METHOD BALANCED ANESTHESIA IN THE SURGERY OF BREAST CANCER

摘要

FIELD: medicine.;SUBSTANCE: invention belongs to medicine, notably to anaesthesiology, and can be applied as anaesthetic aid in mammary gland cancer surgery. To perform it premedication is made by injecting 1-5 mg of midazolam and 50-200 mcg of fentanyl. In sitting position at C_VI-Th_VII level 2-2.5 cm ipsilaterally from upper margin of corresponding vertebrae spinous processes local infiltrative anesthesia is performed. Next, 2 inches long 20 G needle is inserted at these points. After a contact with a spinous process needle is redirected cranially and moved along the sagittal plane 10-15 mm over the process's upper edge until air bubble "loses its resistance" in the moment when needle penetrates through costotransverse ligament. Needle position is identified with pressure monitoring, which involves connection of needle to transducer with T-joint, and when paravertebral space is reached, assessment of pressure drop and inversion. 5 ml of 0.5% bupivacaine with 1:400000 epinephrine or 3 ml of 0.75% ropivacaine with 1:400000 epinephrine in each of nine segments at Cv_I-Th_VII level is injected.;EFFECT: method ensures adequate anesthesia in this category of patients without proceeding to general anaesthesia and repeated blocking, with simultaneous positive influence on central hemodynamics, which allows postoperative rehabilitation shortening and reduces quantity of opioids in postoperative period.;2 cl, 2 ex