Umuthi 'ketamine ": yokusetshenziswa, incazelo, ukwakheka kanye nokubuyekeza

Ukuze afeze noma iyiphi ukuhlinzwa, udokotela udinga ukulungiselela okuyisipesheli anezakhi analgesic. Okungukuthi, abangabantwana izinzwa kuyadingeka. Omunye walena uwukuba le "Ketamine". Yokusetshenziswa zomuthi kumele balitadishisise ngaphambi kokuba yethulwe esigulini.

incazelo Jikelele kanye nendlela okwakheke ngayo izidakamizwa

Ingqikithi uketshezi elinendawo luhlaza okuncane ngokwempilo noma angakutholi nhlobo umbala. 1 ml le ndlela yokuxhumana equkethwe 57,6 mg ketamine. izithako engeziwe kungenziwa isehlane benzalkonium chloride, i-sodium, namanzi nemijovo.

imithi Zifakwe kwezokuphatha esicutshini noma emthanjeni. Uma kufanele asebenzise "Ketamine" imfundo manual elikushoyo lezo zinhlobo ukukhiqizwa:

- Ampules kusho nabantu abangu-okungenani 2 ml. Iphakheji liqukethe 5 vials.

- Amabhodlela 5 ml.

Isenzo kwemithi zomuthi

Ingqikithi samanje inomphumela omuhle analgesic, Nokho, okuyinto, Asihlali isikhathi eside. Ngaphezu kwalokho, "Ketamine" (yokusetshenziswa izindlela esisogwini iphakethe) ayikwazi ukunikeza ezingeni ofanele analgesia imisebenzi besisu. Phakathi nesimiso sokuqondisa izidakamizwa engasenamahloni ukwazi hhayi ngokugcwele nokugwinya, ukukhwehlela futhi laryngeal ikhaliphe ukulondolozwa. Ngemva kokuphathwa zomuthi isiguli lezi zimpawu:-high blood pressure, contractility esivimba amanzi. Lwamathambo imisipha ithoni kuleli cala hhayi ziyancipha.

Ngemva kokuphela izidakamizwa e abantu kukhona ukozela, okungase avuse ukuhhema, amaphupho acacile kakhulu. Ngaphezu kwalokho, emva kokuphothulwa umphumela izinzwa e isiguli isikhala neliphithene. Lesikhatsi lesi bakwazi ukuqhubeka 8 amahora. Uma uthatha ketshezi ngokuhlanganyela antipsychotics, zonke lezi imiphumela ukunciphisa umfutho wabo nokukhanya. Umkhawulo semthethweni isikhathi amahora 2-3.

Ukuze abaphathi esicutshini, lo mphumela zingandiswa. Effect Its izidakamizwa iqala kwemizuzu engu-10. Kufanele kuqashelwe ukuthi umthamo izidakamizwa 1 mg / kg singavimbela ukusungulwa 6 amaminithi kuphela. Ukuze kuzuzwe ngomzuzu-25 izinzwa umphumela, kubalulekile ukwethula 4-8 mg / kg. "Ketamine" (yokusetshenziswa - umhlahlandlela yangempela esenzweni) zisakazwa wonke umzimba futhi lingena kusivimbeli gazi ebuchosheni. Futhi uketshezi olungenambala olusegazini amaprotheni ke sibopha ukuthi 12% kuphela. Ingxenye-ukuphila ihora izidakamizwa 2. izidakamizwa ezibonisiwe is excreted ku umchamo nakuba inani elincane metabolites kungabonakala nasemkhakheni emzimbeni kwaphela izinsuku eziningana.

izinkomba

Uma udokotela wakho uye wanquma ukuba amise "Ketamine hydrochloride", imfundo manual kuzosiza wazisingatha izinkomba ukusetshenziswa zomuthi. ungabahlukanisa phakathi kwabo kukhona:

• izinqubo kuhlinzwa ngaphandle esifushane. Ngesikhathi esifanayo isidingo muscle akunandaba. Ikakhulukazi, ekubonisa abantu abanayo umfutho ophansi wegazi uyalandelwa.

