Fedorenko I. Optimization of antinociceptive defence the operations on an occasion of diffuse toxic goitre in the conditions of intravenous anaesthesia

Work is devoted to development of the anaesthetic providing of patients which are operated on an occasion of diffuse toxic goitre in the conditions of the independent breathing with partly stored consciousness for realization of minimum verbal contact and prevention of laryngeus nerves damage. After offered treating-preventive premedication complex during 3th days the combined anaesthesia by a phentanyl with the dosed introduction of propofol in the conditions of medicinal sleep with the partly stored consciousness multiplied the degree of braking of nociceptive impulsation, mobilized all homoeostatic nocifensors, that showed up stability of levels of cortisol, glycemia, egestion of adrenalin and noradrenalin with day's urine in intra- and afteroperation periods. Complete to the orientation in space and in time recommenced quick on 9 min., that allowed to shorten the period of permanent dynamic afteroperation supervision in the chamber of intensive therapy. Neuroleptoanalgesia at patients with a thyrotoxicosis with a diffuse goitre did not provide adequate nociceptive defence, as a result of what the hypophys-superrenal and simpatico-adrenal systems continued to activate.