In some cases, for example, when treating young children, due to the difficulties associated with installing an intravenous infusion system, the first bougie sessions are performed under mask fluorotane rouche anesthesia. Subcutaneous bougie allows the doctor to perform bougie in a calm environment, eliminating arbitrary and involuntary movements of the patient and the possibility of injury to the esophageal wall with an esophagoscope, which greatly facilitates this procedure. After euthanasia of the patient and intubation of the trachea, before the beginning of bougie, the level of stricture, its appearance, size and position of the opening at the entrance to the stricture are visually determined through an esophagoscope. For better orientation on the boughs inserted into the esophagus, the distance from the front teeth to the stricture is determined. PVC beads are used as dilators, which are dipped in hot water before being introduced into the esophagus to soften and make them elastic, then lubricated with petroleum jelly or glycerin. In most cases, bougie begins with the introduction of bougie numbers 18-22 or more into the esophagus of adults, i.e. when bougie is under anesthesia, larger diameter bougie is used from the very beginning. Carrying boughs of this diameter into the esophagus requires some physical effort from the doctor, while sometimes traces of blood appear in the esophagus, which is usually associated with tearing of the scar folds of the membranous strictures. Such minor hemorrhages usually stop after 2-3 times drying the esophagus with a cotton swab and are not grounds for stopping bougie. Having expanded the esophagus to a size that allows bougie numbers 28-40 in adults for 1-3 sessions, subsequent bougie sessions can be performed in a polyclinic "blindly", i.e. without the use of esophagoscopy. In a polyclinic, bougie is performed under local anesthesia of the pharynx and esophagus with 5-10% novocaine solution of 5-10 ml by spraying it in the pharynx or lubricating it with 1% dicaine solution with preliminary premedication of 1 ml of 1% promedol solution and 0.5 ml of 0.1% atropine sulfate solution. The intervals between bougie sessions in the first month are 5-6 days. During this time, painful sensations along the esophagus subside, and general well-being improves. At a later date (in the second and subsequent months), when the patency of the esophagus is significantly improved, supportive bougie is performed 1-2 times a month. The duration of treatment of cicatricial constrictions and strictures of the esophagus with augmentation depends on its effectiveness. Le code promo 1xbet vous offre un avantage compétitif dès le départ. En validant ce code, vous obtenez un bonus supplémentaire de 100% sur votre premier dépôt, pour un plafond de 300 $. Que vous visiez les victoires en tennis ou les gains au blackjack, ce bonus booste votre confiance et votre potentiel de gains dès votre première connexion.