Icyo Succinylcholine Aricyo: Ibyo Ikoreshwa, Uburyo Bwo Kuyifata, Ingaruka Zayo n'Ibindi

Succinylcholine ni umuti ukomeye utuma imitsi yoroha ukoreshwa mu gihe cyo kubaga no mu gihe cy'ubuvuzi bwihutirwa kugira ngo imitsi ihagarare by'agateganyo. Uyu muti ukora vuba kugira ngo ufashishe abaganga gukora ibikorwa byo kurokora ubuzima nk'ugushyiraho imiyoboro yo guhumeka cyangwa gutegura abarwayi kubagwa igihe imitsi igomba koroha.

Succinylcholine Ni Iki?

Succinylcholine ni umuti uhagarika imitsi, utuma imitsi ihagarara by'agateganyo. Uyu muti ubarirwa mu cyiciro cy'imiti yitwa imiti ituma imitsi yoroha, bivuze ko ikora ihungabanya ibimenyetso bisanzwe hagati y'imitsi yawe n'imitsi.

Uyu muti ukoreshwa gusa ahantu havurirwa haba hari abaganga n'abakozi b'ubuzima, nk'ibyumba byo kubagira, ibitaro byihutirwa, n'ibitaro byita ku barwayi barembye. Abaganga bakoresha uyu muti iyo bakeneye koroshya vuba imitsi yose y'umubiri wawe, harimo n'iyo dukoresha mu guhumeka, niyo mpamvu ihora itangwa hamwe n'imashini ifasha guhumeka.

Uyu muti ukora mu gihe cy'amasegonda 30 kugeza kuri 60 kandi akenshi ukora iminota 5 kugeza kuri 10. Kubera uko ukora vuba kandi ukamara igihe gito, abaganga bakunda kuwita "sux" kandi bakawufata nk'uw'agaciro mu bihe byihutirwa aho koroshya imitsi byihuse bishobora kurokora ubuzima.

Succinylcholine Ikoreshwa Kuri Iki?

Succinylcholine ikoreshwa cyane cyane mu koroshya gushyiraho imiyoboro yo guhumeka, bivuze gufasha abaganga gushyiraho umuyoboro wo guhumeka mu muhogo wawe. Iki gikorwa ni ngombwa mu gihe cyo kubagwa iyo ukeneye gukoresha imashini ifasha guhumeka cyangwa mu bihe byihutirwa iyo umuntu adashobora guhumeka wenyine.

Uyu muti ufasha kandi mu bikorwa bimwe na bimwe byo kubaga aho koroshya imitsi byuzuye bikenewe. Abaganga bashobora gukenera ko imitsi yawe ihagarara rwose kugira ngo bakore imirimo yoroshye, cyane cyane hafi y'inda, igituza, cyangwa igihe bakora hafi y'ingingo z'ingenzi.

Abaganga b'indwara z'igitaraganya bakoresha succinylcholine iyo umuntu akeneye gufashwa guhumeka ako kanya. Ibi bishobora kubaho mu gihe umutima uhagaze, igihe cy'ihungabana rikomeye, cyangwa igihe umuntu afite ingorane zo guhumeka kandi akeneye ubufasha bwihutirwa kugira ngo akire.

Succinylcholine ikora ite?

Succinylcholine ikora ibuza imibanire hagati y'imitsi yawe n'imitsi yawe ku gice cy'imitsi. Bitekereze nk'aho byaciye umurongo wa terefone hagati y'ubwonko bwawe n'imitsi yawe, bikabuza amabwiriza yose yo kugenda kugera.

Iyi ni imiti ikomeye cyane kuko itera ubumuga bwuzuye bw'imitsi yose y'ubushake, harimo n'izo ukoresha guhumeka. Ubumuga bubaho mu buryo buzwi, butangirira ku mitsi mito mu maso yawe n'amaso, hanyuma bugakwira mu ngingo zawe, hanyuma bugahindura urugingo rwawe rwo guhumeka n'imitsi yo guhumeka.

