Kuthatha isikhathi esingakanani ukuthi ikati livuke ku-anesthesia?

Umlobi: John Stephens
Usuku Lokudalwa: 25 Ujanuwari 2021
Ukuvuselela Usuku: 20 Unovemba 2024
Anonim
Kuthatha isikhathi esingakanani ukuthi ikati livuke ku-anesthesia? - Izifufuzo Ezifuywayo
Kuthatha isikhathi esingakanani ukuthi ikati livuke ku-anesthesia? - Izifufuzo Ezifuywayo

-Delile

Kunezizathu eziningi zokuthi kungani ikati kufanele lihlaliswe phansi noma lingabulawa izinzwa, ngenxa yolaka noma ukwesaba lapho kuvakashelwa udokotela wezilwane noma ngezinqubo zokuhlinza ezincane noma imisebenzi emikhulu. i-anesthesia, ikakhulukazi okujwayelekile, kuphephe kakhulu, ngokungafani nalokho abafundisi abaningi abakucabangayo, njengolwazi lwamanje lwemithi, iphesenti lokufa okubangelwa i-anesthesia lingaphansi kuka-0.5%.

Kepha Kuthatha isikhathi esingakanani ukuthi ikati livuke ku-anesthesia? Ngabe isikhathi sekati sokululama esilinganisiwe ngemuva kokuhlinzwa? Kule ndatshana kaPeritoAnimal, sikutshela konke mayelana ne-anesthesia nokuthambisa emakati, ukuthi yini okufanele uyenze ngaphambili, izigaba zayo, imiphumela, imithi kanye nokululama kwayo. Ukufunda okuhle.


Umehluko phakathi kokuthambisa nokubulala izinzwa

Abantu abaningi badida i-sedation ne-anesthesia, kepha iqiniso ukuthi, ziyizinqubo ezimbili ezihluke kakhulu. THE ukuthambisa iqukethe isimo sokucindezeleka kohlelo oluphakathi lapho izilwane zilala khona zingaphenduli okuncane noma zingaphenduli ezenzweni zangaphandle. Ngakolunye uhlangothi, i- izinzwa, okungaba okwasendaweni noma okujwayelekile, okujwayelekile okubangela ukulahleka komuzwa ojwayelekile nge-hypnosis, ukuphumula kwemisipha kanye ne-analgesia.

Kodwa-ke, ngaphambi kokuhambisa ikati lakho ekuhlinzweni, udokotela wezilwane wakho uzokhuluma nawe nge ukuhlolwa kwangaphambi kokubulala izinzwa. Lokhu kubaluleke kakhulu ukuhlola isimo sempilo yomlingani wakho we-feline nokuhlelela umthetho olandelwayo we-anesthetic ecaleni lakho ngalinye. Lokhu kuqukethe:

  • Qedela umlando wezokwelapha (izifo ezikhona nemithi)
  • Ukuhlolwa komzimba (izimpawu ezibalulekile, ulwelwesi lwamafinyila, isikhathi sokugcwalisa kabusha se-capillary nesimo somzimba)
  • Ukuhlaziywa kwegazi kanye ne-biochemistry
  • Ukuhlaziywa komchamo
  • I-Electrocardiogram ukuhlola isimo senhliziyo
  • Kwezinye izimo, nama-radiographs noma i-ultrasound

Kuhlala isikhathi esingakanani ekseni?

