Ekubulaweni Kwezinzwa "Sevoranom": yokusetshenziswa, imiphumela Izibuyekezo

"Sevoran" (isithako - sevoflurane) - ejenti izinzwa is ngempumelelo kusetshenziswa imithi yokwenza ephefumula izinzwa. Ukwethulwa le ndlela ivumela izidakamizwa esikhathini esifushane kakhulu isikhathi ukuze unqamule ukwazi lesiguli, kodwa ngemuva kokuthi uqede konke abuyiselwe ngokushesha.

Ekubulaweni Kwezinzwa "Sevoranom" lapho zaphathwa ephelezelwa ukuyaluza kancane futhi kungekho lubonakale ukucasuka umgudu mucosa. Ngakho, akunakwenzeka ukuba liyochukuluza uketshezi oluqinile esihlahleni tracheobronchial futhi sikhuthaze isimiso sezinzwa. Umuthi isishukumisela ukucindezelwa umthamo-kuncike umsebenzi zokuphefumula uphinde wehlise blood pressure.

kuyinto izinzwa kanjani? "Sevoran" akunamthelela ingcindezi intracranial, akusenzi ekuphenduleni carbon dioxide, ke akuphazamisi nezinso yokwehluleka kwesibindi akakubangeli ukwanda kulezi zitho, ngisho uma isiguli kuyoba ngaphansi izinzwa isikhathi eside. Kodwa kanjani ukubala umthamo ukuba izinzwa siphumelele futhi ngesikhathi esifanayo kuphephile?

Isikali

Ekubulaweni Kwezinzwa "Sevoranom" isiguli ngasinye ikhethwa ngamunye.

Ngakho, ukungenelela kuhlinzwa sidla esebenzisa izinzwa vaporizer. Ngokuvamile, nababulala izinzwa ukusebenzisa amadivaysi ekhethekile ukuthi ulinganiswe ngokunembile salokhu izidakamizwa.

Umthamo akhethiwe uma ngayinye. Titration lide ngakho uze siletha imiphumela efiselekayo, ngesikhathi esifanayo kufanele inake umlando lesiguli emitholampilo yokugula kwakhe, co-morbidities kanye nobudala. Emva kokuphothula ukusuthisa "Sevorane" ekwakhiweni iqondiswa esigulini phakathi eqenjini ehlanganisa barbiturates, noma olunye uhlobo izinzwa lapho kuhloswe ukuba kuholele ngemithambo yegazi ukuthola izinzwa ezijulile. Ngokuvamile ukusetshenziselwa lokhu-mpilo inhloso oxide nitric noma "Sevorane" kanye nomoya-mpilo.

Ekubulaweni Kwezinzwa "Sevoranom" ngezinga elincane ngaphambi kokuba sihlinzwe ivumela esiteji wobuthongo obukhulu ngoba amaminithi ambalwa, futhi kuziwa njengoba abadala nezingane ngokufanayo. Nale izinzwa sici kakhulu a ophumayo esheshayo isimo izinzwa ngaphandle kokusebenzisa amathuluzi ezengeziwe: iziguli akuvamile esekhala ukucindezeleka kuqhubeka isikhathi eside ngemva kwalokho, ngokushesha abuyiselwe umsebenzi ukucabanga, abantu neze ukungakhululeki endaweni ukuhlinzwa kanye imijovo.

Ngaphezu kwalokho, "Sevoranom" ukubulala izinzwa inikeza ezingeni kudingekile ngokusungula indlela yokubulala izinzwa. Ubuningi ukhethwa uhla kusuka 0.55 kuya ku-3%, umuthi co-zinikwa oxide nitric.

Indlela ukuchitha narcosis "Sevoranom"?

izinzwa inhalation nale izidakamizwa, kanye nanoma yimuphi omunye ukulungele kahle ukuba iphathwe isiguli - kanjalo sigweme imiphumela emibi. Isimo main - kungcono esiswini esingenalutho. Abadala belulekwa ukuba bangadli amahora 6-8 ngaphambi nje kokuba ahlinzwe, nezingane - amahora 4-5. Lo mthetho iyadingeka ukuba abantu babulawelwe kuzo, isiguli kungenziwa kuvikelwe kuphela kuleli cala, ngoba ukuhlanza kungenzeka, okuholela inkinga ezifana ebuhlanzweni angangeni umgudu wokuphefumula.

