METHOD OF PERFORMING ANAESTHETIC MANAGEMENT IN HIP REPLACEMENT BY DIRECT ANTERIOR APPROACH IN PATIENT'S SUPINE POSITION Russian patent published in 2024 - IPC A61M19/00 A61K31/4458 A61P23/02 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology, orthopaedics and rehabilitation, and can be used to perform anaesthesia in hip replacement by direct anterior approach in patient's supine position. Spinal anaesthesia is performed, during which the patient is placed in a lying position on his/her side, palpated and marked with an interval between the spinous processes of the vertebrae. Subarachnoid space is punctured at the level of L3-L4. A spinal needle with a stiletto is inserted through the introducer along the midline parallel to the spinous processes. After the spinal space is identified, a syringe is connected to the needle, and 2.5–3 ml of a hyperbaric solution of bupivacaine with concentration of 0.5% is introduced. A pericapsular nerve block is performed, during which the patient is placed in a supine position, and a local anaesthetic is injected into a plane between a lumbar muscle tendon medially and a pubic ramus laterally. After negative aspiration test, 15–20 ml of ropivacaine solution with concentration of 0.5% is introduced. A lateral femoral cutaneous nerve is blocked, during which a lateral femoral cutaneous nerve is identified between a fascia lata tensioner and a tailor's muscle, which is triangular in ultrasound scanning. Stimulating needle with an injection line for conduction anaesthesia is introduced at an angle along the long axis in the direction from the lateral to the medial edge of the US transducer mark, negative aspiration test is followed by administering 2–5 ml of ropivacaine with concentration of 0.2%.

EFFECT: method provides reducing postoperative pain syndrome, avoiding the need to prescribe opioid analgesics in the postoperative period, early activation and acceleration of postoperative rehabilitation, prevention of deep vein thrombosis of lower extremities due to blockade of lateral cutaneous nerve of thigh and pericapsular group of nerves.

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