Propofol ni iki: Ibikoreshwa, Urutonde rw'imiti, Ingaruka ziterwa n'iyo miti n'ibindi

Propofol ni umuti ukomeye uterwa mu maraso ugutera gusinzira cyane kandi bigenzurwa mu gihe cy'ibikorwa by'ubuvuzi. Uyu muti wera nk'amata ukora vuba kugira ngo ugutere kutamenya na gato, bigatuma abaganga babaga cyangwa bakora izindi mvura mugihe utazi neza ibiri kuba.

Uzakira propofol gusa mu bitaro cyangwa ikigo cy'ubuvuzi aho abantu bafite ubumenyi bazagenzura neza guhumeka kwawe n'ibimenyetso by'ingenzi. Ifatwa nk'imwe mu miti ikora neza cyane y'ububabare iboneka uyu munsi, ifasha abantu babarirwa muri za miliyoni gukorerwa imvura neza kandi batagira ububabare.

Propofol ni iki?

Propofol ni umuti w'igihe gito ukoreshwa mu kuvura ububabare uherereye mu cyiciro cy'imiti yitwa sedative-hypnotics. Igaragara nk'umuti wera wuzuye, usa nk'amata, niyo mpamvu abaganga rimwe na rimwe bayita "amata yo kwibagirwa."

Uyu muti ukora mugutinda imikorere y'amashanyarazi y'ubwonko bwawe, mu by'ukuri ugahagarika ubwenge bwawe by'agateganyo. Bitandukanye n'indi miti imwe yo kuvura ububabare, propofol ntiyiyongera mu bice by'umubiri wawe, bivuze ko ubyuka vuba iyo imiti ihagaritswe.

Uyu muti wabanje gukorwa mu myaka ya za 1970 kandi wabaye ishingiro ry'imikorere y'ubu buvuzi bw'ububabare. Ingaruka zayo zizwi kandi zikora neza zituma ari amahitamo akunda gukoreshwa mu buryo bwinshi.

Propofol ikoreshwa kubera iki?

Propofol ifite intego eshatu z'ingenzi mu bigo by'ubuvuzi: kuvura ububabare muri rusange kubaga, gutuza mu gihe cy'ibikorwa, kandi rimwe na rimwe ku barwayi bari mu bitaro byita ku barwayi barembye. Muganga wawe azahitamo propofol iyo bakeneye kutamenya neza kandi bigenzurwa.

Kubikorwa byo kubaga, propofol igufasha gusinzira vuba no kutamenya mu gihe cyose cyo kubaga. Ibi birimo ibintu byose kuva kubaga guto hanze y'abarwayi kugeza ku bikorwa bikomeye nk'ubuvuzi bw'umutima cyangwa kwimura ingingo.

Mugihe cyo gukora isuzuma, propofol itanga umuti ugabanya ubwenge cyangwa umuti ukomeye bitewe n'ibyo ukeneye. Ibikorwa bisanzwe birimo colonoscopies, endoscopies, imirimo imwe yo mu menyo, hamwe n'ubushakashatsi bumwe bwo kugaragaza bifuza ko uguma wihagaze neza.

Mu bigo byita ku barwayi barembye, propofol ishobora gukoreshwa ku barwayi bakeneye kuguma bafashwe umuti mugihe bari kuri ventilateur. Ibi bifasha kugabanya impungenge n'akababaro mugihe cyo kuvurwa bikomeye.

Propofol ikora ite?

Propofol ikora yongera ingaruka z'imiti yo mu bwonko yitwa GABA, isanzwe ifasha gutuza imitsi yawe. Iyo propofol yongereye imikorere ya GABA, mu by'ukuri ishyira ubwonko bwawe mu gihe kigenzurwa cyo kutagira ubwenge.

Uyu ni umuti ukomeye cyane ukora vuba. Muri segonda 30 kugeza kuri 60 nyuma yo guterwa urushinge, birashoboka ko uzumva urushye hanyuma ukabura ubwenge rwose. Ingaruka zirashira vuba mugihe urushinge ruhagaze, mubisanzwe mumunota 10 kugeza kuri 15.

Bitandukanye na bimwe mu miti ituma umuntu atagira ubwenge uhumeka, propofol ijya mu maraso yawe yinyuze muri IV. Ibi bituma umuganga wawe w'ubuvuzi ashobora kugenzura neza urwego rwo kugabanya ubwenge bwawe akoresheje guhindura umuvuduko w'urushinge.

Nagomba gufata propofol nte?

Ntabwo uzifata propofol ubwawe - buri gihe itangwa nabaganga bafite imyitozo banyuze kumurongo wa IV mumavuriro cyangwa ibigo byabazwe. Uyu muti usaba gukurikiranwa buri gihe kw'ihumeka ryawe, umuvuduko w'umutima, n'umuvuduko w'amaraso.

