He aha te Remifentanil: Ngā Whakamahinga, te Inenga, Ngā Pānga Taha me Ētahi Atu

Ko te Remifentanil he rongoā mamae opioid kaha e tukuna ana mā te IV i te wā o te pokanga me ētahi atu tikanga rongoā. He tere rawa tōna mahi, ā, ka tere te ngaro, he mea tino pai mō ngā wāhi e hiahia ana ngā tākuta ki te whakahaere tika i te whakamaimoa mamae. Whakaarohia he taputapu tino motuhake e whakamahia ana e ngā tākuta rongoā hei whakamarie i a koe i te wā o ngā mahi, me te whakarite kia ara ake koe i muri mai.

He aha te Remifentanil?

No te rōpū rongoā e kiia nei ko te opioids waihanga te Remifentanil, i hangaia motuhake mō te whakamahi i ngā hōhipera me ngā pokapū pokanga. Kāore i rite ki ētahi atu rongoā mamae ka tango pea koe i te kāinga, ka tukuna anake tēnei mā te raina IV e ngā tākuta whakangungu. Koinei tā mātou e kī ana he opioid ultra-poto-mahi, ko te tikanga ka tīmata te mahi i roto i ngā hēkona, ā, ka mutu te mahi i te wa ano ka mutu te whakauru.

He kaha rawa te rongoā, ā, ahakoa te iti o te nui ka taea te whakamaimoa mamae nui. Ko tēnei kaha, i honoa ki tōna tīmatanga tere me te whakaweto, he mea nui i roto i ngā rūma whakahaere i te wā e tika ana te whakahaere mamae. E kore koe e tūtaki ki tēnei rongoā i waho o te hōhipera, nā te mea e hiahia ana kia aroturukihia tonu, me ngā taputapu motuhake hei whakahaere i te haumaru.

He aha te Remifentanil e whakamahia ana?

Ko te Remifentanil te mea nui e whakamahia ana i te wā o te rongoā whānui hei āwhina i te whakahaere i te mamae i te wā e kore koe e mōhio i te wā o te pokanga. Ka whakamahia hoki i roto i ngā wae tiaki kaha mō ngā tūroro e whakamahi ana i ngā hauora me te hiahia ki te whakamaimoa mamae tonu. Ka āwhina te rongoā ki te whakarite kia noho pai koe i roto i ngā tikanga rongoā i te wā e taea ai e ngā tākuta te whakatika i tō whakahaere mamae i te wā tūturu.

I tua atu i te pokanga, he whai hua tenei rongoa i nga wa o etahi tikanga tātaritanga kaore pea i te pai, i te mamae ranei. Ko etahi tikanga ngakau, te neurosurgery, me etahi atu mahi uaua e whai hua ana mai i nga ahuatanga ahurei o te remifentanil. Ko te painga nui ko te kore e noho roa ana i roto i to punaha i muri i te mutunga o te tikanga, e awhina ana i a koe kia tere ake te whakaora.

Me pehea te mahi a Remifentanil?

Ka mahi a Remifentanil ma te here ki nga kaiwhiwhi opioid i roto i to roro me to taurakira, e aukati ana i nga tohu mamae kia tae atu ki to mohiotanga. E kiia ana he opioid tino kaha, ko te tikanga ka taea e nga horopeta iti te whakaputa i nga paanga nui. Heoi, kaore i rite ki etahi atu opioids, ka pakaru tere to tinana ma nga enzyme i roto i to toto me nga kiko.

Ko tenei pakaru tere te mea e tino ahurei ana te remifentanil me te whai hua i roto i nga waahi rongoa. Ahakoa ka roa pea nga haora ki etahi atu opioids ki te ngaro, ka ngaro nga paanga o te remifentanil i roto i nga meneti i muri i te whakamutua o te whakauru. Ma tenei ka taea e to roopu rongoa te whakarato i te whakamaarama mamae nui i nga wa o nga tikanga me te whakarite kia tere te whakaora i muri mai kaore he moe roa, he raruraru ranei te manawa.

Me pehea taku tango i te Remifentanil?

E kore koe e tango i te remifentanil - ka whakahaerehia tenei rongoa e nga tohunga rongoa whakangungu ma te raina IV. Ka ata tatau e to tohunga rongoa, to taakuta ranei i te horopeta tika i runga i to taumaha, to ahuatanga rongoa, me te tikanga e mahia ana e koe. Ka hoatu te rongoa hei whakauru tonu, ko te tikanga ka rere tonu ki roto i to toto i te reiti whakahaere.

