FIELD: medicine; anesthesiology.
SUBSTANCE: invention can be used for prolonged high spinal and endotracheal anesthesia with import-substituting medicinal products with subnarcotic doses of ketamine during operations on the upper floor of the abdominal cavity. After local anesthesia, a puncture and catheterization of the spinal space at the level of L4-L5 is performed using a median approach with the help of a set for extended spinal anesthesia. The catheter is pulled by 3 cm in the cranial direction. An isobaric solution of BloccoC is introduced into the catheter at an initial dose of 20 mg with further prolongation of the medicinal product administration at a half dose and regulation of blockade control by tilting the head end of the table to 45–60°. Then, a single intravenous administration of ketamine in a subnarcotic dose, fentanyl 2 μg/kg, and trakrium muscle relaxant 0.5 mg/kg is performed, followed by tracheal intubation and endotracheal anesthesia by inhalation of 2.0% halothane. In the postoperative period, preemptive analgesia is performed by re-introducing BloccoC at half the dosage into the spinal catheter. The subnarcotic dose of ketamine is 0.7 mg/kg.
EFFECT: method provides complete segmental blockade and relaxation of muscles in the area of operation, stability of central hemodynamic parameters during surgery and in the postoperative period, proactive postoperative analgesia, as well as early awakening and extubation of the patient on the operating table due to the introduction of a local anesthetic into the catheter, with a decrease in doses narcotic analgesics in the intraoperative period, as well as a combination of high spinal anesthesia and endotracheal anesthesia.
2 cl, 1 ex
