Ichiza "ketamine": imiyalelo ukusetyenziswa, inkcazo, ukwakhiwa kunye nohlolo

Ukuze aphumeze nayiphi utyando, ugqirha kufuneka ukulungiselela ezizodwa ene iipropati iintlungu. Oko kukuthi, iintlungu efunekayo. Enye yezi i "Ketamine". Imiyalelo zokusetyenziswa ichiza kufuneka ngocoselelo kufundwa phambi kokuba usiwe kumguli.

inkcazo jikelele kunye nokwakhiwa ichiza

Le nto ke into engamanzi ene-nombala kancinane okanye akukho umbala. 1 ml kwesi eziqulethwe 57.6 mg ketamine. izithako oloNgezelelweyo lungafumaneka bodwa benzalkonium chloride, isodiyam, namanzi injectable.

amayeza isicelo nolawulo intramuscular okanye efakwa. Ukuba kufuneka usebenzise "Ketamine" yemiyalezo ithi malunga kweendlela zemveliso:

- Ampules kuthetha nge abangama-ml ubuncinane 2. Le mpahla iqulathe ezineengqayi-5.

- iibhotile ml-5.

Isenzo amayeza ye ichiza

Le nto ikhoyo kuba nemiphumo emihle iintlungu, kodwa, nakuba kunjalo, akuthethi xesha lide. Ukongezelela, "Ketamine" (imiyalelo ukusebenzisa indlela ebekwe kwi package) akakwazi ukunika inqanaba efanelekileyo analgesia imisebenzi esiswini. Ngexesha ulawulo ichiza elinganeno hayi ngokupheleleyo sezingqondweni kwaye igwinya, ukhohlokhohlo kunye ingqondo laryngeal basindiswe. Emva ulawulo ichiza isigulane ezi mpawu: uxinzelelo oluphezulu lwegazi, contractility engabalulekanga. kwezihlunu skeletal kule ityala alisonjululwanga lifinyele.

Emva kokuphela ichiza ebantwini kukho ukozela, nto leyo iwuxhokonxileyo nemibono, amaphupha acacileyo kakhulu. Ngaphezu koko, emva kokugqitywa isiphumo iintlungu kwindawo isigulane isithuba bezibuza. Eli xesha uyakwazi ukuqhubeka iiyure ezisi-8. Ukuba uthatha i kweziyobisi kunye antipsychotics, zonke ezi ziphumo ukunciphisa namandla nokukhanya. Ithuba wihi ezona yure 2-3.

Ukuze ulawulo intramuscular, oku kungenziwa lenyuke. ukusebenza kwayo ichiza iqala kwemizuzu eli-10. Kufuneka kuqatshelwe ukuba ithamo lwemithi 1 mg / kg kunganqanda ukusekwa imizuzu 6 kuphela. Ukuze kufikelelwe isiphumo iintlungu wemizuzu engama-25, kuyimfuneko ukwazisa 4-8 mg / kg. "Ketamine" (imiyalelo zokusetyenziswa - isikhokelo ngokwenene isenzo) isasazwa ngokubanzi kuyo umzimba kwaye ingena umqobo segazi lobuchopho. Kunye neeproteni plasma sibopha ukuthi%-12 kuphela. Kwisiqingatha ubomi ilixa kweziyobisi 2. ichiza Kuboniswa salawo kwi umchamo nangona imali encinane metabolites ibonakala emzimbeni iintsuku eziliqela.

Ubungqina obubonakalayo buxela

Ukuba ugqirha wakho egqibile ukumisela "Ketamine hydrochloride", umyalelo manual kuya kunceda zijongene kunye ezibonisa ukuba ukusetyenziswa kweziyobisi gwenxa. zingahlukaniswa phakathi kwazo zezi:

• Iinkqubo zotyando ngaphandle ixesha elifutshane. Ngelo xesha linye imfuno kwemisipha zokwehlisa Akukhathaliseki. Ingakumbi, ibonisa ukuba abantu babe wegazi waphawula.