I mua i te whiwhinga i te remifentanil, ka whakanohohia e tō rōpū hauora he katetere IV ki tō ringa, ki tō pūhi rānei. Ka aroturukihia koe e rātou i ngā wā katoa o te whakaurunga mā te whakamahi i ngā taputapu motuhake e aroturukihia ana tō tere o te ngākau, te pēhanga toto, te taumata hāora, me te manawa. Ka taea te whakatika i te horopeta i ia wā i runga i te urupare a tō tinana me ngā whakaritenga o tō tikanga.

Kāore he whakarite motuhake e hiahiatia ana i tō taha mō te kai, te inu rānei, i te mea ka whakatauhia ēnei whakatau hei wāhanga o tō mahere rongoā whānui. Ka hoatu e tō rōpū hauora ki a koe ngā tohutohu motuhake mō te kai me te inu i mua i tō tikanga i runga i te momo pokanga, te rongoā rānei e whiwhi ana koe.

Kia Pēhea te Roa e Tango Ai au i te Remifentanil?

Ko te roa o te rongoā remifentanil e whakawhirinaki ana ki tō tikanga hauora me ngā hiahia takitahi. I te wā o te pokanga, ka whiwhi koe i te rongoā mō te roa katoa o te mahi, e 30 meneti pea ki te maha haora. I ngā wāhi tiaki kaha, ka roa pea te roa ki ngā rā ki te mea kei runga koe i te hauora me te hiahia ki te whakahaere mamae tonu.

Ka whakamutua e tō rōpū hauora te whakaurunga remifentanil i te wā e kore e hiahiatia ana mō tō tiaki. I te mea ka tere te whakawātea o te rongoā i tō pūnaha, ka tīmata koe ki te rongo i ōna pānga e ngaro ana i roto i te 5 ki te 10 meneti i muri i te whakamutunga o te whakaurunga. Ko tēnei whakawātea tere tētahi o ngā painga nui o te rongoā, i te mea ka taea e ia te whakawhiti mārie ki te whakaora.

He Aha ngā Pānga Taha o te Remifentanil?

Pērā i ngā rongoā opioid katoa, ka taea e te remifentanil te pānga taha, ahakoa he maha e whakahaerehia ana e tō rōpū hauora i te wā o te whakahaere. Ko ngā pānga taha tino noa ko te manawa puhoi, te whakaheke i te tere o te ngākau, me te pēhanga toto iti. Ko ēnei pānga e tūmanakohia ana, ā, e tino aroturukihia ana, me tō rōpū hauora e rite ana ki te whakatika i te horopeta, ki te whakarato rānei i te tautoko atu ki te hiahiatia.

Anei ngā pānga taha ka pā ki a koe, kua whakarōpūhia e te auau o te puta:

Ngā pānga taha noa e mātakitaki ana, e whakahaere ana hoki tō rōpū hauora:

• Te puhoi, te pāpaku rānei o te manawa (te pēhi i te manawa)
• Te heke o te tere o te ngākau (bradycardia)
• Te pēhanga toto iti (hypotension)
• Te whakapairuaki me te ruaki i muri i te oho ake
• Te mārō o ngā uaua mō te wā poto, ina koa i te uma
• Te wiri i te wa e ngaro ana te rongoā

Ngā pānga taha kāore i te tino noa engari he mea nui:

• Te mōmona nui (pruritus)
• Te whanoke, te māmā rānei o te mahunga
• Te werawera, te whero rānei
• Te mamae o te mahunga i te wā whakaora
• Te raruraru mō te wā poto i te oho ake

Ngā pānga taha kāore i te noa engari he mea nui:

• Ngā tauhohenga mate pāwera nui (anaphylaxis)
• Te tino puhoi o te tere o te ngākau e hiahia ana ki te wawaotanga
• Te tino heke o te pēhanga toto
• Ngā uaua manawa roa
• Ngā manawataki ngākau rerekē (arrhythmias)

Ko te rongo pai, nā te mea kei te whiwhi koe i te remifentanil i roto i te taiao hauora e whakahaerehia ana, ka taea e tō rōpū te whakatika wawe i ngā pānga taha ka puta. He rongoā me ngā taputapu kei a rātou hei whawhai i ngā raruraru me te whakarite i tō haumaru puta noa i te tukanga.

Ko wai kāore e tika kia tango remifentanil?

Kāore te remifentanil i te tika mō te katoa, ā, ka āta arotake tō rōpū hauora i tō hītori hauora i mua i te whakamahi. Ko ngā tāngata e pā ana ki ētahi mate pāwera, ngā āhuatanga manawa, ngā raruraru ngākau rānei, me whai huarahi whakahaere mamae kē. Heoi, ko te taiao hōhipera e whakahaerehia ana, ka taea e ngā tākuta te whakamahi i te remifentanil i te haumaru ahakoa i ētahi āhuatanga mōrearea.