Ngaphambi isiguli kuzoholela ukusebenza, cishe izinsukwana kutuswa unamathele ukudla. Kwaze kwaba yilapho sebeshiye ukuqeqeshwa ngaphambi, usukulungele ukuhlinzwa nge "Sevoranom". Ogulayo ufaka imaski ebusweni, ngokusebenzisa futhi ephansi ukugeleza igesi supply kuzokwenzeka. Sibekezele ezumeka cishe ngokushesha, emva kwemizuzu 1-2. Ngemva kwephupho lebhokisi ipayipi ukuze umthambo neuropathy, uma kunesidingo, kungaba intubate. Noma yimuphi operation, makube ngisho esifushane futhi elula, yisimo ngabaqaphi nesineke futhi ulawula obulala izinzwa izinzwa umthamo ukuze ngokusungula indlela yokubulala izinzwa ukujula eyayidingeka. Lapho bacwiliswa izinzwa esigulini egcina izigaba eziningana:

1. Emangalisa. Uthatha akukho imizuzu engaphezu kuka-4 no kwenzeka ngokushesha ngemva kokuba umuntu waqala ukusebenzisa izinto zokubulala izinzwa. Libhekene yokuthi isiguli engazizwa ubuhlungu, kodwa ukwazi ugciniwe. Kulesi sigaba, odokotela enze iDemo operation - autopsied ithumba noma phlegmon.
2. Excitation. Phakathi nesineke sakhe kuzuba ingcindezi, unembeza, futhi akukho ubuhlungu, kodwa akukho kokungenela kuhlinzwa ngalesi sikhathi asikwazi wachitha.
3. izinzwa Steel, okuyinto ihlukaniswe izinhlobo eziningana ukujula:

• olukha phezulu;
• lula;
• obunzima, walala;
• isigaba agonal - ukukhubazeka okuphelele izitho ezibalulekile.

4. Awakening. Kuleli qophelo iqala nokuvulwa yonke imisebenzi yomzimba.

Izici "Sevoran"

Ekubulaweni Kwezinzwa "Sevoranom" kumele sisetshenziswe kuphela by professional, abaphathi nesineke amakhono kokuba esesimweni esinjalo. Ngalesi sikhathi njalo kufanele okungenani ibe imishini isandla esizovumela ukusebenzisa zonke izinyathelo ezidingekile ukuze ubuyisele umbhalo ipheshana zokuphefumula noma yokusiza umuntu ukuba aphefumule, uma ngesikhathi ukusebenza, sekwenzeka ayengakulindele.

Izinga ngokusungula indlela yokubulala izinzwa lapho usebenzisa lolu izidakamizwa lishintsha ngokushesha okukhulu kakhulu, okwenza obulala izinzwa ukusebenzisa vaporizers kuphela ukukala ngokukhethekile. Phakathi ushona ngokusungula indlela yokubulala izinzwa e isiguli kungabonakala nasemkhakheni nesanda hypotension futhi zokuphefumula emizimbeni ukucindezeleka.

Uma usebenzisa imali yesondlo izinzwa ke nge okwandisa lokuhlala ingcindezi izidakamizwa uzokwehla kubonakale, kuba encike ngqo kwi umthamo "Sevoran". ukunciphisa kakhulu abukhali futhi eqinile wegazi kungenzeka kubangelwa ngezinga ezijulile izinzwa.

Consciousness ngemva kokubulawa izinzwa uyabuya nesineke emva kwamaminithi ambalwa, kodwa ngisho lokhu amakhono engqondo abuyiselwe kuphela ngemva kwamahora ambalwa. odokotela abahlinzayo Abaningi futhi odokotela bamazinyo ubhekwa izidakamizwa kangcono izinzwa "Sevoran". ku isicelo yomhlahlandlela ithuluzi uthi isenzo kwenzeka cishe ngaso leso sikhathi, futhi kushiya ogulayo besesimweni ngokusungula indlela yokubulala izinzwa ngokushesha, ezimweni eziningi ngaphandle kwemiphumela, nakuba ngezinye izikhathi ziyenzeka.

Izinzuzo usebenzisa "Sevoran"

Kuyinto ephawulekayo ukuthi lo mshumayeli ekwakhiweni senzelwe nokuphatha abantu esifundazweni izinzwa, has eziningi eziwusizo:

• ukucwiliswa ezisheshayo izinzwa (cishe ngokushesha nje ngemva umoya lokuqala) futhi indlela elula - ngeke ikwazi ukubekezela imizuzu engaphezu kwengu-20 ngemva okuphakelayo zomuthi sithule.
• Cishe akunamthelela izitsha uhlelo, inhliziyo negazi zokuphefumula.
• Izinga eliphezulu controllability.
• Umkhawulo ophansi yokucasuka zokuphefumula.
• Non-enobuthi esigulini.
• Nge kakhulu izinzwa umphumela izinzwa zalo ngempumelelo amazinyo isetshenziselwa nalapho zokuhlinzwa evulekile.
• ukubonakaliswa ezingavamile nemiphumela engemihle.
• Ikhono ukusebenzisa njengendlela mononarkoza.
• Lwenza ukusetshenziswa ephansi ukugeleza izinzwa, elibangela lesi ubuncane ukugeleza rate zomuthi, ukungabi okuphelele ukungcoliswa kwemvelo izidakamizwa ngazimbili.

