He aha ka Succinylcholine: Nā hoʻohana, ka nui, nā hopena ʻaoʻao a me nā mea hou aku

ʻO ka Succinylcholine he lāʻau hoʻomaha ʻiʻo ikaika i hoʻohana ʻia i ka wā o ke ʻoki a me nā kaʻina hana pilikia e hoʻopōloli i nā ʻiʻo no ka manawa. Hana wikiwiki kēia lāʻau lapaʻau e kōkua i nā kauka e hana i nā kaʻina hana e ola ai e like me ka hoʻokomo ʻana i nā paipu hanu a i ʻole ka hoʻomākaukau ʻana i nā maʻi no ke ʻoki ʻana i ka wā e pono ai ka hoʻomaha ʻana o ka ʻiʻo.

He aha ka Succinylcholine?

ʻO ka Succinylcholine he mea e ālai ana i ka neuromuscular e hoʻoulu ai i ka paralysis ʻiʻo no ka manawa. No ka papa o nā lāʻau lapaʻau i kapa ʻia he depolarizing muscle relaxants, ʻo ia hoʻi, hana ia ma ka hoʻopilikia ʻana i nā hōʻailona maʻamau ma waena o kou mau aʻalolo a me nā ʻiʻo.

Hoʻohana ʻia kēia lāʻau lapaʻau i nā wahi lapaʻau i mālama ʻia e like me nā lumi hana, nā keʻena pilikia, a me nā ʻāpana mālama koʻikoʻi. Hoʻohana nā mea mālama ola iā ia i ka wā e pono ai lākou e hoʻomaha koke i nā ʻiʻo a pau o kou kino, me nā mea i hoʻohana ʻia no ka hanu ʻana, ʻo ia ke kumu e hāʻawi mau ʻia ai me ke kākoʻo mechanical ventilation.

Hana ka lāʻau i loko o 30 a 60 kekona a maʻamau ka lōʻihi o 5 a 10 mau minuke. Ma muli o kona hoʻomaka wikiwiki a me ka pōkole, ua kapa pinepine nā poʻe loea lapaʻau iā ia he

Hoʻohana nā kauka lāʻau lapaʻau pilikia i ka succinylcholine ke pono kekahi i ka mālama ʻana i nā ala ea. Hiki paha kēia i ka wā o ka hopu ʻana i ka naʻau, ka ʻeha nui, a i ʻole ke pilikia nei kekahi i ka hanu ʻana a pono i ka hana wikiwiki e ola ai.

Pehea e hana ai ʻo Succinylcholine?

Hana ʻo Succinylcholine ma ka pale ʻana i ke kamaʻilio ʻana ma waena o kou mau aʻalolo a me nā ʻiʻo ma ka hui neuromuscular. E noʻonoʻo iā ia me he mea lā e ʻoki ana i ke kelepona ma waena o kou lolo a me kou mau ʻiʻo, e pale ana i nā kauoha neʻe mai ke komo ʻana.

Ua manaʻo ʻia he lāʻau lapaʻau ikaika loa kēia no ka mea e hoʻoulu ai i ka paralysis piha o nā ʻiʻo manawaleʻa a pau, me nā mea āu e hoʻohana ai e hanu. Hana ʻia ka paralysis ma ke ʻano i manaʻo ʻia, e hoʻomaka ana me nā ʻiʻo liʻiliʻi i kou maka a me nā maka, a laila e neʻe ana i kou mau lālā, a ma hope e pili ana i kou diaphragm a me nā ʻiʻo hanu.

Hoʻopau koke ʻia ka lāʻau e nā enzymes i loko o kou koko i kapa ʻia ʻo pseudocholinesterases. ʻO kēia wāwahi wikiwiki ke kumu e pau ai nā hopena i ka wikiwiki, maʻamau i loko o 5 a 10 mau minuke, e palekana ai no nā kaʻina hana pōkole.

Pehea wau e lawe ai i ka Succinylcholine?

ʻAʻole loa ʻoe e lawe iā succinylcholine iā ʻoe iho - hāʻawi ʻia e nā poʻe lapaʻau i hoʻomaʻamaʻa ʻia i nā wahi haukapila. Hāʻawi ʻia ka lāʻau lapaʻau ma o ka laina intravenous (IV) pololei i loko o kou kahe koko a i ʻole he injection intramuscular i loko o kahi ʻiʻo nui.

Ma mua o ka loaʻa ʻana o ka succinylcholine, e hāʻawi ʻia ʻoe i ka anesthesia maʻamau e hoʻolilo iā ʻoe i ka ʻike ʻole. He mea nui kēia no ka mea ʻo ka lāʻau lapaʻau e hoʻopōʻino wale i kou mau ʻiʻo akā ʻaʻole ia e pili i kou ʻike a i ʻole ka manaʻo ʻeha, no laila pono ʻoe e hiamoe mua.

