METHOD FOR APPLYING ANESTHESIA WHEN PERFORMING HYPERTHERMIC INTRAOPERATIVE CHEMOTHERAPY OF MALIGNANT NEOPLASMS IN ABDOMINAL CAVITY AND SMALL PELVIS ORGANS

FIELD: medicine. ^ SUBSTANCE: method involves carrying out patient premedication with Phenozepam tablets at a dose of 0.0005-0.001 g, Sibazon intramuscularly introduced at a dose of 10 mg 30 min before operation on the eve and in the morning at operation day and Dimedrol at a dose of 10 mg. Then the patient is placed on operational table on mattress heated to temperature of 37-39C and connected to monitor. The central vein is punctured and catheterized and preoperative patient infusion preparation is started by intravenously dropping 500 ml of crystalloid solutions heated to temperature of 37-42C like Ringer solution or Acesol, or Trisol, or Lactasol, and the same quantity of colloid solutions HES 6% or HES 10%. Then epidural space is punctured at Th7-L1 level with subsequent catheterization following so that with catheter top being arranged at Th5-Th11 level. 4 ml of 0.5% Bupivacaine hydrochloride solution test-dose is epidurally introduced in bolus mode into the epidural space with its action being estimated. Then anesthetic is fractionally introduced in 4-5 ml large portions under arterial blood pressure and pulse control with the total amount reaching 15-20 ml with earlier entered test-dose quantity being taken in account. Oxygen inhalation is carried out through narcosis apparatus mask at a rate of 5-8 l/min on the background of independent patient breathing. Then intravenous bolus 0.1% atropine injection is introduced at a dose of 0.005 mg/kg. Anesthesia induction of 2% sodium thiopental solution is carried out at a dose of 4-5 mg/kg, and also 0.005% Phentanyl solution at a dose of 0.0025-0.0035 mg/kg as intravenous bolus injection into the central vein. Trachea intubation is carried out on the precurarization background by introducing Arduan at a dose of 1-2 mg or Esmeran at a dose of 10-20 mg. The patient is transferred to artificial lung ventilation on the background of a muscular relaxation by introducing 2% Ditiline solution at a dose of 1.5-2 mg/kg, and body temperature control gauge is arranged in the middle one-third of patient esophagus. Anesthesia is supported at all stages of operation under artificial lung ventilation conditions by carrying out inhalation with nitrous oxide and oxygen mixture with their proportion being from 2:1 up to 3:1 using flow-reversing respiratory contour having respiratory ventilation volume of 7-8 ml/kg and minute ventilation of 100-120 ml/kg. 0.5% Bupivacaine hydrochloride solution is also introduced into the ep