METHOD OF CONDUCTING ANAESTHESIA IN CHRONIC PAIN SYNDROME IN CANCER PATIENTS BY ULTRASOUND-GUIDED PARAVERTEBRAL BLOCK Russian patent published in 2024 - IPC A61M25/01 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to anaesthesiology, and can be used for anaesthesia in chronic pain syndrome in cancer patients by paravertebral block under ultrasound control. At half the distance between the xiphoid process and the anterior axillary line at level of 10th rib, location of the port pocket is marked. In thoracic or lumbar regions at the puncture site skin incision 3 cm long is made along spinous processes under local anaesthesia. Skin is separated and a pocket is formed to prevent kinking of the catheter. Puncture is performed with a Tuohy needle, wherein the Tuohy needle is inserted or 2.0 cm lateral to the middle of the transverse process, brought behind it, and performing an injection with spreading of the administered local anaesthetic at level of 2 dermatomes, or the Tuohy needle is introduced at the middle of the transverse process, and performing an injection with spreading of the administered local anaesthetic at level of 5 dermatomes. Paravertebral catheter is delivered through a Tuohy needle until its tip extends 3 cm from the needle tip. Catheter is fixed with a retainer, placed in the formed pocket and sutured by the ears to the fascia, 6 cm long incision is made parallel to the spinal axis to the needle entry point on the skin, purse-string suture is applied on the fascia surrounding the needle location, tightening the fascia around the catheter. After removing the needle, the catheter is fixed on the periosteal fascia. Pocket for a port overlying an edge of a costal arch is formed from a transverse incision with length of 8 cm in a marked place at level of 10th rib. Catheter is tunnelled from the periospinal region to the port pocket and fixed on the port.

EFFECT: method provides adequate anaesthesia for patients with difficult-to-control pain, prevention of complications such as hypotension, urination disorder, stool retention, possibility of unilateral anaesthesia in thoracic spine due to introduction of small doses of narcotic and local analgesics into port chamber.

1 cl, 8 dwg, 4 ex