METHOD OF ULTRASOUND-ASSISTED BLOCKADE IN ARTHROSCOPIC SURGICAL INTERVENTIONS IN THE SHOULDER JOINT

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to anaesthesiology. Patient takes the chosen position. Long-axis ultrasound scan with a linear sensor of 8–12 MHz is performed with the separation of the suprapatropic artery and nerve. Needle with an anesthetic is entered with the needle point running to the suprathiopathic nerve and the anesthetic is administered. In this case, the patient is placed in a prone position on a healthy side. Scanning is performed in the region of the superspinous fossa of the scapula, slipping ventral until the incisure of scapula is verified in the ultrasound scanner, after which the sensor is moved from the area above the incisure of the scapula back to the superspinous fossa, with a simultaneous ventral inclination and the location of the scanning plane of the sensor in the superspinous fossa near the incisure of the scapula. As a needle, a neurostimulation needle is used, injection is medial to the sensor. As an anesthetic, a solution of ropivacaine is administered, after which, without changing the position of the patient, the sensor is transferred to the horizontal plane and the place of divergence of the posterior circumflex humeral artery from the axillary artery and the axillary nerve is identified. Needle is entered lateral to the sensor along the long axis in the ventromedial direction. Solution of ropivacaine is administered until the appearance of hypoechogenic shadows around the nerve and the cessation of contractions of the deltoid muscle. As an anesthetic, at each injection, 5 ml of 0.75 % ropivacaine is administered. Blockade is supplemented by general anesthesia with intubation of the trachea using sevoflurane.;EFFECT: method allows to reduce the risk of serious complications and prevent the risk of compression-ischemic neuropathy of the suprathinus nerve, method does not affect hemodynamics, does not cause motor blockade of the limb below the shoulder joint, which allows an early evaluation of traction complications.;3 cl, 3 ex, 10 dwg