Health & Safety
our customers are the primary task!
Any intervention in the human body, both surgical and anesthetic, requires time for subsequent recovery. At this time, the patient is most vulnerable and requires special attention.
Especially for this purpose, our clinic has a ward of postoperative observation and intensive care. It has all the necessary modern equipment that meets the world standards of patient safety. Functional beds are not only comfortable, but also allow you to take the correct anatomical position of the body, which is important for aesthetic operations, which are associated with a strong tension of the tissues. Each bed has a special anesthesia panel with access to oxygen and other medical gases. This allows for respiratory support if necessary, and also ensures the possibility of operation of artificial lung ventilators in case of development of emergency conditions.
All the necessary drugs for intensive care in emergency conditions, and equipment for respiratory support and defibrillation are at hand and always ready to work.
The clinic takes care that each of the staff develops not only in terms of anesthesiology, but also in the direction of intensive care. Constant trainings, conferences and seminars help to keep skills and knowledge at the current world level. Nurses, as well as doctors, have all the necessary first aid skills in a hospital setting.
The safety and health of our customers is paramount.
All surgical interventions, procedures that cause pain, in modern medicine are carried out under anesthesia.
The type of anesthesia depends on the type, duration of the operation, the general condition of the patient.
There are two types of anesthesia:general anesthesia and spinal anesthesia, in which a certain area of the body
loses sensitivity.
Types of anesthesia
Endotracheal anesthesia
Spinal anesthesia
Epidural anesthesia
- Local anesthesia
How is the examination of the anesthesiologist-resuscitator and what is it for?
- The anesthesiologist examines the patient before the operation, while not only paying attention to the underlying disease for which the operation is to be performed, but also finds out in detail the presence of concomitant diseases
- If the patient is operated on in a planned manner, then, if necessary, treatment of concomitant diseases, sanitation of the oral cavity is carried out
- The doctor finds out the allergic history (whether all drugs and substances are transferred to the patient)
- Clarifies whether the patient has undergone surgery and anesthesia in the past
- Draws attention to the shape of the face, chest, neck structure, severity of subcutaneous fat
- Such a detailed reception is necessary in order to choose the right method of anesthesia for each individual patient.
For this method of anesthesia, a special (spinal) very thin needle, a syringe and a selected anesthetic are used. A very important point is the correct position of the patient. This is emphasized in epidural and spinal anesthesia.
- anesthesia in the spine is done in this position: the patient is in a sitting position (you need to bend his back, press his chin to his chest, his arms are bent at the elbows) or lies on his side. A sitting posture is preferable: the spinal zone is better seen. Complete immobility is necessary to avoid complications with spinal anesthesia;
- before anesthesia is performed in the back, the doctor determines by palpation the optimal place for the injection (the zone between 5, 4 and 3 vertebrae);
- to avoid infection or blood poisoning, special means are used to treat the place where the subdural anesthesia will be performed, everything should be completely sterile; local anesthesia is performed in the area of insertion of the spinal needle;
- the needle for this procedure is long (about 13 cm) and small in diameter (about 1 mm), so in some cases local anesthesia is not done;
- the needle is inserted very slowly, passes all the layers of the skin, the epidural layer, the hard membrane of the spinal cord membrane. At the entrance to the subarachnoid cavity, the movement of the needle is stopped and a mandren (a conductor that closes the lumen of the needle) is removed from it. If the action is carried out correctly, cerebrospinal fluid flows out of the cannula of the needle;
- an anesthetic is injected, the needle is removed, the injection site is closed with a sterile bandage.
Immediately after the administration of the drug, the patient may experience a side effect: tingling in the lower extremities, spilling heat, it lasts a short time - this is the natural effect of anesthesia. Unlike epidural (half an hour), absolute anesthesia with spinal anesthesia occurs after 10 minutes. The type of drug determines the duration of anesthesia and depends on the time how long the operation will last.
If it is necessary to deprive the lower part of the human body of sensitivity during the operation, spinal anesthesia is done. The essence of this method is the introduction of an anesthetic in a certain place near the spinal cord (in the back - from which this method began to be called so). This is a subarachnoid space located between the meninges and the spinal cord, filled with cerebrospinal fluid (cerebrospinal fluid).
A huge number of large nerves pass through the cerebrospinal fluid, their transmission of pain signals to the brain and need to be blocked. Spinal anesthesia is done in the lumbar region, the area below the lower back is anesthetized. The anesthesiologist must pass a needle to the spine, intervertebral ligaments, epidural region and the lining of the brain and administer a selected anesthetic.