Ka tūpato tō tākuta mēnā he āhuatanga tō:

Ngā aukati tino (ngā āhuatanga kāore e tika kia whakamahia te remifentanil):

• He mate pānga mō remifentanil, ētahi atu rānei rongoā i runga i te fentanyl
• Ngā raruraru manawa nui, kāore he tautoko hauora mīhini
• Ētahi momo aukati ngākau, kāore he pacemaker
• He mate ate nui e pā ana ki te whakawhiti rongoā

Ngā āhuatanga e hiahia ana kia tūpato me te aroturuki:

• Te mate pūkahukahu aukati (COPD), ētahi atu rānei raruraru manawa
• Ngā raruraru manawa, te pōturi rānei o te ngākau
• Te mate tākihi e pā ana ki te whakawātea rongoā
• He hītori o te whakamahi rāhui, te whakawhirinaki rānei ki te opioid
• Ngā tūroro kaumātua, tērā pea ka nui ake te tairongo ki ngā pānga
• Te hapū, ina koa i te wā o te whānautanga

Ngā āhuatanga onge e hiahia ana kia whakaarohia:

• Myasthenia gravis, ētahi atu rānei mate ngoikore uaua
• He wharanga nui ki te upoko, te pikinga rānei o te pēhanga roro
• Ētahi momo āhuatanga ira e pā ana ki te whakawhiti rongoā
• Ngā urupare kino i mua ki te rongoā whakamoe

Ahakoa kei a koe tētahi o ēnei āhuatanga, kaua e māharahara - he wheako tō tō tō rōpū hauora ki te whakahaere i ngā āhuatanga uaua, ā, ka whakawhanake rātou i te mahere rongoā whakamoe haumaru mō ō hiahia motuhake.

Ngā Ingoa Waitohu o Remifentanil

Kei te wātea a Remifentanil i raro i ētahi ingoa waitohu, ko Ultiva te mea e mōhiotia whānuitia ana i te ao. I ngā hōhipera, tērā pea ka kitea e koe ko Remifenta i ētahi whenua, ahakoa ko te whakauru kaha me ngā pānga e noho rite ana ahakoa te ingoa waitohu. Ka mōhio tō rōpū hauora ki te putanga e whakamahia ana i tō rātou whare.

Ka tae mai te rongoā hei paura me whakaranu ki te wai pure, te wai tote rānei i mua i te whakamahi. Ko tēnei whakarite ka mahia e ngā kaimahi whare rongoā whakangungu, ngā tohunga hauora rānei e whakamahi ana i ngā tikanga pure tino tika. Kāore koe e hiahia ki te māharahara mō te waitohu e whiwhi ana koe - ka tutuki ngā putanga katoa i ngā paerewa haumaru me te whai hua.

Ngā Kōwhiringa mō Remifentanil

He maha atu ngā rongoā opioid ka taea te whakamahi mō ngā kaupapa rite i te wā o te pokanga me ngā tikanga rongoā. Ko Fentanyl, sufentanil, me alfentanil he rongoā e pā ana, he rite te mahi engari he rerekē te wā tīmatanga me te roa o te mahi. Mā tō tākuta rongoā whakamoe e whiriwhiri te kōwhiringa pai rawa atu i runga i tō tikanga me ō hiahia rongoā.

Mō ētahi tikanga, ka pai pea ngā momo kē-kore-opioid, ka whakamahia rānei i te taha o ngā opioid. Kei roto i ēnei ngā rongoā pēnei i te propofol mō te whakamārie, ngā tikanga rongoā rohe e whakamahi ana i ngā rongoā whakamoe rohe, ngā huarahi whakahaere mamae hou rānei e whakaiti ana i te hiahia mō ngā opioid. Mā tō rōpū rongoā e kōrero te huarahi pai rawa atu mō tō āhuatanga.

He Pai Ake Anei a Remifentanil i a Fentanyl?

He painga motuhake tō Remifentanil me fentanyl i runga i te āhuatanga rongoā. Ko te painga nui o Remifentanil ko tōna roa poto rawa - ka ngaro i roto i ngā meneti i muri i te whakamutu i te whakauru, e āhei ana te whakaora tere me te mana tika i ngā tikanga. Ko Fentanyl, i tērā taha, e whakarato ana i te mamae roa ake, engari he roa ake te wā ki te whakawātea i tō pūnaha.

Mō ngā pokanga e hiahia ana koe kia ara ake wawe me te mārama, he pai ake te remifentanil. Heoi, mō ngā tikanga e hiahiatia ana te mamae tonu i muri i te pokanga, ka pai ake te fentanyl. Mā tō tākuta rongoā whakamoe e whiriwhiri i runga i te momo tikanga, tōna roa e tūmanakohia ana, me ō hiahia rongoā takitahi.

