followed by puncturing and catheterising an epidural space at the level of ThVII-ThVIII according to the standard practice and introducing a test dose of 2% lidocaine 3 ml. If observing no signs of intrathecal introduction of local anaesthetics 10 minutes later, a basic dose containing 0.75-1% naropin 10 ml or 0.25-0.5% marcaine 10 ml and clofelin 3-5 mcg/kg is introduced. Total intravenous anaesthesia follows 20 minutes after pre-medication with atropine 0.01 mg/kg, 1% diphenylhydramine 1 ml and relanium 10 mg and urethral catheterisation. A narcosis is induced with propofol in a dose of 2 mg/kg. Anaesthesia is maintained with propofol 2-4 mg/kg·h. After that, within the first hour following the detoxification, naloxone 12 mg is introduced intravenously; a naloxone measurement rate is supposed to make 0.8 mg/h for 4-5 following hours of general anaesthesia. The repeated introduction of 0.75-1% naropin 6 ml or 0.25-0.5% marcaine 6 ml and clofelin 2-3 mcg/kg into the epidural space is performed 90 minutes later. After the procedure is terminated, and the patient recovers, prolonged epidural analgesia is conducted by introducing 0.2% naropin 10 ml and clofelin 1 mcg/kg into the epidural space every 4 hours for 24-48 hours.

EFFECT: method provides safety of ultrafast opioid detoxification and prolongs the remission in the given category of patients.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to anaesthesiology and resuscitation, and may be used in epidural anaesthesia. That is ensured by administering slowly intravenously a basic dose of the local anaesthetic: 0.2-1% naropin or 0.2-0.5% marcaine, or 1-2% lidocaine; 1% Sol. Nicotini acidi 1% - 0.5-1 ml into the epidural space 10-20 minutes later. After 5-10 minutes, nicotine test results are visually evaluated by determining a clear interface of skin colour - hyperemic and normal - along an axillary line from both sides. The normal skin interface corresponds to the sympathetic block.

EFFECT: method provides higher accuracy and simplification of measuring the sympathetic block.

1 ex

FIELD: medicine.

SUBSTANCE: dexamethasone 8 mg and ketoprofen 100 mg is administered intravenously once prior to the operation. A lumbar plexus is blocked in a combination with a parasacral block and inserting perineural catheters to administer weak 0.2% Ropivacaine, local anaesthetic 20 ml. Paracetamol 1,000 mg is administered intravenously 30 minute before the operation is completed. After the operation is completed, the perineural catheter of the lumbar plexus is used to infuse 0.2% Ropivacaine 300 ml at 6-8 ml/hour for 4-5 days. Ketoprofen 100 mg is administered intramuscularly twice a day for 3 days. Through the perineural catheter of the parasacral plexus, 0.2% Ropivacaine 10 ml is administered twice every 12 hours.

EFFECT: method provides the adequate anaesthesia in the given category of patients by having an effect on primary pain components, as well as ensures the continuous and prolonged anaesthesia both intra-, and postoperatively, prevents the stable and chronic pain syndrome and the motor block of the extremities, reduces a rate of toxic complications.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to cardiology and gynaecology, and can be used in the differential diagnostics of cardiogenic myocardial ischemia and the genital-cardial inhibitory reflex accompanied by pain syndrome caused by a gynaecological pathology. That is ensured by ECG recording. That is followed by two-side block of round ligaments of the uterus by an anaesthetic solution in an amount of 15.0-20.0 ml from each side. The ECG is recorded again 60-90 min after the block, and the recording is compared to the pre-block ECG. If the ECG findings tend to be positive, ischemia caused by the genital-cardial inhibitory reflex accompanied by pain syndrome caused by a gynaecological pathology is diagnosed. If no positive dynamic is observed, cardiogenic myocardial ischemia is diagnosed.

EFFECT: technique provides the effective differential diagnosis of cardiogenic myocardial ischemia and the genital-cardial inhibitory reflex accompanied by pain syndrome caused by a gynaecological pathology.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to anaesthesiology and resuscitation, and can be used as an anaesthetic support in the necrectomy of the lower limbs in the patients with the diabetic foot. That is ensured by performing the nerve block anaesthesia of the sciatic nerve with a local anaesthetic. The block anaesthesia is performed for 72 hours.

EFFECT: method provides reducing the length of the wound epithelialisation and accelerating its healing by improving blood circulation caused by prolonged retention of the vasodilatation effect, including after administering anaesthesia in these patients is terminated.

2 dwg, 3 tbl, 2 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.