• Ukuthuthwa izigulane kwezinye izibhedlele.

• Isidingo yimveliso Ukubulawa esisiseko.

• ukutshisa unyango.

• Ukwenziwa kwe ukuphululwa instrumental, leyo ezinokudala ubuhlungu obukhulu.

• Imfuneko ukuphumeza imisebenzi likaxakeka, okubangelwa umothuko esibuhlungu, ukopha kakhulu.

• Ukufakelwa kwe catheter entliziyweni.

• Uqhaqho okanye uqhaqho yamanina.

• zazo zotyando ezilwanyaneni.

Izimo

Ukuba isabelo "Ketamine" imiyalelo zokusetyenziswa (ukusetyenziswa lwezilwanyana eli yeza naye uvumelekile) uthi ezi Izimo:

1. uvakalelo oluphezulu kakhulu kubahlali ukuba amayeza.

2. Arterial lwegazi, apho kukho ukwanda ziqhubeke koxinzelelo.

3. iposi engabalulekanga okanye angina kwiinyanga ezintandathu ezidlulileyo.

4. insufficiency nzima kakhulu sezintso.

5. Ukwaphulwa yegazi kwegazi ebuchotsheni.

6. Le ithi convulsive nabanesithuthwane, kuquka nabantwana.

7. Ukukhulelwa zisanyisa.

8. Alcoholism.

lumkani ukuba abo izigulane ababonisa ukusilela intliziyo ezingapheliyo, kwaye abafuna ukwenza i operation kule pharynx okanye kwingqula. Kulo mzekelo, ukuze isetyenziswe relaxant ngakumbi.

Iimpawu and esithathwa

Eli yeza kubhalwa emthanjeni (bolus kunye ithontsi) okanye IM. Ukuba umsebenzi lwenziwa kubantu abadala, kuyimfuneko ukwazisa into yegazi. Ubungakanani yokulungiselela 2-3 mg / ubunzima bomzimba kg. Ukuba uceba intramuscular isitofu, ngoko ke kufuneka kubekho 4-8 mg / ubunzima bomzimba kg. Ukuze ukusebenza iintlungu kwaqhubeka ngakumbi kwenziwa isisombululo "Ketamine" kwi 2 mg / kg ngeyure nganye. Ukuba isibeki esebenzayo, umxube 0.1% yaziswa ngesantya ngamathontsi 20-50 ngomzuzu.

Inkcazelo kunye Umsebenzisi "Ketamine" kufuneka kubeka wacacisela ngabazali, ukuba nokusebenza mbo njengoko umntwana. Kulo mzekelo ukulungiswa zingasetyenziswa njenge isiseko okanye Ukubulawa esisiseko. le yesibini Ukuba olukhetho lukhethiwe, ngoko ichiza kufuneka zifakelwe intramuscularly okanye yegazi. uthetha ithamo ixhomekeke ubudala umntwana kwaye 8-12 mg / kg kwiimveku, 6-10 mg / kg - umntwana ukusuka kwiminyaka 1 ukuya ku-6, malunga 4-8 mg / kg - abantwana abadala nabafikisayo. Ukuba kusetyenziswa Inaliti efakwa, ke kukho kufuneka nokuba sikuhambise nkusungula 3.2 mg / kg, kunye Ukongeza ngamaxesha beziyobisi kulo msebenzi.

Ukuphucula amanyathelo beziyobisi kungenzeka ngoncedo "Fentanyl", "promedolom", "droperidol." Kule ithamo "Ketamine" sinciphile ngokuyimfuneko.

Buhle zingafuneki khona ukuze yenzeke?

Ukuba ugqirha kuyimfuneko ukusebenzisa i "Ketamine" yemiyalezo (. Ixabiso le ichiza malunga 150 engange) ilumkisa kuni kukuvela reactions ezibi okunokwenzeka:

• Tachycardia kunye ukunyuka koxinzelelo.