Isikhathi sokutholisa ikati sincike ohlotsheni lwenqubo eyenziwe, ehlukahluka kuye ngobude besikhathi nenqubekela phambili yenqubo kanye nokwehluka komuntu ngamunye. Ukuthambisa ikati, kungasetshenziswa inhlanganisela yokuthambisa, i-tranquilizers noma i-analgesics, njengokulandelayo:


Ama-phenothiazines (acepromazine)

Kuhlala isikhathi eside kangakanani ikati eline-phenothiazines? Cishe amahora amane. Lesi yisidambisi esithatha imizuzu engama-20 ukwenza, kepha ngomphumela wamahora ama-4 ngokwesilinganiso. isilwane kumele sibe umoya-mpilo uma isetshenziswa njengethomalazi ngenxa yesifo senhliziyo esiyivelisayo. Kubonakala nge:

  • I-antiemetic (ayibangeli ukuhlanza)
  • ukujula okujulile
  • Ayinaye ophikisana naye, ngakho-ke ikati lizovuka lapho umuthi usenziwa umzimba
  • I-Bradycardia (ukushaya kwenhliziyo okuphansi)
  • I-Hypotension (umfutho wegazi ophansi) ongafika emahoreni ayisithupha ubude
  • Ungakhiqizi i-analgesia
  • ukuphumula kwemisipha ngokulinganisela

Ama-agonists e-Alpha-2 (i-xylazine, i-medetomidine ne-dexmedetomidine)

Kuhlala isikhathi esingakanani ukuhlalisa ikati ngama-alpha-2 agonists? Ziyizidambisi ezinhle ezithatha imizuzu eyi-15 ukwenza futhi zibe nesikhathi esifushane sokuthambisa, cishe amahora amabili. Banomphikisi (i-atipamezole), ngakho-ke uma isetshenzisiwe, bazovuka ngesikhathi esifushane ngaphandle kokulinda isikhathi esidingekayo kuze kuphele amandla okuthambisa. Kumele ifakwe umoya-mpilo ngenxa yemiphumela yenhliziyo abayikhiqizayo:


  • Ukuphumula okuhle kwemisipha.
  • I-analgesia emaphakathi.
  • I-Emetic (yenza ukuhlanza).
  • I-Bradycardia.
  • I-Hypotension.
  • I-Hypothermia (yehla ekushiseni komzimba).
  • I-Diuresis (ukukhiqizwa komchamo owengeziwe).

I-Benzodiazepines (i-diazepam ne-midazolam)

Kuhlala isikhathi eside kangakanani ikati eline-benzodiazepines? Kusuka kumizuzu engama-30 kuye emahoreni ama-2. I-Benzodiazepines yizithambisi ezithatha imizuzu engaphezulu kwengu-15 enesitha (i-flumacenil) futhi ikhiqize imiphumela elandelayo:

  • ukuphumula kwemisipha enamandla
  • Akunamthelela ohlelweni lwe-cardiovascular
  • ungahlali phansi
  • Ungakhiqizi i-analgesia

Ama-opioid (i-butorphanol, i-morphine, i-methadone, i-fentanyl ne-pethidine)

Kuhlala isikhathi eside kangakanani ukuthambisa ikati ngama-opioid? Cishe amahora amabili. Ama-opioid angama-analgesics amahle asetshenziswa ezikhathini eziningi ngamakhambi okuthambisa ukufaka isandla ekuthomalaliseni noma ukulungiselela ikati i-anesthesia. Bajwayele ukucindezela isikhungo se-cardiorespiratory kakhulu futhi abanye, njenge-morphine, bane-emetic. Esikhathini esedlule, bekukholelwa ukuthi ama-opioid, njenge-morphine, ayephikiswa emakati ngenxa yemiphumela yawo evuselelayo. Kulezi zinsuku ingasetshenziswa ngaphandle kwezinkinga, kepha ukugcina umthamo, umzila, ishejuli kanye nokuhlanganiswa kwemithi, njengoba kuvela izinkinga uma seziningi ngokweqile, zidala i-dysphoria, i-delirium, ukuthokomala kwezimoto nokuquleka.

Ngakolunye uhlangothi, ngenkathi i-butorphanol ikhiqiza i-analgesia encane futhi isetshenziswa ekuthomalaliseni noma ekwenzeni umuthi ngaphambi kwe-anesthesia ejwayelekile, i-methadone ne-fentanyl yizona ezisetshenziswa kakhulu kulolu hlobo lawula ubuhlungu ngesikhathi sokuhlinzwa ngenxa yamandla ayo amakhulu we-analgesic. Banomphikisi wokuguqula imiphumela yabo ebizwa nge-naloxone.