E loaʻa i nā mea mālama ola nā mea pono a pau ma mua o ka hāʻawi ʻana iā ʻoe i kēia lāʻau lapaʻau, me nā ventilators, oxygen, a me nā lāʻau lapaʻau pilikia. E nānā pū lākou i kāu puʻuwai, ke koko, a me nā pae oxygen i ke kaʻina holoʻokoʻa.

Pehea ka lōʻihi e lawe ai au i ka Succinylcholine?

ʻAʻole lawe ʻia ka Succinylcholine no ka manawa lōʻihi - he lāʻau lapaʻau hoʻokahi wale nō i hoʻohana ʻia no nā kaʻina hana kūikawā. ʻO ka maʻamau, e mau ana nā hopena ma waena o 5 a 10 mau minuke, ʻo ia ka manawa lawa no nā kauka e hoʻopau i ke kaʻina hana e pono ai.

Inā pono ka manawa lōʻihi o ka hoʻomaha ʻana o nā ʻiʻo, e hoʻololi kāu hui lapaʻau i kahi ʻano ʻē aʻe o ka mea hoʻomaha ʻiʻo e mau ana no ka lōʻihi. Koho ʻia ka Succinylcholine ke pono nā kauka i ka hoʻomaka wikiwiki akā ʻaʻole makemake lākou i nā hopena lōʻihi.

Hiki ke ʻokoʻa iki ka lōʻihi mai kēlā kanaka i kēia kanaka ma muli o nā mea e like me ke kaumaha o kou kino, ka hana o ka puʻupaʻa, a me ka wikiwiki o kou kino e wāwahi i ka lāʻau. Hoʻihoʻi ka hapa nui o nā kānaka i ka hana maʻamau o ka ʻiʻo i loko o 10 a 30 mau minuke ma hope o ka loaʻa ʻana o ke ana.

He aha nā hopena ʻaoʻao o ka Succinylcholine?

Hoʻopili ʻia nā hopena ʻaoʻao maʻamau o ka succinylcholine i kona mau waiwai hoʻomaha ʻiʻo. Hiki iā ʻoe ke ʻike i ka ʻeha ʻiʻo a i ʻole ka ʻoʻoleʻo ma hope o ke kaʻina hana, e like me ke ʻano o kou manaʻo ma hope o kahi hana ikaika.

ʻIke kekahi poʻe i ka ʻū ʻiʻo pōkole a i ʻole nā fasciculations ma hope koke o ka loaʻa ʻana o ka lāʻau. He mea hopohopo kēia akā he mea maʻamau a hōʻike i ka hana ʻana o ka lāʻau e like me ka mea i manaʻo ʻia.

Eia nā hopena ʻaoʻao maʻamau e hiki ai iā ʻoe ke ʻike:

• ʻEha ʻiʻo a i ʻole nā ʻeha e mau ana no 1-2 mau lā
• Hoʻonui i ka hana ʻana o ka kohu
• Nā loli liʻiliʻi i ka puʻuwai
• Hoʻonui manawa i ke kaomi maka
• Hoʻonui iki i nā pae potassium i kou koko

He maʻalahi kēia mau hopena a hoʻoponopono iā lākou iho i ka wā e haʻalele ai ka lāʻau i kāu ʻōnaehana.

ʻOiai he mea maʻamau, hiki ke loaʻa kekahi mau hopena ʻaoʻao koʻikoʻi a koi i ka lāʻau lapaʻau koke. Mālama pono ʻia kēia mau kūlana e kāu hui lapaʻau i ke kaʻina hana.

ʻO nā hopena ʻaoʻao koʻikoʻi akā ʻaʻole maʻamau e pili ana:

• Hyperthermia ʻino - he piʻi weliweli o ka mahana o ke kino
• Nā hopena maʻi ʻaʻai koʻikoʻi me ka pilikia o ka hanu ʻana a i ʻole ka pehu ʻana
• Nā piʻi weliweli o nā pae potassium (hyperkalemia)
• Nā loli nui i ka puʻuwai
• ʻO ka paralysis lōʻihi e mau ana ma mua o ka mea i manaʻo ʻia

Ua hoʻomaʻamaʻa kūikawā ʻia kāu hui lapaʻau e ʻike a mālama koke i kēia mau pilikia inā loaʻa lākou.

ʻO wai ka mea pono ʻole e lawe i ka Succinylcholine?

