Rud E. Optimization of methods of general anesthesia and prevention disturbances of transcutaneous hemodynamic duringendoscopic surgery on the kidney.

The scientific work is dedicated to improving results of percutaneous endoscopic surgical procedures on the kidneys by improving the methods of general anesthesia through the development of effective methods to prevent hemodynamic disturbances and complications from other systems. The basis of the study put hemodynamics, blood gas parameters during operation, glycemic profile and effectiveness of the proposed scheme of post-operative analgesia. Determine the dependence of the severity of postural changes in hemodynamics during percutaneous endoscopic surgical procedures on the kidneys in the position of the patient on his stomach on the qualitative composition of the infusion of support and methods of general anesthesia. Furthermore, the structure and frequency studied in the early postoperative period with different patterns of general anesthesia. Based on the studies we found that the dynamics of changes in blood pressure and heart rate during percutaneous nephrolithotripsy are conditioned by turning the patient on his stomach and lifting the roller operating table epigastric that causes both compression of aorta and vein cava inferior and epigastric reflex (reflex Tom-Ru ). Degree postural hemodynamic changes is dependent upon the qualitative composition of the support of the infusion, regardless of the method of anesthesia (total intravenous anesthesia with propofol or inhalation anesthesia with sevoflurane) under condition of maintaining an adequate depth of general anesthesia (bispectral index in the range of 40-60 units). It is proved that the incidence of postoperative nausea and vomiting after transcutaneous endoscopic surgery on the kidneys in the prone position does not depend on the method of general anesthesia. Proven effectiveness of the proposed scheme perioperative anesthesia during endoscopic surgery transcutaneous kidney.