Uyu muti usenywa vuba n'amasomo mu maraso yawe yitwa pseudocholinesterases. Uku gusenyuka vuba nicyo gituma ingaruka zigenda vuba, akenshi mu minota 5 kugeza ku 10, bigatuma bigira umutekano kurushaho mu bikorwa bigufi.

Nkwiriye gufata succinylcholine nte?

Ntabwo uzigera wifata succinylcholine ubwawe - itangwa gusa n'abantu b'inzobere mu by'ubuvuzi mu bitaro. Uyu muti utangwa binyuze mu murongo wa intravenous (IV) mu maraso yawe cyangwa nk'urushinge rwo mu mutsi munini.

Mbere yo guhabwa succinylcholine, akenshi uzahabwa anesthesia rusange kugira ngo utagira ubwenge. Ibi ni ngombwa kuko uyu muti uhagarika gusa imitsi yawe ariko ntugire icyo uhindura ku bwenge bwawe cyangwa kumva ububabare, bityo ugomba kubanza gusinzira.

Abaganga bazaba bafite ibikoresho byose bikenewe biteguye mbere yo kuguha uyu muti, harimo ibikoresho byo guhumeka, umwuka wa oxygen, n'imiti yihutirwa. Bazagenzura kandi umuvuduko w'umutima wawe, umuvuduko w'amaraso, n'urugero rwa oxygen mu gihe cyose cy'inzira.

Nzamara Nde Nshobora Gufata Succinylcholine?

Succinylcholine ntijyenda ifatwa igihe kirekire - ni umuti utangwa inshuro imwe ukoreshwa gusa mu bikorwa byihariye. Ibyo ukora bikunze kumara iminota 5 kugeza kuri 10, akenshi bikaba bihagije kugira ngo abaganga barangize igikorwa cyose gikenewe.

Niba hakenewe igihe kirekire cyo kuruhura imitsi, ikipe yawe y'ubuvuzi izahindukirira ubundi bwoko bwo kuruhura imitsi bumara igihe kirekire. Succinylcholine ihitwamo by'umwihariko iyo abaganga bakeneye gutangira vuba ariko ntibashake ingaruka zirambye.

Igihe cyo gukora gishobora gutandukana gato ku muntu ku muntu bitewe n'ibintu nk'uburemere bwawe, imikorere y'impyiko, n'uko umubiri wawe usenya umuti. Abantu benshi basubirana imikorere isanzwe y'imitsi mu minota 10 kugeza kuri 30 nyuma yo guhabwa urugero.

Ni Iyihe Ngaruka Ziterwa na Succinylcholine?

Ingaruka zisanzwe ziterwa na succinylcholine zijyanye n'imikorere yayo yo kuruhura imitsi. Ushobora kugira ububabare bw'imitsi cyangwa gukakara nyuma y'igikorwa, kimwe n'uko wumva nyuma yo gukora imyitozo ikomeye.

Abantu bamwe bagira imitsi ikubagana cyangwa fasciculations nyuma yo guhabwa umuti. Ibi bisa nk'ibiteye impungenge ariko mu by'ukuri ni ibisanzwe kandi bigaragaza ko umuti ukora nk'uko byitezwe.

Dore ingaruka zisanzwe ushobora guhura nazo:

• Ububabare bw'imitsi cyangwa kubabara bimara iminsi 1-2
• Kongera umusonga
• Impinduka ntoya mu mutima
• Kongera igihe gito umuvuduko mu jisho
• Kongera gato urugero rwa potasiyumu mu maraso yawe

Izi ngaruka muri rusange ni ntoya kandi zikemura zonyine igihe umuti uva mu mubiri wawe.

Nubwo bidasanzwe, ingaruka zimwe zikomeye zirashobora kubaho kandi zigasaba ubufasha bwihuse bw'ubuvuzi. Ibihe nk'ibi bikurikiranwa cyane n'ikipe yawe y'ubuvuzi mu gihe cyose cy'igikorwa.

