Method of ultrasound-assisted blockade in arthroscopic surgical interventions in the shoulder joint
SUBSTANCE: invention relates to medicine, namely to anaesthesiology. Patient takes the chosen position. Long-axis ultrasound scan with a linear sensor of 8–12 MHz is performed with the separation of the suprapatropic artery and nerve. Needle with an anesthetic is entered with the needle point running to the suprathiopathic nerve and the anesthetic is administered. In this case, the patient is placed in a prone position on a healthy side. Scanning is performed in the region of the superspinous fossa of the scapula, slipping ventral until the incisure of scapula is verified in the ultrasound scanner, after which the sensor is moved from the area above the incisure of the scapula back to the superspinous fossa, with a simultaneous ventral inclination and the location of the scanning plane of the sensor in the superspinous fossa near the incisure of the scapula. As a needle, a neurostimulation needle is used, injection is medial to the sensor. As an anesthetic, a solution of ropivacaine is administered, after which, without changing the position of the patient, the sensor is transferred to the horizontal plane and the place of divergence of the posterior circumflex humeral artery from the axillary artery and the axillary nerve is identified. Needle is entered lateral to the sensor along the long axis in the ventromedial direction. Solution of ropivacaine is administered until the appearance of hypoechogenic shadows around the nerve and the cessation of contractions of the deltoid muscle. As an anesthetic, at each injection, 5 ml of 0.75 % ropivacaine is administered. Blockade is supplemented by general anesthesia with intubation of the trachea using sevoflurane.
EFFECT: method allows to reduce the risk of serious complications and prevent the risk of compression-ischemic neuropathy of the suprathinus nerve, method does not affect hemodynamics, does not cause motor blockade of the limb below the shoulder joint, which allows an early evaluation of traction complications.
3 cl, 3 ex, 10 dwg
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.
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.
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
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
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.
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.
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
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
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.
SUBSTANCE: invention relates to means for carrying out visualisation-guided medical procedures. Method of processing X-ray image contains stages, at which: 2D X-ray image of anatomical area, which includes ultrasound probe, is received, ultrasound probe s detected on it, ultrasound probe is superposed with reference coordinate system, with taking into account evaluation of position and orientation of ultrasound probe relative to reference coordinate system. Superposition stage additionally contains stage, at which presented in digital form projection of 3D model of ultrasound probe is correlated with ultrasound probe detected on X-ray image, with obtaining evaluation of ultrasound probe position and orientation from correlated 3D model. Computer-readable carrier contains stored in it sets of instructions for system-processing unit for combination of ultrasound and X-ray images, which contains X-ray system of 2D X-ray image, ultrasound system, including ultrasound probe, processing unit and monitor for combined image presentation.
EFFECT: application of invention makes it possible to increase accuracy of position determination.
9 cl, 4 dwg
SUBSTANCE: nephrosonography is performed to determine a kidney volume (V pk, mm3). Child's height and age are specified and used to determine a reference kidney volume (V rk, mm3), to calculate a kidney volume coefficient (Kkv) by formula: , wherein Kkv is the kidney volume coefficient; V pk is the patient's kidney volume, mm3, and V rk is the reference kidney volume, mm3. In the unilateral ureteral obstruction, a healthy kidney volume coefficient (Khkv) and a obstruction kidney volume coefficient (Kokv) are calculated. If K hkv is more than 1.0, the absence of compensatory hypertrophy and hyperfunction is diagnosed; the morphofunctional kidney condition from the side of an obstructed ureter occurs to be noninvolved; the conservative treatment of the obstruction is preferred. If K hkv is more than 1.0 and less than 1.8, K okv is more than 1.0, compensatory hypertrophy and hyperfunction of the healthy kidney; the morphofunctional kidney condition from the side of the obstruction is depressed; a preserving surgery is chosen. Khkv between 1.8 or 2.0 and Kokv less than 1.0 enable diagnosing manifested compensatory hypertrophy and hyperfunction of the healthy kidney; kidney downsizing, functional depression are diagnosed from the side of the obstruction, and a nephrectomy is preferred.
EFFECT: method enables choosing the therapeutic approach to the ureteral obstruction in the children by detecting the clinical manifestations of the urinary outflow obstruction.
SUBSTANCE: invention relates to medicine, namely to ultrasonic diagnostics, neurosurgery, vascular surgery and neurology. Colour duplex scanning in horizontal and vertical position of patient is performed. Pathological tortuosity is diagnosed in case of presence of deformation of main neck arteries with angle of tortuosity less than 60° in horizontal and vertical positions, turbulence of blood flow in area of tortuosity, more than 50% acceleration of systolic blood flow in area of deformation in comparison with proximal part of artery, reduction of blood flow rate more distally than tortuosity in comparison with proximal part of artery to tortuosity more than 20%.
EFFECT: method makes it possible to increase diagnostics accuracy due to change of hemodynamics under impact of change of patient's body position.
SUBSTANCE: invention relates to medical equipment, namely to diagnostic ultrasound systems. Curved converter of high-intensity focused ultrasound (HIFU) contains curved piezoelectric matrix, which has opposite convex and concave surfaces, with concave surface being transmitting surface, and multitude of zones of acoustic transmission. Multitude of electrodes is located on surfaces of curved piezoelectric matrix. Curved adjustment layer, formed in monolithic, continuous way, is formed with required curvature of curves matrix of converters, and is attached to transmitting surface. Printed circuit board and back plate are located on side of matrix, opposite to adjustment layer, with back plate limiting air channel between printed circuit board and plate, and printed circuit board limits air channel between printed circuit board and matrix.