Mbere yo gukora ibikorwa byawe, ikipe yawe y'ubuvuzi izashyira catheter ya IV mumitsi yo mu kuboko kwawe cyangwa ukuboko. Propofol izatangwa binyuze muri iyi IV haba nk'urushinge rumwe cyangwa urushinge rukomeza, bitewe n'igihe ibikorwa byawe bifata.

Umuganga wawe w'ubuvuzi azabara urugero nyarwo rwakoreshejwe ashingiye ku kigereranyo cyawe, imyaka, amateka yawe y'ubuvuzi, n'ubwoko bw'ibikorwa urimo gukora. Bazatangira urushinge kandi bakurikirane neza mugihe cyose cy'inzira.

Ntabwo ukeneye kurya cyangwa kunywa ikintu cyihariye mbere yo guhabwa propofol, ariko mubisanzwe ugomba kwirinda kurya no kunywa amasaha menshi mbere yaho. Itsinda ryawe ry’abaganga rizagutanga amabwiriza yihariye yerekeye igihe cyo guhagarika kurya no kunywa.

Nzamara igihe kingana iki mfata Propofol?

Igihe cyo gutanga propofol giterwa n'uburyo bw'ubuvuzi bwawe kandi bugenzurwa na anesthesiologist yawe. Kubikorwa bigufi, ushobora guhabwa propofol iminota 15 kugeza kuri 30 gusa, mugihe kubagwa birebire bishobora gusaba amasaha menshi yo kuyitera.

Itsinda ryawe ry’abaganga rizahagarika gutera propofol igihe igikorwa cyawe kirangiye. Umuti usohoka mu mubiri wawe vuba, bityo mubisanzwe uzatangira gukanguka mumiminota 10 kugeza kuri 15 nyuma yo kurangiza kuyitera.

Mu bigo byita ku barwayi barembye, abarwayi bamwe bashobora guhabwa propofol iminsi cyangwa ndetse n'ibyumweru, ariko ibi bisaba gukurikiranwa cyane kandi bikorwa gusa iyo bibaye ngombwa mu buvuzi.

Ni izihe ngaruka ziterwa na Propofol?

Abantu benshi bafata propofol neza, ariko nk'imiti yose ikomeye, irashobora gutera ingaruka. Ingaruka zisanzwe zibaho mugihe cyangwa nyuma yo kuyitera kandi zikurikiranwa cyane n'itsinda ryawe ry’abaganga.

Mugihe cyo gukora, ushobora guhura no kugabanuka by'agateganyo kw'umuvuduko w'amaraso cyangwa guhumeka gahoro, niyo mpamvu gukurikiranwa buri gihe ari ngombwa. Abantu bamwe kandi bagira ibihe bigufi byo gutera kw'umutima bidahwitse, ariko ibi mubisanzwe bikemuka vuba.

Ingaruka zisanzwe ushobora kubona nyuma yo gukanguka zirimo:

• Isesemi ryoroheje cyangwa kuruka
• Urugero cyangwa kumva utameze neza
• Umutwe
• Gusinzira bishobora kumara amasaha make
• Urujijo rw'agateganyo cyangwa kutamenya aho uri
• Urubavu cyangwa gutwika ahantu batera urushinge

Izi ngaruka mubisanzwe zoroheje kandi zigenda uko umuti usohoka mu mubiri wawe. Itsinda ryawe ryo koroherwa rizagufasha gucunga ibibazo byose.

Ingaruka zikomeye ziterwa n'uyu muti ni gake ariko zishobora kuba zirimo allergie ikomeye, igabanuka rikomeye ry'umuvuduko w'amaraso, cyangwa ingorane zo guhumeka. Iyi ni yo mpamvu propofol itangwa gusa mu bigo by'ubuvuzi bifite ibikoresho byihutirwa byiteguye.

Gake cyane, abantu bamwe bashobora guhura na propofol infusion syndrome, uburwayi bukomeye bushobora kugira ingaruka ku mutima n'imitsi. Ibi bikunda kubaho gusa iyo umuti umaze igihe kinini utangwa, kandi ufite urugero rwo hejuru, kandi bikagenzurwa neza mu bigo byita ku barwayi barembye.

Ninde utagomba gufata Propofol?

Abantu benshi bashobora gufata propofol neza, ariko ibibazo bimwe na bimwe bisaba kwitonda cyane cyangwa imiti itandukanye. Umuganga wawe w'ibijyanye no kubaga azasuzuma amateka yawe y'ubuvuzi neza kugirango amenye niba propofol ikwiriye kuri wewe.

Abantu bafite ibibazo bikomeye by'umutima, cyane cyane abafite umutima udakora neza cyangwa umuvuduko w'amaraso muke cyane, bashobora gukenera uburyo butandukanye bwo kubaga. Propofol ishobora kugabanya umuvuduko w'amaraso by'igihe gito, ibyo bishobora kuba ingorane kuri abo bantu.