• Ezokuthutha iziguli kwabanye izibhedlela.

• Isidingo umkhiqizo ngokusungula indlela yokubulala izinzwa eziyisisekelo.

• ashise ukwelashwa.

• Ukwenziwa kwama manipulation wezinsimbi, okungase kubangele ubuhlungu obunzima.

• Isidingo nokuqalisa imisebenzi ephuthumayo, kubangelwa ukushaqeka esibuhlungu, ukopha okunzima.

• Ukufakwa kwanoma ipayipi enhliziyweni.

• Ukubeletha noma ukuhlinzwa izifo zabesifazane.

• manipulations Steel ezilwaneni.

Izimo

Uma wabelwe "Ketamine" yokusetshenziswa (ukusetshenziswa wezilwane le imithi futhi kuvunyelwe) uthi ngalezi Izimo:

1. ukuzwela kakhulu okusezingeni eliphezulu ukuze nabavoti we imithi.

2. Arterial umfutho wegazi ophakeme, lapho kukhona ukukhuphuka ziphikelele ingcindezi.

3. isilethikusebenza noma angina e ezinyangeni eziyisithupha ezedlule.

4. Kakhulu ezinzima esingamahlalakhona kwezinso.

5. Ukwephulwa kwegazi igazi ebuchosheni.

6. uthi convulsive nesokuwa, kuhlanganise nezingane.

7. Ukukhulelwa kanye lactation.

8. Alcoholism.

niqaphelisise ukuba kulezo ziguli ababonisa ezingamahlalakhona ukumelwa inhliziyo, futhi abadinga afeze ukuhlinzwa phezu pharynx noma umphimbo. Kulokhu, ingase okwengeziwe isicelo relaxant.

Izici umthamo

Lokhu imithi ingasatshenziswa emthanjeni (bolus uconsisele) noma kwi-IM. Uma ukusebenza Kwenziwa abadala, kubalulekile ukwethula into ngemithambo yegazi. Ngobungako lokulungiselela 2-3 mg esisindo / kg. Uma uhlela ukuba esicutshini umjovo ke kukhona kudingeka 4-8 mg esisindo / kg. Ukuze umphumela izinzwa eyathatha okwengeziwe esizosingathwa "Ketamine" isixazululo at 2 mg / kg ngehora. Uma weThrojani osebenzayo, ikhambi 0.1% yethulwa ngesilinganiso esingamaphesenti 20-50 amathonsi ngomzuzu.

Incazelo kanye Umsebenzisi "Ketamine" Kumelwe nakanjani kube wachazela abazali, uma ukusebenza Kwenziwa nengane. Kulokhu ukulungiswa ingasetshenziswa njengendlela base noma izinzwa eziyisisekelo. Uma ukhetho lwesibili ekhethiwe, izidakamizwa ke kufanele afakwe intramuscularly noma ngemithambo yegazi. kusho umthamo incike yobudala ingane futhi 8-12 mg / kg for izinsana, 6-10 mg / kg - ingane kusukela eminyakeni 1 kuya kwele 6, mayelana 4-8 mg / kg - izingane ezindala kanye intsha. Uma kusetshenziswa umjovo emthanjeni, kukhona ke kudingeka ukwethula 3.2 mg / kg, ne kwalokho gqwa zomuthi kulo msebenzi.

Thuthukisa isenzo izidakamizwa kungenzeka ngosizo "Fentanyl", "promedolom", "droperidol." Ngalesi umthamo "Ketamine" ngempela encishisiwe.

Buhle buni obungaba engadingeki kungenzeka?

Uma udokotela kuyadingeka ukusebenzisa "Ketamine" imfundo manual (. Intengo umuthi ruble mayelana 150) ixwayisa wena we nesenzakalo okungenzeka ukusabela ezingezinhle:

• Tachycardia nokwanda ingcindezi.