EFFECT: application of invention makes it possible to facilitate giving required shape to converter.
15 cl, 13 dwg
SUBSTANCE: neurovisualisation examination of brain is carried out, Cirs comorbidity index and Kaplan-Feinstein comorbidity index are determined, cochleovestibular syndrome, eye-moving impairments, type of diabetes mellitus are identified. Value of discriminate function (D) is calculated. If D value is higher than zero, diagnosed are consequences of ischemic brain stroke (IBS) with hyperhomocysteinemia (HH), if D is lower than zero, consequences of IBS without HH are diagnosed.
EFFECT: method makes it possible to increase reliability of diagnostics of IBS consequences, which is achieved due to complex analysis of said parameters.
SUBSTANCE: inner angle (α) between back surfaces of an episternum and a mesosternum is preoperatively ultrasonically measured in a patient. A spiral oesophagomyotomy is performed. Tendons of the sternum legs of sternocleidomastoid muscles are dissected away from the episternum. A retrosternal tunnel is created. If α<165°, the episternum is dissected away at the level of a lower edge of the second rib. If α>165°, the episternum is dissected away at the level of a lower edge of the first rib. A colonic graft is delivered onto the neck through the retrosternal tunnel. An end-to-end anastomosis is applied between a cervical segment of the oesophagus and the colonic graft.
EFFECT: reducing invasiveness and postoperative complications by an individual approach to determining the episternum resection extent.
SUBSTANCE: direct size between the most distant points of a presenting segment of the foetus head at the level of the sagittal plane, large transverse size of the foetus head between the most distant points of the parietal tubers, transverse size of the shoulders between the most distant points of the acromial processes and the anteroposterior size of the foetus chest at the level of VII thoracic vertebra and the base of the xiphoid process are determined. A probability coefficient of the foetus shoulder dystocia is calculated by a mathematic formula. Development of the foetus shoulder dystocia is made on the basis of the obtained coefficient value.
EFFECT: method makes it possible to predict the development of the foetus shoulder dystocia due to the evaluation of the significant ultrasonic indices in the foetus.
1 tbl, 4 ex
SUBSTANCE: ultrasonic examination of brachial artery is realised. During ultrasound examination lumen of brachial artery in systole and diastole is determined, reactive hyperaemia test and test with nitroglycerinum intake are performed. After that, values of lumen, obtained before performing test and after them, are compared. Presence of endothelial dysfunction is identified on the basis of degree of obtained data change. If value of brachial artery diameter after reactive hyperaemia test is less than 12% in systole and less than 13% in diastole, as well as after intake of nitroglycerinum, if value of brachial artery diameter in systole is less than 20% and less than 21% in diastole, endothelium dysfunction is diagnosed.
EFFECT: method provides detection of affection of vessel wall in said category of patients at the earliest stages.
SUBSTANCE: predicting neonatal hypoglycaemia in an infant born by a woman suffering diabetes mellitus in the stages of at least 36 weeks of pregnancy is ensured by foetal ultrasonic scanning. A pancreatic gland (PG) is visualised in a cross-section of the foetal abdomen. Its maximum anterior-posterior dimension is measured at the body level, and if its dimension is more than 1.55 cm, the neonatal hypoglycaemia is predicted. In a particular case, the PG is visualised better if displaying the cross-section of the foetal abdomen at the level of a stomach and an intra-abdominal segment of an umbilical vein is followed by rocking and rotating an ultrasonic probe.
EFFECT: method enables improving the early postnatal adaptation, preventing the postnatal complications, incidence of disease and death caused by the hypoglycaemic conditions in the newborns born by the women suffering diabetes mellitus by correcting them timely due to the accurate prediction of developing neonatal hypoglycaemia starting from the stage of 36th week of pregnancy.
2 cl, 3 ex
SUBSTANCE: patient's serum asparagine aminotransferase (AST) is measured. That is combined with duplex scanning to measure a splenic vein diameter (SVD) and a body weight. The measured AST, SVD and body weight are used to calculate a fibrosis index by formula: FI=-6.31+0.19*AST-1.02*SVD+0.24*BW, wherein FI is the fibrosis index, -6.31 is a constant, 0.19-1.02 and 0.24 are the coefficients, AST is blood serum asparagine aminotransferase (Unit/l), SVD is the splenic vein diameter (mm), and BW is the patient's body weight (kg). The constant and coefficients in the presented formula are calculated by multiple regression method; a dependent variable is a liver density value according to ultrasonic elastography findings. If the derived fibrosis index is less than 6.3, the absence of fibrosis (stage F0) is stated. If the fibrosis falls within the range of 6.3 to 8.3, the first stage of fibrosis (F1) is diagnosed. The fibrosis index of 8.4 to 10.8 corresponds to the second stage of fibrosis (F2). The fibrosis index of 10.9 to 13.9 corresponds to the third stage of fibrosis (F3). If the fibrosis index is more than 13.9, hepatic cirrhosis (stage F4) is diagnosed.
EFFECT: technique provides the adequate differentiation of the fibrosis stages in the patients with chronic viral hepatitis by the complex assessment of biochemical, ultrasonic and antropometric parameters.
SUBSTANCE: method involves carrying out skeletotopic conjunction and organ element localization description relative to vertebra body. Neck organ picture is described in skeletotopic manner using anterior contour of cervical vertebra body and transverse processes in upper, median and inferior portion of cervical vertebra with the exception of the first and the second one.
EFFECT: high accuracy in diagnosing pathological processes in neck organs and creating computer models.