Ngakho-ke, ubude be-sedation buzoncika ekuguqulweni komzimba nekati uqobo. Isilinganiso ngu cishe amahora amabili uma kungenjalo ukubuyisela emuva ukuhlehlisa nomphikisi. Ngokuhlanganisa izidakamizwa ezimbili noma ngaphezulu ezivela ezigabeni ezahlukahlukene, kuvumela ukwandisa imiphumela oyifunayo ye-pharmacological futhi, ngaleyo ndlela, kunciphise imithamo futhi Okuqhamuka uma udla imishanguzo. Isibonelo, inhlanganisela ye-butorphanol ne-midazolam ne-dexmedetomidine imvamisa iyasebenza kakhulu ukuthambisa ikati elinovalo, elibuhlungu, elicindezelekile noma elinolaka ngokubonisana, nokuba nomphikisi kuguqula imiphumela, ukwazi ukuya ekhaya uphapheme noma uzele kancane.

Kuthatha isikhathi esingakanani ukuthi ikati livuke ku-anesthesia?

ikati lithatha isikhathi eside ihora, ngaphansi noma ngisho namahora amaningana ukuvuka ku-anesthesia. Lokhu kuya ngenqubo eyenziwe nezimo zempilo yekati. Ngakho-ke, kubalulekile ukuthi wazi ukuthi izinqubo zokubulala izinzwa zinezigaba ezine:

Isigaba 1: ukunikezela ngaphambi kwesikhathi

Inhloso yakho enkulu ukudala ifayili le- "umatilasi wokubulala izinzwa" ukunciphisa umthamo we-anesthetics elandelayo, ukunciphisa imiphumela emibi yemithamo encike kuyo, ukunciphisa ukucindezeleka, ukwesaba nobuhlungu ekati. Lokhu kwenziwa ngokuphatha inhlanganisela ehlukile yezidambisa isisu, izidambisi zemisipha, kanye nezithambisa izinhlungu esixoxe ngazo esigabeni esedlule.

Isigaba 2: ukwenziwa okubulala izinzwa

Ngokunikeza i-anesthetic engenza umjovo, njenge-alfaxalone, i-ketamine noma i-propofol ukwenza ikati lilahlekelwe ukucabanga kwalo, ngakho-ke, vumela ukufakwa (ukufakwa kwephubhu ku-trachea we-feline ukwethulwa kwe-anesthetic engaphakathi) ukuqhubeka nenqubo yokubulala izinzwa.

Lezi zigaba zivame ukuhlala cishe imizuzu engama-20-30 isiyonke kuze kube yilapho izidakamizwa ziqala ukusebenza futhi zivumela isinyathelo esilandelayo.

Isigaba 3: ukugcinwa

siqukethe i- ukuphatha okuqhubekayo we-ejenti yokubulala izinzwa, kungaba ngesimo se:

  • Ukuhogela: (njenge-isoflurane) kanye ne-analgesia (ama-opioid afana ne-fentanyl, methadone noma i-morphine) kanye / noma izidakamizwa ezingezona ukuvuvukala ezinjenge-meloxicam ezizothuthukisa ubuhlungu be-postoperative nokuvuvukala. Lesi sakamuva singabuye sinikezwe ekugcineni kwe-anesthesia kanye ne-antibiotic ukuvikela ukutheleleka okungenzeka.
  • ngemithambo yegazi: I-Propofol ne-alfaxalone ekufakweni okuqhubekayo noma i-bolus ephindaphindiwe ene-opioid enamandla njenge-fentanyl noma i-methadone. Ukusetshenziswa kwayo akunconywa isikhathi esingaphezu kwehora noma amabili emakati ukuze kugweme ukubuyiswa okuhamba kancane, ikakhulukazi ngepropofol.
  • Imisipha: i-ketamine ne-opioid yokuhlinzwa okufushane kwemizuzu engama-30. Uma isikhathi esiningi sidingeka, umthamo wesibili we-ketamine engaphakathi kwemisipha unganikezwa, kepha hhayi ngaphezu kuka-50% womthamo wokuqala.