Ingaruka zikomeye ariko zitamenyerewe zirimo:

• Hyperthermia mbi - kwiyongera gukabije kw'ubushyuhe bw'umubiri
• Uburwayi bukomeye bwo kwivumbura ku bintu bituma umuntu arwara, bigatuma umuntu ahumeka nabi cyangwa agahura
• Kwiyongera gukabije kw'urugero rwa potasiyumu (hyperkalemia)
• Impinduka zikomeye mu mutima
• Ubumuga burambye bumara igihe kirekire cyane kurusha uko byari byitezwe

Itsinda ryawe ry'abaganga ryatojwe by'umwihariko kumenya no kuvura ibi bibazo ako kanya niba bibaye.

Ninde utagomba gufata Succinylcholine?

Abantu bamwe ntibagomba guhabwa succinylcholine kubera kwiyongera kw'ibibazo bikomeye. Itsinda ryawe ry'abaganga rizareba neza amateka yawe y'ubuzima mbere yo gutekereza kuri uyu muti.

Abantu bafite uburwayi runaka bwo mu bwoko butuma batamenya uko bamenya umuti bashobora guhura n'ubumuga burambye. Ibi birimo abafite pseudocholinesterase deficiency, uburwayi aho umubiri wawe utagira imyunyungugu ikenewe kugirango umenye succinylcholine vuba.

Ibyo bintu bituma succinylcholine iba akaga cyane birimo:

• Muscular dystrophy cyangwa izindi ndwara z'imitsi
• Ukwangirika gukomeye cyangwa ibikomere bya vuba
• Ukwangirika kw'umugongo
• Indwara ikomeye y'impyiko
• Amateka ya hyperthermia mbi
• Uburwayi runaka bwo mu bwonko nka ALS cyangwa multiple sclerosis
• Kuruhuka mu gitanda cyangwa kutagira icyo ukora vuba

Ibi bintu bishobora kongera ibyago byo kwiyongera kwa potasiyumu cyangwa izindi ngorane zikomeye zishobora gutera urupfu.

Amazina ya Succinylcholine

Succinylcholine iboneka munsi y'amazina menshi y'ubwoko, Anectine ikaba imwe mu zikoreshwa cyane. Andi mazina y'ubwoko arimo Quelicin na Sucostrin, nubwo verisiyo rusange ikoreshwa cyane mu bigo byinshi by'ubuvuzi.

Bitewe n'izina ry'ubwoko, verisiyo zose zirimo ikintu kimwe gikora - succinylcholine chloride. Guhitamo izina ry'ubwoko mubisanzwe biterwa n'icyo ivuriro ryawe cyangwa ikigo cy'ubuvuzi gifite.

Izindi nzira zishobora gukoreshwa aho succinylcholine

Hariho imiti myinshi isimbura imitsi ishobora gukoreshwa aho succinylcholine, bitewe n'uburyo bw'ubuvuzi buriho. Iyi miti isimbura akenshi ikora gahoro ariko ikamara igihe kirekire kurusha succinylcholine.

Izindi nzira zisanzwe zikoreshwa zirimo rocuronium, vecuronium, na atracurium. Rocuronium akenshi ihitwamo kuko ikora vuba nkuko succinylcholine ikora ariko ntigira ibyago byo kuzamura potasiyumu ku buryo bukomeye.

Uburyo bwo guhitamo izindi nzira buterwa n'ibintu nk'uko imitsi ikeneye kuruhuka vuba, igihe igikorwa kizamara, n'uburwayi bwawe bwihariye. Umuganga wawe w'ibijyanye no kubaga azahitamo uburyo bwizewe kandi bukwiye kuri wowe.

Ese succinylcholine iruta rocuronium?

Succinylcholine na rocuronium buri imwe ifite ibyiza byayo bitewe n'uburyo bw'ubuvuzi buriho. Succinylcholine ikora vuba, akenshi mu gihe cy'amasegonda 30-60, mugihe rocuronium ifata amasegonda 60-90 kugirango igere ku kuruhuka kw'imitsi nk'uko byari bimeze.

Icyiza gikuru cya succinylcholine ni igihe gito ikora. Niba hari ikitagenda neza mugihe cyo gushyira umwuka mu muhogo, ubumuga burashira vuba, bigatuma umwuka wa kamere usubira. Ibi bituma bifite agaciro cyane mu bihe by'ubutabazi aho inzira y'umwuka ishobora kugorana kuyicunga.