EFFECT: performing the effective spinal anaesthesia combined with reducing a probability of hypertension by dilating the epidural space preliminary in accordance with the intra-abdominal pressure.

1 tbl, 1 dwg, 2 ex

FIELD: medicine.

SUBSTANCE: at the initial stage of the intraoperative period, immediately before the local anaesthesia and the femoral artery puncture, ketorolac tromethamine is administered intravenously as an analgesic, and propofol as a sedative agent. Ketorolac tromethamine is administered in a dose of 15-75 mg, while propofol is administered in a dose of 50-250 mg.

EFFECT: method prevents developing pain and psychoemotional responses caused by the given interventions, including postoperatively by the fast development of the adequate analgesic effect accompanied by the controlled sedation level.

1 tbl, 10 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: invention refers to medicine, namely to gynaecology, and can be used for diagnosing the transport dysfunction of the uterine tubes. That is ensured by hysteroscopy accompanied by inserting catheters into the uterine cavity within openings of the uterine tubes, bringing them out through the vagina and fixing to the inner thigh. A colour solution is introduced into the abdominal cavity through a puncture of the posterior vaginal vault. That is followed by a double-side block of the round ligament of the uterus with the anaesthetic solution in an amount of 15.0 ml every 4-6 hours. Keeping the transport function is shown by observing the colour solution 24 hours later in the catheter lumen. The transport dysfunction of the uterine tubes is shown by no ingress of the colour solution into the catheter.

EFFECT: technique provides the reliable diagnosis of the transport dysfunction of the uterine tubes, including their intramural departments, except for the functional component of the transport dysfunction, with no surgical intervention required.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to neurology, surgery orthopaedics and traumatology, and can be used for treating inflammatory-degenerative arthropathies. That is ensured by determining an access parameters for a local therapeutic injection in accordance with the fact which inflammatory-degenerative disease of which periarticular tissue is diagnosed in the patient and which somatotype is specific for the patient. The local therapeutic injection is performed in a CLB tendon and a rotator cuff, or in a deltoid muscle, or in a subdeltoid burse, or in a supraspinous muscle, or in an infraspinatus muscle. The access parameter for the local therapeutic injection into the above periarticular tissues is a location of an injection needle point, as well as a needle direction and depth.

EFFECT: by the most accurate local administration of the drug preparation taking into account a patient's somatotype, the method provides the effective treatment in the above category of patients.

19 cl, 11 tbl, 2 ex

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.

EFFECT: effective and safe pain management in the given category of patients by providing the required Novocaine concentration in the retroperitoneal space.

1 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: recording ECG is followed by a perianal block with an anaesthetic solution in an amount of 10.0-15.0 ml. Then 60-90 min later ECG is recorded once again, and this recording is compared to the pre-block recording. If observing a positive dynamics of the ECG results, ischemia caused by the anorectal cardioinhibitory reflex is diagnosed. No positive dynamics observed enables diagnosing cardiogenic myocardial ischemia.

EFFECT: method makes it possible to perform the more accurate differential diagnosis of the above pathologies by following a specific procedure in case of pain syndrome in the given category of patients.

1 ex

FIELD: medicine.

SUBSTANCE: claimed is a device for the formation of a required concentration of liquid anaesthetics in anaesthetic apparatuses, containing a mixing-and-evaporating chamber, a reservoir for a liquid anaesthetic, connected by a hydraulic main line with the mixing-and-evaporating chamber by means of a shutoff-and-pass valve and a jet. The shutoff-and-pass valve is electrically connected to a command-and-control electronic unit. The device also contains a microcompressor of the pressure boost of air into the said reservoir and a sensor of pressure control in the reservoir for the liquid anaesthetic. Claimed is a method for the formation of a required concentration of anaesthetics in evaporators of anaesthetic apparatuses in carrying out low-flow anaesthesia, in which the injection of a liquid anaesthetic is realised by a doser of anaesthetics directly into the breathing gas flow. Injection is realised by discrete single doses. The volume of a discrete single dose of injection is set by the ratio: where Vp is the volume of a discrete single dose of the liquid anaesthetic, supplied in each injection; Qa is the estimated total flow of the liquid anaesthetic, injected per the time unit, required for the provision of a specified concentration of anaesthetic vapours in the breathing mixture; Fmax is the frequency of the discrete doses of injections per the time unit, which is technically maximally achievable by the doser of anaesthetics.

EFFECT: inventions provide the accuracy of dosing the vapours of liquid anaesthetics in the wide range of changes of their concentrations and flows of the carrier-gas in carrying out low-flow anaesthesia.

2 cl, 1 dwg

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