METHOD OF ANAESTHESIA FOR CAESAREAN SECTION IN PREGNANT WOMEN WITH EISENMENGER SYNDROME

摘要

FIELD: medicine.;SUBSTANCE: invention relates to anaesthesiology and methods of circulatory support in pregnant women with Eisenmenger syndrome. Performing anaesthesia, catheterization of radial artery by Seldinger technique with 22G catheter; Seldinger jugular catheterization using ultrasound navigation for monitoring central venous pressure (CVP) and monitoring venous blood gases with Centrofix Trio 7F catheter. Puncture and catheterization of the epidural space is performed at the level of L2-L3 of spine with 20G catheter. Extracorporeal membrane oxygenation (ECMO) apparatus is adjusted. Anaesthesia and surgical intervention are preceded by catheterization of the femoral vein and femoral artery by ultrasound navigation with Centrofix Duo 7F catheters. ECMO apparatus is set to standby mode. It is followed by epidural anaesthesia with ropivacaine 0.75% 15-20 ml with titration of slow fractional saturation. If a pregnant woman develops acute decompensation of heart failure during a surgical intervention, assisted circulation is performed using an ECMO apparatus in standby mode connected to a pregnant woman by means of the above Centrofix Duo 7F catheters.;EFFECT: higher safety and effectiveness of surgical intervention in pregnant women with Eisenmenger syndrome due to elimination of disadvantages inherent in the analogue.;1 cl, 2 tbl, 4 ex