Rocuronium, ariko, irizewe kubantu bafite uburwayi runaka. Ntitera kuzamuka kwa potasiyumu ku buryo bukomeye bishobora kubaho kuri succinylcholine, bituma iba nziza kubarwayi bafite ibikomere, ibibazo, cyangwa indwara z'imitsi.

Uburyo bwo guhitamo hagati yiyi miti buterwa n'uburyo bwawe bw'ubuvuzi, ubukana bw'igikorwa, n'ibintu byawe byihariye by'ibibazo. Itsinda ryawe ry'abaganga rizagena uburyo bwizewe kandi bukwiye kuri wowe.

Ibikunze kubazwa kuri succinylcholine

Ese succinylcholine irizewe kubafite indwara z'umutima?

Succinylcholine irashobora gukoreshwa neza ku bantu barwaye indwara z'umutima, ariko bisaba gukurikiranwa neza. Uyu muti ushobora gutera impinduka z'agateganyo mu mutima no kuzamuka gake mu rwego rwa potasiyumu, ibyo ikipe yawe y'abaganga izakurikiranira hafi.

Abantu bafite urugero rwo hejuru rw'umutima cyangwa indwara zimwe na zimwe z'umutima bashobora gukenera imiti itandukanye. Umuganga w'umutima wawe n'umuganga w'ibitaro bazakorana kugira ngo bamenye uburyo bwiza bwo kuvura indwara y'umutima yawe.

Nkwiriye gukora iki niba nahawe succinylcholine nyinshi mu buryo butunganye?

Ntushobora guhabwa succinylcholine nyinshi mu buryo butunganye kuko itangwa gusa n'abantu b'inzobere mu by'ubuvuzi mu bihe byagenewe. Niba umuti urenze urugero rwashoboka, byahita bimenyekana kandi bikavurwa n'ikipe yawe y'abaganga.

Uburyo nyamukuru bwo kuvura umuti wa succinylcholine urenze urugero ni ukwitaho, harimo gukomeza guhumeka mu buryo bwa mashini kugeza igihe imiti igaragarira. Ikipe yawe y'abaganga ifite amabwiriza yihariye n'ibikoresho byiteguye gukemura ibibazo byose.

Nkwiriye gukora iki niba nciwe urugero rwa succinylcholine?

Iki kibazo ntikireba succinylcholine kuko si umuti ufata ku gihe. Itangwa rimwe gusa mu gihe cy'imikorere yihariye y'ubuvuzi mu bitaro.

Niba ufite ibibazo bijyanye n'imiti ufata mu rugo, ugomba kuvugana n'umuganga wawe usanzwe cyangwa umufarumasiti kugira ngo akuyobore ku bijyanye n'urugero rwatanzwe.

Nshobora kureka gufata succinylcholine ryari?

Succinylcholine ihagarara gukora mu minota 5-10 nyuma yo gutangwa. Nta kintu na kimwe ugomba gukora kugira ngo uhagarike ingaruka zayo - umubiri wawe usenya umuti mu buryo busanzwe.

Niba ubaza ibijyanye no guhagarika indi miti mbere y'imikorere aho succinylcholine ishobora gukoreshwa, umuganga wawe azaguha amabwiriza yihariye ku miti ugomba gukomeza cyangwa guhagarika by'agateganyo.

Nshobora gutwara imodoka nyuma yo guhabwa succinylcholine?

Ntabwo ugomba gutwara imodoka nibura amasaha 24 nyuma yo guhabwa succinylcholine, kuko buri gihe itangwa hamwe na anesthesia rusange mugihe cyo kuvura. Anesthesia igira ingaruka kumyumvire yawe, imbaraga zawe, no guhuza ibintu byawe nyuma yuko succinylcholine imaze gushira.

Uzaba ukeneye umuntu ugutwara nyuma yo kuvurwa, kandi ugomba kwirinda gufata ibyemezo bikomeye cyangwa gukoresha imashini kugeza wuzuye neza anesthesia.