METHOD OF CONDUCTING COMBINED ANESTHESIA IN HIGH RISK PATIENTS WITH OPERATIONS ON THE ABDOMINAL CAVITY ORGANS Russian patent published in 2018 - IPC A61M16/01 A61K31/4468 A61K31/165 A61P23/00 

FIELD: medicine.

SUBSTANCE: invention relates to anesthesiology. Catheterization of the epidural teeth is made with a subsequent test dose of lidocaine, premedication, preoxygenation with pure oxygen, induction of general anesthesia, myoplegia, intubation, denitrogenisation with pure oxygen, inhalation anesthesia with xenon. In this case, premedication is performed with omeprazole at a dose of 20 mg and phenazepam at a dose of 1 or 2 mg per day before the surgery before bed. Induction of general anesthesia is carried out by diazepam administration in a dose of 5 mg, propofol in a dose of 1.0-1.5 mg⋅kg^-1 up to the target values of the bispectral index 30-40, fentanyl 2-3 mg⋅kg^-1 and succinylcholine at a dose of 1.5-2.0 mg⋅kg^-1 and pipecuronium at a dose of 0.06 mg⋅kg^-1 with preliminary precurarization with pipecuronium in a dose of 1 mg. After denitrogenation, the breathing circuit is filled with a mixture with a xenon content of 44-50 vol.%, which is used to maintain the anesthesia. In this case, a continuous intravenous microfluidic administration of fentanyl is carried out at a dosage of 2-3 mcg⋅kg^-1⋅h^-1 during a continuous infusion into the epidural teeth of 0.2% of ropivacaine at a rate of 4-10 ml⋅h^-1. For patients under the age of 60 years in the premedication are additionally included phenazepam orally in a dose of 2 mg, patients from 60 to 70 years - orally, phenazepam in a dose of 1 mg. Before intubation, the oropharynx is irrigated with a spray with 10% lidocaine, 2-3 doses of the drug are used. To maintain muscle relaxation, bolus administration of 2 mg pipecuronium every 30 minutes of surgery is used.

EFFECT: method allows to stabilize the hemodynamic parameters, eliminate the need for repeated denitrogenisation and the transition to total intravenous anesthesia during denitrogenisation, the patient to recover quickly after anesthesia.

4 cl, 4 ex