Zonke izinzuzo ezichazwe ngenhla abonisa ukuthi izidakamizwa iphumelela kakhulu futhi has cishe awekho imiphumela, ngakho-ke livame ukusetshenziswa lapho siphatha amazinyo ngaphansi izinzwa jikelele abadala kanye nezingane, kanye nezinye izinqubo zokuhlinza.

Imiphumela emibi kanye contraindications

Kodwa akumelwe sikhohlwe ukuthi yimuphi izidakamizwa has side effects kanye Izimo, futhi konke lokhu kungenxa izici esigulini ngasinye. Akunakwenzeka ukuqagela ukuthi ngiziqonde ukulungiselela umzimba. Ngisho imithi engalimazi kakhulu kungabangela abanye abantu nemiphumela emibi, lokhu kusebenza futhi izinzwa.

• Isiyezi, ukozela, Ukudlikizela, izinguquko ngokwedlulele kwemizwelo - lezi zimpawu kungenzeka ngaphakathi kwezinsuku ezimbalwa emva isicelo ngokusungula indlela yokubulala izinzwa.
• iziyaluyalu zokuphefumula, ukukhwehlela.
• Jumps wegazi, tachycardia noma bradycardia.
• Ukucanuzela kwenhliziyo, ukuhlanza.
• komzimba.
• Chills nomkhuhlane.

Ngaphezu kolunye imiphumela ezimweni ezingajwayelekile "Sevoran" (yokusetshenziswa wabhekisela) has Izimo, futhi kufanele wazi esigulini ngasinye ngaphambi kokuba kwadingeka ukuba izinto zokubulala izinzwa. Phakathi Izimo:

• Ukuzwela ekhethekile emuthini.
• yofuzo ukuba komzimba ebulalayo.
• Phakathi ibele.

Futhi, zonke izindlela ngoba ephefumula izinzwa Kunconywa ukusebenzisa ngokucophelela okukhulu in iziguli esingamahlalakhona kwezinso, umfutho ophakeme wegazi intracranial, isifo senhliziyo kanye pathologies kwamanyuroni. Izingane abavunyelwe ukusebenzisa "Sevoran", kodwa kuphela umthamo ephansi futhi ngaphansi kokuqondisa udokotela, ngisho nangemva sokuthola izinto zokubulala izinzwa.

ukweqisa izidakamizwa

Endabeni ka ukweqisa izidakamizwa, izimpawu isiguli angavela:

• Ukushintsha umsebenzi isimiso sezinzwa esiyinhloko.
• Hypotension.
• nciphisa semithambo.
• Ngibanjwe.
• ukuboshwa zokuphefumula.

Uma kukhona izimpawu, kufanele ngokushesha yeka ukuphatha izidakamizwa, ukusungula ukuphefumula tube ehlanzekile futhi uqale ukupholisa yokufakelwa umoya-mpilo, ukulandela umsebenzi inhliziyo, uma ufuna ukwethula izidakamizwa ukwakhela kulo.

Ukuxhumana nezinye izidakamizwa

izinzwa inhalation kuhlanganiswe kahle imithi ukuthi avame ukusetshenziswa abahlinzayo phakathi nokuhlinzwa. Lokhu kusebenza izidakamizwa ezithinta isimiso sezinzwa, imisipha relaxants, elwa ne-webhaktheriya, amahomoni, ngemikhiqizo yegazi. ekusebenzisaneni Esibi aye atholakala.

imiyalelo Special ukusetshenziswa

"Sevoranom" ayikwazi ukusetshenziswa bebodwa ekhaya. Lesi sidakamizwa kufanele sinikezwe, khetha umthamo kanye ukuqapha isimo lesiguli kuphela ongudokotela obulala izinzwa, kuyinto efiselekayo kulabo abanokuhlangenwe nakho of ukubulawa kwezinzwa okuvamile.

Ukuze unikeze okuyiwa ephefumula izinzwa, ikakhulukazi "Sevoran" izidakamizwa, udinga ukusebenzisa vaporizers ulinganiswe. Kufanele wazise nesineke ukuthi izinzwa angebe isikhashana ukuze uthole beshayela futhi sisebenze yimuphi umshini ezihambayo, ngoba kungenzeka lokuhlushwa ukunakwa kube kahle.

Izici isicelo "Sevoran" ekwelapheni amazinyo abantwana

Uma siphatha amazinyo ngaphansi izinzwa jikelele, "Sevoran" abavunyelwe ukusebenzisa kokubili abadala kanye nezingane. Ngaphezu kwalokho, lolu hlobo izinzwa livame ukusetshenziswa ngesikhathi nezinye imisebenzi izingane:

• Esiphuthumayo kokungenela kuhlinzwa e ukuvuvukala acute ku ngalo ingaphakathi ngomlomo (ithumba ithumba).
• ukuhlinzwa ezokuziKhethela (ukukhishwa izinyo, izinhlumba).
• Pulpit, caries amaningi futhi periodontitis.