• Ukwanda kakhulu kwi izinkcwe.

• Ukuvela nemibono kwaye yababuhlungu lengqondo ukuphazamiseka ngexesha angalulama zomzimba.

• nokuxinana umoya nokudandatheka zokuphefumla.

• Ubuhlungu.

• Ingaba ububomvu kuyo inaliti.

• Ukudideka esithubeni.

Ukuba bekukho libanda, iziyobisi, ukuze kuthi ukudakumba sokuphefumla. Kulo mzekelo, kufuneka wenze nokuphefumla ngumntu. Ukuba kukho ukuphazamiseka convulsive, ngoko asuswe ngokusebenzisa isixhobo ezifana "Diazepam".

oyi

Emva ulawulo ichiza kwisigulana akanakuba ebudeni bemini okanye abandakanyeke kuwo nawuphi na izinto eziyingozi ezifuna ingqalelo ukwanda. Xa kungekho tyala musa ukuqhuba imoto. Ukongeza:

• Ungaze co-ulawulo iziyobisi thaca kunye barbiturates.

• Sebenzisa ungakwazi kuphela ugqirha iyeza. Thenga oko nakwiikhemisti ngaphandle kagqirha, wena awukwazi. Lalisebenzisa ichiza kuphela yezigulana okanye esibhedlele.

• «Atropine" linokusetyenziswa isicelo ukuze sinciphise izinkcwe.

• Xa usebenzisa amayeza kufuneka lonke ixesha esweni ukuphefumla yomguli, ingakumbi kwimisebenzi phecana yokuphefumla ophezulu njengoko spasm kwemisipha masticatory kunokwenzeka.

• «Diazepam" hayi kuphela inceda ukwehlisa amathuba twitching ngokuzenzekelayo izihlunu, kodwa kuthintela inyathelo psychomimetic.

Ngokumalunga lwendibaniso kunye namanye amayeza, "Ketamine 'ukuba ikhulise isiphumo analgesics ezidakumbisayo uhlobo, anxiolytics kunye nezinye izinto ezinokuthi zinqanda ukusebenza CNS.

Ukuphononongwa, analogs kunye neempawu yokugcina

Ukuba ufuna kwegazi, anesthesiologist unokusebenzisa eli amayeza njengoko "Ketamine". Imiyalelo zokusetyenziswa (in ezineengqayi equlathe ml 2 kuqulunqo elisetyenziswa ngokufuthi) Kwakhona ubonelela analogs, into enokuba nokwakheka efanayo. Mhlawumbi kunye namanye amayeza equlathe eyona nto efanayo esebenzayo, uya lulungele wena ngakumbi. Phakathi analogue ukuze kuchazwe zezi: "Kalipsol", "Ketanest", "Ketalar".

Gcina imveliso kwindawo epholileyo apho abantwana abakwazi ukufikelela. iziyobisi Ifumaneka kuphela ngokumiselwa, xa ukusetyenziswa kwaso kuthintelwe ngokungqongqo ekhaya. lobushushu yokugcina kufuneka abe ngaphezulu degrees 30. iziyobisi Iipakethe ngokuyimfuneko sivalisisekile ngalo lonke ixesha. Impilo iimpapasho iinyanga ezingama-24.

Ngokumalunga izimvo zezigulane, zahluke kakhulu. Umzekelo, isici esihle ithathwa ukusebenza ichiza ngenxa yokuba isigulane akuthethi zintlungu. Noko ke, imiphumo zomzimba kungemnandi kakhulu. Phuma kwi zomzimba, njengoko uninzi lwezigulane, kunzima kakhulu.

Ngoku uyazi yonke ingcaciso malunga ichiza "ketamine". Imiyalelo yokusebenzisa, ixabiso, review akukho lasemfihlekweni nawe. Hlala uphilile!