Neuroaxial anesthesia is carried out with various drugs: local anesthetics and adjuvants (additives to them). Common drugs for spinal anesthesia:
- Lidocaine. Suitable for short operations. Used in combination with fentanyl, for 30 to 45 min. provides the tenth level of the block;
- procaine. The drug has a short duration of action. A 5% solution is used. To strengthen the blockade, it is combined with fentanyl; bupivacaine. The difference is the relative indicators of action. The duration of the blockade level is up to an hour, it is possible to use higher doses (from 5 mg and above);
- naropin. It is used for long-term operations. Spinal anesthesia can be done with a 0.75% solution (3-5 hours of action) and 1% (4-6 hours);
- adjuvants: adrenaline (prolongs the block time), fentanyl (enhances the anesthetic effect);
- in some cases, morphine or clonidine is used as an additive.
Spinal and epidural anesthesia is used almost everywhere, if there are no contraindications to use. The injection is made one-time with neuroaxial anesthesia (what is the main difference with the epidural technique, where a catheter is inserted to inject the drug).
Contraindications for the use of this method are as follows: low level of platelets in the blood, reduced blood clotting, heart rhythm disturbance, infectious processes in the area of drug administration. Recovery is fast.
Indications for spinal anesthesia are diverse, they are divided into two types: relative and absolute. Relative contraindications include:
- emergency cases when there is no time to carry out all the preparatory procedures with the patient; unstable mood (lability) of the patient;
- abnormal disorders of the structure of the spine;
- increased intracranial pressure;
- the risk of bleeding and uncertainty of the time of the operation;
- hypoxia, diseases of the central nervous system.
The absolute contraindications of this type of anesthesia include:
- categorical refusal of the patient;
- lack of conditions for resuscitation and poor lighting;
- allergy to anesthetics;
- skin infections: sepsis, herpes, meningitis;
- intracranial hypertension.
Treatment under anesthesia is the only possibility of providing surgical care to the patient or carrying out complex manipulations. Often, the doctor anesthetizes a specific area, which is provided by puncturing it with an anesthetic solution and is called local anesthesia.
Such anesthesia is used for facelifting, blepharoplasty, otoplasty, scar correction, etc.
Local anesthesia is the introduction of an anesthetic into the skin and other anatomical structures of the place where surgical intervention is expected.
Injections of the anesthetic are superficial, only in exceptional cases the doctor can conduct a deeper administration of the drug. Local anesthesia is performed by injecting the drug through a very thin needle, so the actual anesthesia procedure is painless. Often, the introduction of an anesthetic is combined with sedation - sedatives are introduced into the patient's body that normalize the psychological state of a person, reducing the feeling of anxiety and worry.
This type of anesthesia refers to non-inhalation types of anesthesia, which are characterized by a long-lasting effect and a greater depth of exposure compared to inhalation anesthesia.
Intravenous anesthesia can be performed using the following drugs:
- Thiopental, Rekofol, Oxybutyrate and Propofol – classic anesthesia
- Fentatil with diphenhydramine - neuroleptanalgesia, which can be carried out on spontaneous breathing or combined with artificial ventilation of the lungs
- Sibazone with Phentatyl is ataralgesia, which provides superficial, gentle anesthesia and can be carried out with other types of anesthesia.
This type of anesthesia is used to remove abscesses and phlegmon, which occur with complications, it is also possible to treat benign tumors of small sizes, if their removal under general anesthesia is not possible.
One of the most commonly used methods of anesthesia when performing complex surgical interventions is endotracheal anesthesia, which involves immersing the body in a state of deep narcotic (medication) sleep. At the same time, the muscles completely relax, the patient does not have independent breathing.
To achieve the desired state, doctors conduct a set of measures for the patient:
- Intubation of the trachea is the introduction of an intubation tube into the lumen of the trachea, which is necessary to ensure artificial ventilation of the lungs.
- Intravenous administration of narcotic anesthetics, sedatives and tranquilizers.
- Introduction of muscle relaxants - they block neuromuscular transmission.
- Artificial ventilation of the lungs.
The quality of endotracheal anesthesia depends not only on the experience of the anesthesiologist, but also on how correctly the patient's condition is monitored. Be sure to monitor blood pressure, pulse, oxygen saturation.