Isikhathi salesi sigaba siyehluka futhi kuzoya ngohlobo lokuhlinzwa ukuthi ikati lakho lizobekwa ini. Uma kungukuhlanza, nxazonke ihora elilodwa; ukuthena, okuthe xaxa, njengokuthatha ama-biopsies; uma usebenza emzimbeni wangaphandle, njengama-hairballs, kungathatha isikhashana, kanti uma kungukuhlukumezeka, kungahlala isikhathi eside amahora amaningana. Futhi kuya ngekhono likadokotela ohlinzayo kanye nezinkinga ezingenzeka zokuhlinzwa.

Isigaba 4: ukutakula

Ngemuva kokuphothula i-anesthesia, ukuvuselelwa kuqala, okufanele isheshe, ingabi nengcindezi futhi ingabi nezinhlungu uma inqubo, izinhlanganisela nemithamo yemithi esetshenziswayo ihlonishwa. Uzodinga ukuqapha ukungaguquguquki kwakho, isimo sakho, izinga lokushisa kwakho futhi, kamuva, izinkinga ezingaba khona ezifana nomkhuhlane nokuhlanza, okungakhombisa ukutheleleka. Ngokuvamile, ikati elidala elinempilo, elondlekile, eligonyiwe nelikhulelwe izikelemu ululama kusuka ku-anesthesia izinsuku ezimbili ngemuva kokungenelela kanye nokulandelana kwayo Ezinsukwini eziyi-10 kamuva.

Ngakho-ke, ubude be-anesthesia buyahluka ngokuya ngobude besikhathi sokuhlinzwa, isimo sesilwane nokwakheka komzimba, amakhono kadokotela, izinkinga, imithi esetshenzisiwe nesikhathi sokuvuselela. Ngakho-ke, maqondana nombuzo wokuthi kuthatha isikhathi esingakanani ikati ukuvuka e-anesthesia, impendulo ukuthi enye i-anesthesia ihlala ihora noma ngaphansi, abanye ingahlala amahora amaningana. Kepha ungakhathazeki, nge-protocol efanele ye-anesthetic, analgesia, control of constants ebalulekile kanye nokushisa yi-anesthetist, ikati lakho lizophepha futhi lingazizwa buhlungu noma ukucindezelwa, kungakhathalekile ukuthi isikhathi singakanani i-anesthesia.

Ikati lami alelulami ku-anesthesia

Isikhathi esithatha isilwane ukuthi silulame ku-anesthesia sizoya ngenani elifakelwe lona, ​​uhlobo lwe-anesthesia esetshenzisiwe kanye nekati uqobo. Noma ikati lakho elincane lizile ukudla ngaphambi kokuhlinzwa, lisengaba nenyongo noma ukudla okusele esiswini salo noma uzizwe unesiyezi.

Ungakhathazeki, kuyinto ejwayelekile uma kusetshenziswa ama-alpha-2 sedatives noma amanye ama-opioid. Kujwayelekile futhi ukuthi ikati ngemuva kokuvuka lihambe emaceleni lididekile noma likhulule ngaphandle kwesizathu, lithathe amahora ambalwa ukulidla, noma lichame kakhulu ngalolo suku ukuqeda uketshezi oluthe xaxa olunikezwa uketshezi phakathi kwe-anesthesia. Ngesikhathi sokululama ngemuva kwekati elingasebenzi, ngokwesibonelo, kuyadingeka ukuthi ahlale ku indawo eshisayo, emnyama futhi ethule.

