METHOD FOR PREVENTION OF INTRAOPERATIVE MANIPULATION SPASM OF CEREBRAL ARTERIES IN MICROSURGICAL CLIPPING OF CEREBRAL ARTERY Russian patent published in 2025 - IPC A61M16/12 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to neurosurgery, anaesthesiology and resuscitation, and can be used for prevention of intraoperative manipulation cerebral artery spasm during microsurgical clipping of cerebral artery. Upon completion of the clip application, the gaseous form of nitrogen monoxide (NO) is fed into the gas-air mixture through the respiratory ventilation circuit, wherein NO concentration is increased in steps – every 5 minutes by 2 times starting from 1 to 64 ppm, then concentration is increased by 5 ppm every minute to achieve target value within 64-80 ppm. During stepwise increase of NO concentration the following parameters are controlled: tidal volume, ratio of volume of gas-air mixture inhalation/exhalation per minute, concentration of carbon dioxide in the exhaled mixture, concentration of thrombocytes in blood, concentration of methemoglobin in the jugular vein, systolic and diastolic pressure, oxygen saturation in the bulb of the jugular vein, cardiac index, amount of extravascular pulmonary water, wherein NO concentration increase is stopped when at least one of the monitored values is obtained, and the achieved NO concentration value is taken as the target value. Further, NO is fed at the target concentration value until the end of the operation while controlling the above parameters; at the end of the operation, the NO concentration is reduced from the target value to 0 ppm for 30 minutes.

EFFECT: method provides regression of cerebral manipulation angiospasm in the intraoperative period, reduced incidence of infarction, reduced cerebral ischemia according to CT data, improved perfusion according to CT-perfusion of the brain due to relaxation of the muscular wall of the artery and reduced rate of blood flow through the artery.

3 cl, 7 dwg, 1 ex