Kāore tētahi rongoā i te

Ka taea te whakamahi marie a Remifentanil ki ngā tāngata e mate ana i te ngākau, engari me tino mātakitaki, me whakatika te horopeta. Ka taea e te rongoā te whakaiti i tō tere o te ngākau me te whakaheke i te pēhanga toto, he mea pea e pā ana ki te mea kei a koe ō raru ngākau. Heoi anō, he tohunga whakangungu ngā tākuta rongoā hei whakahaere i ēnei pānga, ā, he rongoā kei a rātou hei tautoko i te mahi o tō ngākau ki te hiahiatia.

Ka tino arotakehia tō āhua ngākau i mua i te pokanga, ā, ka whakatika tō rōpū hauora i te mahere rongoā ki tō hauora ngākau. Ka whakamahi pea rātou i ngā horopeta iti ake, ka whakarato i te mātakitaki ngākau atu, ka whai rongoā ngākau rānei i te tūnga. He maha ngā tāngata e mate ana i te ngākau e whiwhi marie ana i te remifentanil i ia rā i ngā hōhipera puta noa i te ao.

Q2. Me aha au mēnā ka whakamahi au i te nui rawa o te Remifentanil?

E kore e taea e koe te nui rawa o te remifentanil i te mea ka hoatu anake e ngā tākuta whakangungu mā te āta whakahaere i ngā whakaurunga IV. E kore rawa te rongoā e tukuna mō te whakamahi i te kāinga, ā, ka puta katoa te whakahaere i raro i te tirotiro hauora tonu me te mātakitaki tonu i ō tohu nui.

Mēnā ka kite ngā kaimahi hauora i ngā tohu o te nui rawa o te rongoā - pēnei i te manawa puhoi rawa, i te pēhanga toto iti rawa - ka taea e rātou te aukati tonu i te whakaurunga me te whakarato i ngā rongoā whakawātea pēnei i te naloxone ki te hiahiatia. Ko te wā poto rawa o te remifentanil te tikanga ka tere te whakaoti i te nuinga o ngā pānga nui rawa i te wā e mutu ana te whakaurunga.

Q3. Me aha au mēnā ka ngaro au i te horopeta o te Remifentanil?

Kāore tēnei pātai e pā ana ki te remifentanil i te mea ka hoatu hei whakaurunga tonu i ngā wā o ngā tikanga hauora, kāore i te horopeta kua whakaritea. Ka whakahaere tō rōpū hauora i te katoa o te tukanga whakahaere, ka whakatika i te reiti i runga i ō hiahia tonu puta noa i te tikanga.

Ki te puta he raruraru i roto i te whakaurunga na runga i nga take hangarau, ka whakatika tonu to roopu hauora i taua mea, ka whakarite kia noho pai koe. He pūnaha tārua me ētahi rongoā kē atu hei pupuri i te mana whakahaere mamae tika i roto i tō tukanga.

Q4. Āhea Āhau e Kati ai te Tango Remifentanil?

Kāore koe e whakatau ki te whakamutu i te remifentanil - ka whakatau tō roopu hauora i te wā e kore e hiahiatia ana i runga i tō tukanga me te ahunga whakamua o te whakaora. I te wā o te pokanga, ka mutu pea te whakaurunga i te mutunga o te mahi. I ngā wāhi tiaki kaha, ka whakamutua e rātou i te wā e kore e hiahiatia ana e koe te hauora miihini, te whakahaere mamae kaha rānei.

Nā te mea ka tere te whakawātea o te remifentanil i tō pūnaha, kāore he tukanga whakamutu haere pēnei i ētahi atu opioids. Kia mutu te whakaurunga, ka ngaro ngā pānga i roto i ngā meneti, ka taea e koe te huri mārie ki ētahi atu momo whakahaere mamae, te whakaora rānei.

Q5. Ka Pūmau te Remifentanil i te Waranga?

Ahakoa he opioid kaha te remifentanil, he iti rawa te waranga i te mea e whakamahia ana i roto i ngā wāhi hauora. Ka kitea koe ki a ia i te wā e kore e mohio ana i ngā tukanga, i te wā rānei e tino mate ana i roto i te tiaki kaha, ā, ka whakamutua i te wā e kore e hiahiatia ana e te rongoā. Ko te whakamahi rongoā i te wā poto, i te wā e whakahaerehia ana, kāore e hanga i ngā tikanga e hono ana ki te whanaketanga waranga.

Heoi, ki te whai hītori koe mō te whakamahi i ngā matū kino, he mea nui kia kōrero tahi koe i tēnei ki tō roopu hauora i mua i tētahi tukanga. Ka taea e rātou te whai i ngā whakatūpato anō, ā, ka whiriwhiri pea i ētahi atu rautaki whakahaere mamae hei whakarite i tō haumaru me te whakaora tonu i te waranga.