kwesinye isikhathi amakati kungathatha isikhathi eside ukuvuka. Khumbula ukuthi amakati ahluke kakhulu kunezinja ngezindlela eziningi. Ku-anesthesia, bebengeke babe ngaphansi. Ikakhulu, imetabolism yemithi emakati ihamba kancane kunezinja, ngakho-ke kungathatha isikhathi eside ukuvuka. Ikati lakho kungathatha isikhathi eside ukululama ku-anesthesia ngenxa yezizathu ezilandelayo:

Ukushoda kwe-enzyme

Enye yezindlela ezibaluleke kakhulu zokuxubha izidakamizwa zokuqedwa kwazo okulandelayo ukuxubana kwazo ne-glucuronic acid. Noma kunjalo, amakati ane- ukuntuleka kwe-enzyme ye-glucuronyltransferase, ngubani obangela lokhu. Ngenxa yalokhu, ukwenziwa kabusha kwezidakamizwa ezisebenzisa le ndlela kuhamba kancane lapho kufanele usebenzise enye indlela: i-sulfoconjugation.

Umsuka wale nkinga utholakala emikhubeni yokudla yama-felines. Ukuba izidlo eziqinile, azizange ziguquke ukuthuthukisa amasistimu wokusebenzisa i-phytoalexin yezitshalo. Ngakho-ke, emakati imithi ethile (ibuprofen, aspirin, paracetamol kanye morphine) kufanele igwenywe noma isetshenziswe ngemithamo ephansi kakhulu kunezinja, engenayo le nkinga.

I-Propofol njenge-anesthetic

Ukusetshenziswa kwepropofol ekunakekelweni njenge-anesthetic isikhathi esingaphezu kwehora kungandisa isikhathi sokutakula emakati. Ngaphezu kwalokho, i-propofol anesthesia ephindaphindwayo ku-fining ingaveza umonakalo we-oxidative kanye nokukhiqizwa kwemizimba ye-Heinz (inclusions eyakha emaphethelweni amaseli abomvu egazi ngokubhujiswa kwe-hemoglobin).

Ukweqisa izidakamizwa

Amakati ajwayele ukukala kancane, ikakhulukazi uma emancane, ngakho-ke angadlula kalula ngokweqile ngokwandiswa kwenqubo yokutakula, ukuthatha isikhathi eside kakhulu ukuhlanganisa umzimba, ukuze bayeke ukwenza isenzo sabo. Kulezi zimo, kuzokhonjiswa kuphela izidakamizwa eziphikisayo, kepha kucatshangelwa lokho ukuvuka kungaba ngokuzumayo futhi kube ne-dysphoric. Eqinisweni, ukuthambekela ukuzama ukuvuka ngokuqhubekayo nangokuhamba kancane, ngosizo, uma kudingeka, lwama-relaxant anjenge-benzodiazepines.

I-Hypothermia

I-Hypothermia emakati noma ukwehla kwezinga lokushisa komzimba kuvamile ngenxa yobukhulu nesisindo sayo esincane. Lapho izinga lokushisa lehla ngokwengeziwe, kuba nzima ngokwengeziwe ukusebenzisa izidakamizwa, ngenxa yokuncipha kokusebenza kwe-enzymatic, ukwelula ukutakula nokuvuka kusuka ku-anesthesia. Lesi simo kufanele sigwenywe ngokufaka izinto zokwambesa ngaphezulu kwesilwane bese usimboza ngezingubo zokulala noma usebenzisa amatafula okuhlinzwa ashubile, ukufaka uketshezi olufudumele, kanye nokugcina izinga lokushisa ekamelweni lokusebenza cishe ku-21-24 ºC.

Manje njengoba usazi ukuthi kuthatha isikhathi esingakanani ukuthi ikati livuke ku-anesthesia, le vidiyo ekuthengeni amakati ingase ikuthande:

Uma ufuna ukufunda izindatshana eziningi ezifana ne- Kuthatha isikhathi esingakanani ukuthi ikati livuke ku-anesthesia?, sincoma ukuthi ufake isigaba sethu se-Curiosities somhlaba wezilwane.