METHOD OF GENERAL ANESTHESIA WITH PRESERVED SPONTANEOUS BREATHING FOR MEDIUM- AND LOW-TRAUMATIC SURGICAL OPERATIONS Russian patent published in 2019 - IPC A61M16/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to anesthesiology and resuscitation, and can be used in general anesthesia with preserved spontaneous breathing. That is ensured by monitoring the bispectral sedation depth index (BIS-monitoring) with an index interval of 40–60. For the introductory anesthesia, the sevoflurane monoinduction is performed by means of insufflation of the gas-narcotic mixture with the specified value on evaporator of 8 % and flow of 100 % oxygen 8 l/min. Tracheal tube is intubated with an endotracheal tube having an irrigation port for administering drug preparations into the subglottic space. Tube is introduced into the trachea while achieving MAK 1.5 anesthesia level and with the BIS index ≥40. Before the operation, terminal anesthesia of the tracheal mucosa in the area of contact of the endotracheal cuff end with a sublimate space is performed by administering 40–60 mg of 2 % lidocaine solution into the irrigation port of the endotracheal tube. Performing general anesthesia with auxiliary artificial pulmonary ventilation in pressure support mode with maximum triggering sensitivity of 2 l/min, pressure Psupp 6–8 mm of water with sustained sevoflurane inhalation at 1.0 MAK and BIS monitoring in index ≥50. Constant infusion of fentanyl is performed during the operation at a rate of about 1.0 mcg/kg/h. Infusion is terminated 5 minutes before the operation is completed; the sevoflurane delivery is stopped after the postoperative wound is drained. 10 minutes before the patient's expected awakening, a terminal anesthesia of the tracheal mucosa is performed in a zone of contact of the endotracheal cuff end with a sublimate space by inserting into the irrigation port of endotracheal tube 40–60 mg of 2 % lidocaine. After recovering adequate spontaneous breathing, pharyngeal and larynx reflexes, patient's ability to perform elementary commands by modified Aldrete scale 7–9 points and BIS index values ≥60, extubation of trachea.

EFFECT: method provides adequate and safe anesthesia with preserved spontaneous breathing.

1 cl, 1 dwg, 2 ex