Kodwa ngaso sonke isikhathi bamazinyo ekwelapheni amazinyo abantwana usebenzisa imuncwe "Sevoran". Anesthesia izingane phambi kwethu kusho okuboniswe kulezi zimo ezilandelayo:

• Uma kukhona contraindications ukusetshenziswa ukubulala izinzwa engxenyeni ethile.
• Uma ingane nekontakten (liphinyiselwe negativism ukuze udokotela wamazinyo).
• Kukhona zokugula organic isimiso sezinzwa, phakathi kwesikhathi lapho ingane ayikwazi ngempela ngokoqobo ezizungezile.
• Uma kunesidingo esiphuthumayo ukuba afeze sesinyathelo esisodwa wokuvuselelwa ngokwendalo ngalo ingaphakathi ngomlomo ne yenqwaba nezinqubo.

Kodwa akumelwe sikhohlwe ukuthi noma yimuphi umuthi ingane ubona ngozwelo kakhulu. Abazali kufanele wazise udokotela mayelana nokuba khona ingane izimo ezilandelayo ukuthi kukhona Izimo for izinzwa kusho "Sevoran". Imiphumela ingaba ngenye yinto engathí sina kakhulu. Ngakho, it is hhayi Kunconywa ukusebenzisa:

• Inflammations ipheshana engenhla.
• Ngo ukuvuvukala ngokujulile pheshana urinary, isibindi, emaphashini.
• Uma kukhona diathesis exudative.
• ukutheleleka kwakamuva.
• ingcindezi High intracranial.
• zokugula Decompensated.
• Uma ungeke ukwazi ukusebenzisa izinzwa wendawo.

Yiqiniso, ingane kufuneka bona silungise ukwethulwa ukubulala izinzwa "Sevoran". ukwelashwa kwamazinyo ngaphansi ukubulawa kwezinzwa okuvamile wenziwa yini ngesikhathi ukukhishwa izinyo kuphela, kodwa kwezinye izimo, futhi isidingo sokulungiselela inqubo ngamunye:

• Dlula ukuhlolwa - ukunikela ngegazi, umchamo, oyisazi samakhemikhali ezinto eziphilayo.
• ECG.
• Isiphetho wezingane (kusitifiketi kumelwe kubonise ukuthi isiguli ayinakho contraindications ukusetshenziswa lolu hlobo izinzwa).
• Anesthesia iqondiswa kuphela esiswini esingenalutho.

Okwamanje, kukhona izinhlobonhlobo eziningi izidakamizwa i-izinzwa, kodwa eminyakeni yamuva ethandwa kakhudlwana "Sevoran" inkampani American. He kubhekwa njengokuzijabulisa okungenangozi kakhulu emzimbeni, aziyeka ngokubekezela kahle, kokubili abadala yayo kanye nezingane. Anakho ukunambitheka mnandi kakhulu ukuthi izingane donsa ungazizwa yimuphi kabi.

Umthelela ngokushesha, ngokushesha ngemuva yebhangqa umoya, kanye neziguli uvuke ngemva kwemizuzu engu-15 ngemva imithi kwezidingo. Lo mphumela kungenxa yokuthi angaphezu kuka-90% ngokusebenzisa okukhipha ukukhanya kusho ngendlela unmodified. Isiguli imuncwe izidakamizwa, futhi emva kwemizuzu 10-15 egazini sibizwa ayisekho itholiwe. Wabonisa ngokushesha kakhulu emzimbeni, kungekho izitho nomthelela asihlupheki komzimba musa abangele.

Izibuyekezo

Kuhle kakhulu mayelana phendula ukulungiselela hhayi kuphela ubudala omdala isiguli, kodwa futhi izingane, abathi kanjani ukuphefumula umoya elimnandi wazumeka, bese bevula amehlo - futhi beqamba amanga kakade embhedeni, futhi lutho abazi ubuhlungu. Empeleni, yilokho kanye izenzo "Sevoran". Izibuyekezo abazali futhi uqinisekise ukuthi izingane zabo kukhona lula kakhulu ukubekezelela izinzwa, kungekho side effects kanye komzimba kudala. Kuyinto ngiyabonga kuye, izingane eziningi ziye abe njalo nakakhulu ukuvakashela udokotela wamazinyo, nabo bonke ngenxa zonke izinqubo abazenzi ngaphandle ubuhlungu.

iziguli Adult nazo ngempela omuhle ngesimo sakhe ngemva kwalokhu izinzwa. Okubaluleke kakhulu, it kwenziwe onguchwepheshe oqeqeshiwe ke zonke kuyoba kahle.