ʻAʻole pono kekahi poʻe e loaʻa i ka succinylcholine ma muli o ka piʻi ʻana o ka pilikia o nā pilikia koʻikoʻi. E nānā pono kāu hui lapaʻau i kāu mōʻaukala olakino ma mua o ka noʻonoʻo ʻana i kēia lāʻau.

Hiki i nā poʻe me kekahi mau maʻi genetic e pili ana i ke ʻano o ka wāwahi ʻana i ka lāʻau lapaʻau ke loaʻa i ka paralysis lōʻihi. Aia kēia i ka poʻe me ka maʻi pseudocholinesterase deficiency, kahi maʻi kahi i nele ai kou kino i nā enzymes e pono ai e wāwahi koke i ka succinylcholine.

ʻO nā kūlana e hoʻoweliweli loa ai ka succinylcholine:

• Muscular dystrophy a i ʻole nā maʻi ʻiʻo ʻē aʻe
• Nā wela koʻikoʻi a i ʻole nā trauma
• Nā ʻeha i ke kuamoʻo
• Maʻi kīkī koʻikoʻi
• Mōʻaukala o ka hyperthermia ʻino
• Nā kūlana neurological e like me ALS a i ʻole multiple sclerosis
• Hoʻomaha moe lōʻihi a i ʻole ka immobilization

Hiki i kēia mau kūlana ke hoʻonui i ka pilikia o ka piʻi ʻana o ka potassium weliweli a i ʻole nā pilikia koʻikoʻi ʻē aʻe e hiki ke hoʻoweliweli i ke ola.

Nā inoa inoa Succinylcholine

Loaʻa ka Succinylcholine ma lalo o nā inoa inoa like ʻole, ʻo Anectine kekahi o nā mea i hoʻohana nui ʻia. ʻO nā inoa inoa ʻē aʻe e pili ana iā Quelicin a me Sucostrin, ʻoiai ua hoʻohana nui ʻia ka mana generic i ka hapa nui o nā keʻena lapaʻau.

ʻOiai ke inoa inoa, aia nā mana a pau i ka mea hana like - succinylcholine chloride. ʻO ke koho ʻana i ka inoa inoa e hilinaʻi pinepine ʻia i ka mea i loaʻa i kāu haukapila a i ʻole ke keʻena lapaʻau.

Nā Koho ʻē aʻe no ka Succinylcholine

Hiki ke hoʻohana ʻia kekahi mau mea hoʻomaha ʻiʻo ʻē aʻe ma kahi o ka succinylcholine, ma muli o ke kūlana olakino kikoʻī. ʻO kēia mau koho ʻē aʻe e hana mālie ana akā e lōʻihi ana ma mua o ka succinylcholine.

ʻO nā koho maʻamau e komo pū ana me rocuronium, vecuronium, a me atracurium. Koho pinepine ʻia ʻo Rocuronium no ka mea e hana ana ia me ka wikiwiki e like me ka succinylcholine akā ʻaʻole ia e lawe i nā pilikia like o ka hoʻonui ʻana i ka potassium weliweli.

Ke hilinaʻi nei ke koho ʻana i ke koho ʻē aʻe i nā mea e like me ka wikiwiki o ka pono o ka hoʻomaha ʻana o ka ʻiʻo, ka lōʻihi o ke kaʻina hana, a me kou mau kūlana olakino kikoʻī. E koho kāu anesthesiologist i ke koho palekana a kūpono loa no kou kūlana.

Ua ʻoi aku ka maikaʻi o ka Succinylcholine ma mua o Rocuronium?

Loaʻa i ka Succinylcholine a me rocuronium nā pōmaikaʻi like ʻole ma muli o ke kūlana lapaʻau. Hana wikiwiki ʻo Succinylcholine, maʻamau i loko o 30-60 kekona, ʻoiai ʻo rocuronium e lawe i 60-90 kekona e loaʻa ai ka hoʻomaha ʻiʻo like.

ʻO ka pōmaikaʻi nui o Succinylcholine ʻo kona manawa pōkole o ka hana. Inā hewa kekahi mea i ka wā o ka intubation, e pau koke ka paralysis, e ʻae ana i ka hanu maoli e hoʻi. ʻO kēia ka mea e waiwai ai ia i nā kūlana pilikia kahi e paʻakikī ai ke mālama ʻana i ke ala ea.

ʻO Rocuronium, akā naʻe, ʻoi aku ka palekana no ka poʻe me kekahi mau kūlana olakino. ʻAʻole ia e hoʻoulu i ka hoʻonui ʻana i ka potassium weliweli e hiki ke hana me succinylcholine, e lilo ia i koho maikaʻi no nā maʻi me nā wela, trauma, a i ʻole nā maʻi ʻiʻo.

