METHOD FOR ANESTHESIA PROVIDING SELECTIVE DELIVERY OF CHEMOPREPARATION TO THE RETINA IN THE TREATMENT OF INTRAOCULAR RETINOBLASTOMA IN CHILDREN

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to anesthesiology-resuscitation, ophthalmology, oncology and endovascular surgery, and can be used for anesthesia in the selective delivery of the chemopreparation to the retina in the treatment of intraocular retinoblastoma in children. That is ensured by induction and maintenance of anesthesia with sevoflurane, muscular relaxation with rocuronium, heparin prophylaxis following femoral artery puncture and catheterisation, dexamethasone and epinephrine. It involves pneumoprotective artificial pulmonary ventilation with preventive step-by-step increase of inhalation pressure in the upper respiratory tract 3 minutes before catheterization of a.ophthalmica. After catheterisation of a.ophtalmica at the moment of the first respiratory motion with decreasing compliance of lungs, 0.5 mcg/kg of epinephrine is injected with a bolus, pressure is increased by inhalation of Pinsp so that the respiratory volume is not less than 50 % of the initial one, the respiratory rate is increased by 1.5 times. If the level of the average blood pressure drops below 60 mm Hg after bronchospasm resolution, hemodynamics is supported by an adrenaline solution infusion in dose of 0.15 mcg/kg/min. If the manifestations of trigemino-pulmonary reflex are weak and moderate before waking up, 10 % calcium gluconate 1.0 ml and analgin in amount of 0.1 ml are introduced intravenously. Retrobulbar blockade is performed in the children with the expressed degree of reaction in the repeated procedures after the anesthesia induction.;EFFECT: method provides higher safety of anesthesia ensured by reducing the risk of cardiorespiratory disorders, prevention of trigemino-pulmonary reflex and reduction of degree of its manifestation.;1 cl, 2 dwg, 1 ex