• ukwanda ngokweqile e amathe.

• Ukuvela ukusangana futhi ezinzima lengqondo ukuyaluza ngesikhathi sokuthola izinto zokubulala izinzwa.

• Ukuphelelwa ngumoya nokucindezeleka zokuphefumula.

• Ubuhlungu.

• Ingabe ububomvu kusayithi umjovo.

• Disorientation emkhathini.

Uma kwakuba khona kokudla izidakamizwa, kungenzeka ukucindezeleka zokuphefumula. Kulokhu, udinga ukwenza umuntu afakwe emishinini yokuphefumula. Uma kukhona ukuphazamiseka convulsive ke kungaba zisuswe ngokusebenzisa ithuluzi ezifana "Diazepam".

Izixwayiso

Ngemva kokuphathwa zomuthi isiguli akukwazi emini noma bahlanganyele kunoma yiluphi imisebenzi enobungozi ezidinga ukunakwa lenyuke. Akunakusetshenziswa musa ukushayela imoto. Ngaphezu kwalokho:

• Ungalokothi co-ukuphatha izidakamizwa betfulelwa barbiturates.

• Sebenzisa imithi can Udokotela onguchwepheshe kuphela. Thenga ke Pharmacy ngaphandle kadokotela, awukwazi. It wasebenzisa izidakamizwa kuphela ambulensi noma egunjini lasesibhedlela.

• «Atropine" singasetshenziswa for ukuze kuncishiswe amathe.

• Nakuba usebenzisa lo muthi udinga ngaso sonke isikhathi ukuqapha ukuphefumula esiguli, ikakhulukazi engenhla imisebenzi ipheshana zokuphefumula njengoba spasm kungenzeka kwemisipha masticatory.

• «Diazepam" Asigcini unciphise amathuba ukudikiza okungalindelekile imisipha, kodwa futhi kuvimbela isinyathelo psychomimetic.

Ngokuphathelene inhlanganisela neminye imithi, "Ketamine" indlela abangenza ngayo umphumela kwezidakamizwa analgesics uhlobo, anxiolytics kanye nezinye izinto singavimbela ukusebenza CNS.

Ukubuyekeza, analogs nezici isitoreji

Uma udinga kokuhlinzwa, obulala izinzwa zingasebenzisa lokhu imithi ngokuthi "Ketamine". Yokusetshenziswa (in vials equkethe 2 ml we ekwakhiweni elisetshenziswe kaningi) siphinde sihlinzekele nezinhlelo ezihlanganisa analogs, okungenzeka ukwakheka efanayo. Mhlawumbe neminye imithi aqukethe isithako efanayo esebenzayo, ngeke ezikufanelayo ngaphezulu. Phakathi analogue ingashiwo yilezi: "Kalipsol", "Ketanest", "Ketalar".

Gcina umkhiqizo endaweni epholile lapho izingane zingenakuwafinyelela. izidakamizwa Iyatholakala kuphela kadokotela, kanti ukusetshenziswa kwalo akuvumelekile ekhaya. lokushisa isitoreji kufanele kube khona abangaphezu kuka-degrees 30. izidakamizwa Packaging ngempela uvalwe ivaliwe. Impilo okungokomoya izinyanga 24.

Ngokuphathelene amazwana iziguli, sihluke kakhulu. Ngokwesibonelo, isici esihle kubhekwa ukuphumelela izidakamizwa ngoba nesineke engazizwa ubuhlungu. Nokho, imiphumela ngokusungula indlela yokubulala izinzwa kubuhlungu ngempela. Phuma kusukela izinzwa, ngokuvumelana iningi iziguli, sinzima kakhulu.

Manje ngoba sewuyazi ukuthi lonke ulwazi mayelana izidakamizwa "ketamine". Yokusetshenziswa, intengo, ukubuyekezwa ungeyena imfihlo ngawe. Hlala uphilile!