Ke hilinaʻi nei ke koho ma waena o kēia mau lāʻau i kou kūlana olakino kikoʻī, ka wikiwiki o ke kaʻina hana, a me kou mau mea pilikia pilikino. E koho kāu hui lapaʻau i ke koho palekana a kūpono loa iā ʻoe.

Nā Nīnau i Nīnau Pinepine ʻia e pili ana i ka Succinylcholine

Ua palekana ʻo Succinylcholine no ka maʻi puʻuwai?

Hiki ke hoʻohana palekana ʻia ka succinylcholine i ka poʻe me ka maʻi puʻuwai, akā pono e nānā pono ʻia. Hiki i ka lāʻau lapaʻau ke hoʻololi i ka manawa i ka puʻuwai a me ka hoʻonui iki ʻana i nā pae potassium, kahi e nānā pono ai kāu hui lapaʻau.

ʻO ka poʻe me ka maʻi puʻuwai koʻikoʻi a i ʻole kekahi mau maʻi puʻuwai puʻuwai e pono paha i nā lāʻau lapaʻau ʻē aʻe. E hana pū kāu cardiologist a me ka anesthesiologist e hoʻoholo i ke ala palekana loa no kou maʻi puʻuwai.

He aha kaʻu e hana ai inā loaʻa iaʻu ka nui o ka succinylcholine?

ʻAʻole hiki iā ʻoe ke loaʻa i ka nui o ka succinylcholine no ka mea, hāʻawi ʻia e nā poʻe lapaʻau i aʻo ʻia i nā wahi i mālama ʻia. Inā loaʻa kahi overdose, e ʻike koke ʻia a mālama ʻia e kāu hui lapaʻau.

ʻO ka mālama nui ʻana no ka overdose succinylcholine he mālama kākoʻo, me ka hoʻomau ʻana i ka mechanical ventilation a hiki i ka pau ʻana o nā hopena o ka lāʻau lapaʻau. Loaʻa i kāu hui lapaʻau nā protocols kikoʻī a me nā lako i mākaukau e mālama i nā pilikia.

He aha kaʻu e hana ai inā hala iaʻu kahi mahele o ka succinylcholine?

ʻAʻole pili kēia nīnau i ka succinylcholine no ka mea ʻaʻole ia he lāʻau lapaʻau āu e lawe ai ma kahi papa. Hāʻawi ʻia hoʻokahi wale nō i ka wā o nā kaʻina hana lapaʻau kikoʻī i nā wahi haukapila.

Inā he mau nīnau kāu e pili ana i nā lāʻau lapaʻau āu e lawe ai ma ka home, pono ʻoe e hoʻokaʻaʻike i kāu kauka maʻamau a i ʻole ka lāʻau lapaʻau no ke alakaʻi ʻana e pili ana i nā mahele i hala.

I ka manawa hea e hiki ai iaʻu ke hooki i ka lawe ʻana i ka succinylcholine?

Hoʻōki ka succinylcholine i ka hana ʻana ma kona iho i loko o 5-10 mau minuke ma hope o ka hāʻawi ʻia ʻana. ʻAʻole pono ʻoe e hana i kekahi mea e hoʻōki i kāna mau hopena - e wāwahi maoli kou kino i ka lāʻau lapaʻau.

Inā ʻoe e nīnau ana e pili ana i ka hoʻōki ʻana i nā lāʻau lapaʻau ʻē aʻe ma mua o ke kaʻina hana kahi e hoʻohana ʻia ai ka succinylcholine, e hāʻawi kāu kauka iā ʻoe i nā ʻōlelo kikoʻī e pili ana i nā lāʻau lapaʻau e hoʻomau a i ʻole e hoʻōki i ka manawa.

Hiki iaʻu ke kalaiwa ma hope o ka loaʻa ʻana o ka succinylcholine?

ʻAʻole pono ʻoe e kalaiwa no ka liʻiliʻi o 24 hola ma hope o ka loaʻa ʻana o ka succinylcholine, no ka mea, hāʻawi mau ʻia me ka anesthesia maʻamau i ka wā o nā kaʻina hana olakino. Hoʻopilikia ka anesthesia i kou manaʻo, nā reflexes, a me ka hoʻonohonoho ʻana ma hope o ka pau ʻana o ka succinylcholine.

Pono ʻoe i kekahi e kalaiwa iā ʻoe i ka home ma hope o kāu kaʻina hana, a pono ʻoe e pale i ka hana ʻana i nā hoʻoholo nui a i ʻole ka hana ʻana i nā mīkini a hiki i kou ola piha ʻana mai ka anesthesia.