METHOD FOR ANAESTHESIA ACCOMPANYING ADENOTOMY AND TONSILLOTOMY IN CHILDREN Russian patent published in 2014 - IPC A61M19/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to anaesthesiology and emergency medicine, and can be used in anaesthetic management of nasal and oropharyngeal operations in otorhinolaryngeal surgery in children. To this effect, the surgical intervention is preceded by inhalations of 2% lidocaine through a nebuliser at 4 mg/kg of body weight in the maximum dose of 200 mg. A peripheral vein is catheterised. A riskless challenging trancheal intubation requires inducing anaesthesia with Sevorane 8 vol %, N₂O/O₂ 1/1 6 l/min. The intubation is preceded by 2 forced inhalations through an anaesthetic apparatus with a face mask. The pulmonary ventilation effectiveness is assessed by the respiratory excursion. The adequate pulmonary ventilation requires intravenous administration of the nondepolarising muscle relaxant Tracrium 0.4 mg/kg. Once reaching stage III₂ narcosis, the trachea is intubated, and a gas flow in the contour is reduced to 1.0 l/min. Anaesthesia is maintained with Sevorane 1.5-2 vol %, 0.7 MAK, with N₂O/O₂ 1/1 1 l/min, 0.5 MAK. The signs of the challenging trancheal intubation enable inducing anaesthesia with Sevorane 8 vol % at a high O₂ gas flow at 6 l/min. The intubation is preceded by 2 forced inhalations through the anaesthetic apparatus with the face mask. The pulmonary ventilation effectiveness is assessed by the respiratory excursion. Once reaching stage III₂ narcosis with adequate pulmonary ventilation and maintained unassisted respiration, the trachea is intubated, and the gas flow in the contour is reduced to 1.0 l/min. The nondepolarising muscle relaxant Tracrium 0.4 mg/kg is administered intravenously. Anaesthesia is maintained with Sevorane 2-3 vol %, 1 MAK with the artificial pulmonary ventilation with the gas mixture of O₂/Air - 0.5/0.5 l/min. Once the operation is completed, inhalation with 100% O₂ in a semi-open contour with a high gas flow at 5.0 l/min is performed.

EFFECT: method provides the adequate anaesthesia in the given category of patients with no narcotic analgesics used by a differentiated approach to a dose schedule of inhalation anaesthetics and a myorelaxant caused by a risk degree of the challenging tracheal intubation.

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