METHOD FOR REDUCING PRESSURE IN VARIX IN PORTAL HYPERTENSION DURING ENDOLIGATION UNDER ANAESTHESIA Russian patent published in 2018 - IPC A61B8/04 A61K31/21 A61B17/94 A61P9/02 

FIELD: medicine.

SUBSTANCE: invention relates to surgery and anaesthesiology, and resuscitation, and can be used to manage the mediated reduction in venous pressure in varicose dilated oesophagus veins by reducing arterial pressure during endoscopic ligation under general anaesthesia. To do this hemodilution is performed using crystalloid solutions and injected through an automatic syringe micro-jet nitroglycerin. Introduction of nitroglycerin is started after a review of esophagogastroduodenoscopy and measurement of the initial level of pressure in varicose veins of the oesophagus during endoscopic ultrasonography, against intravenous anaesthesia. Dose of nitroglycerin does not exceed the maximum calculated single dose. After appearance of a clear systemic hypotensive effect, as well as a decrease in pressure in the oesophageal varicose veins (control measurement), the dose of nitroglycerin is reduced to a mean dose at the time of endoscopic ligation, focusing further on the achieved antihypertensive effect on blood pressure indicators. In order to assess the effectiveness of controlled hypotension, the previously known method of measuring the pressure inside the oesophageal varices, which is proportional to HPVP, rhythmocardiography, pulseometry, noninvasive measurement of blood pressure, the level of transaminases with prolonged hypotension, is used to evaluate the effectiveness of controlled hypotension. Intravenous microfluid injection of nitroglycerin in the average dosages continues in the postoperative period for 48 hours to achieve the target blood pressure.

EFFECT: method allows to reduce the risk of both perioperative and postoperative complications and to achieve a decrease in the venous pressure of varicose veins of the oesophagus in patients with portal hypertension mediated, due to controlled arterial pressure, which is especially important to reduce the risk of sudden blood loss, due to varix rupture during endoligation or “slippage” of the ligature in the next 48 postoperative hours.

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