METHOD FOR PERIOPERATIVE ANALGESIA WITH VIDEO-ASSISTED ABDO-PERINEAL RECTAL EXTIRPATION Russian patent published in 2022 - IPC A61M5/14 A61B17/00 A61K31/445 A61P23/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to anesthesiology and resuscitation in oncology, and can be used in the perioperative period to improve the quality of analgesia during video-assisted abdominoperineal extirpation of the rectum. The method includes general anesthesia with induction with diprivan 2-2.5 mg/kg, inhalation of sevoflurane 0.3-1.5 vol.% and intravenous fentanyl administration. Before the perineal stage of the operation, a caudal blockade is performed. For this, the patient is turned on his stomach. By palpation, the posterior superior spines of the sacrum are determined, which form one of the sides of an equilateral triangle with the lower apex located in the projection of the sacral fissure. Then, using a linear ultrasound transducer, a sonogram of the sacrum is performed and the sacral horns, sacrococcygeal ligament, coccyx, caudal-epidural space are identified. The sacrococcygeal ligament is punctured with a 22G spinal needle. Further, after a test aspiration and the introduction of a test dose of ropivacaine 2 mg / ml - 3 ml, a solution of ropivacaine 7.5 mg / ml - 15 ml is injected. At the end of the manipulation, the puncture site is closed with an aseptic bandage and the perineal stage of the operation begins.

EFFECT: method improves the quality of perioperative analgesia, reduces the need for additional anesthesia, improves patient safety and comfort, creates optimal conditions for starting the rehabilitation process in the early postoperative period by performing a caudal blockade.

1 cl, 1 tbl, 2 dwg, 2 ex