Niba ufite allergie izwi kuri propofol, amagi, cyangwa soya, uzakenera imiti itandukanye. Propofol irimo lecithin y'igi na amavuta ya soya, bityo allergie kuri ibyo biribwa rimwe na rimwe bishobora gutera ibibazo.

Abagore batwite bakunda guhabwa propofol gusa iyo inyungu ziruta neza ingaruka, kandi akenshi gusa mu bihe byihutirwa. Itsinda ryawe ry'ubuvuzi rizatekereza neza ku bindi bisubizo byizewe mugihe cyo gutwita.

Abantu bafite ibibazo bimwe na bimwe bya genetike bidakunze kuboneka bigira ingaruka ku mikorere y'imitsi bashobora gukenera ingamba zidasanzwe, kuko propofol rimwe na rimwe ishobora gutera ingorane kuri abo bantu.

Amazina y'ubwoko bwa Propofol

Propofol iboneka munsi y'amazina atandukanye y'ubwoko, nubwo verisiyo rusange ikoreshwa cyane. Izina ry'ubwoko bwambere ni Diprivan, ikorwa na AstraZeneca.

Izindi nshuti z'amazina harimo Propoven, Fresofol, na Recofol, bitewe n'umukora n'igihugu. Ariko, ibitaro byinshi n'ibigo byo kubaga bikoresha propofol rusange, isa neza n'izina ry'ubwoko.

Itsinda ryawe ry'ubuvuzi rizakoresha uburyo ubwo aribwo bwose buboneka mu kigo cyabo. Ubwoko bwose bwa propofol bukora kimwe kandi bufite imiterere y'umutekano isa.

Izindi nzira za Propofol

Imiti myinshi yindi ishobora gutanga ingaruka zisa na propofol, kandi umuganga wawe w'ibitaro ashobora kubitoranya bitewe n'ibyo ukeneye cyangwa indwara zawe. Buri kindi gifite inyungu zacyo n'ibitekerezo.

Sevoflurane na desflurane ni imiti y'ububabare ihumeka ishobora gutanga ububabare rusange itasabye gutera IV. Izi gazi zihumekwa binyuze mu gipfuko kandi zishobora kuba uburyo bwiza ku bantu bafite IV itoroshye.

Kugirango bahumurize mugihe cy'ibikorwa, midazolam (Versed) ihuza na fentanyl itanga uburyo bundi. Ubu buryo bukorera gahoro kurusha propofol ariko bushobora gukora kimwe kubikorwa byinshi.

Etomidate ni undi muti w'ububabare wa IV ushobora gutoranywa kubantu bafite ibibazo by'umutima, kuko akenshi ntigira ingaruka nyinshi kumuvuduko w'amaraso kurusha propofol.

Ketamine itanga ubwoko butandukanye bw'ububabare kandi bushobora kuba ingirakamaro kubikorwa bimwe na bimwe cyangwa kubantu bashobora kutitabira propofol.

Ese Propofol iruta izindi miti y'ububabare?

Propofol ifite inyungu nyinshi zituma ikundwa nabaganga b'ibitaro, ariko niba ari

Uyu muti kandi utera isesemi n'umuriro muke ugereranije n'ibindi byinshi bituma umuntu atagira ibibazo byinshi mu gihe cyo gukira. Ibyo ukora birazwi kandi, bigatuma umuganga w'indwara zo mu mutwe ashobora kugenzura urwego rwawe rwo gutuza neza.

Ariko, propofol ntabwo buri gihe ari wo muti mwiza. Ku kubagwa birebire cyane, imiti ihumeka ishobora kuba ikwiriye kurushaho. Ku bantu bafite indwara zimwe na zimwe z'umutima, indi miti ishobora kuba ifite umutekano kurushaho.

Umuvuzi w'indwara zo mu mutwe azahitamo umuti mwiza ku miterere yawe, yitegereza ubuzima bwawe, uburyo bwo kubaga, n'amateka yawe bwite y'ubuvuzi.

Ibikunze Kubazwa Ku Bya Propofol

Ese Propofol ifite umutekano ku bantu barwaye indwara z'umutima?

Propofol irashobora gukoreshwa mu buryo bwizewe ku bantu barwaye indwara z'umutima, ariko bisaba gukurikiranwa by'umwihariko no guhindura neza urugero rw'umuti. Uyu muti ushobora kugabanya igitutu cy'amaraso by'igihe gito no gutuma umutima utera gahoro, ibyo bishobora guhangayikisha abantu bafite indwara zimwe na zimwe z'umutima.

Umuvuzi w'indwara zo mu mutwe azakorana bya hafi n'umuganga w'umutima wawe kugira ngo amenye uburyo bwizewe cyane. Bashobora guhitamo undi muti wo gutera, gukoresha urugero ruto rwa propofol, cyangwa gutanga indi miti yo gufasha imikorere y'umutima wawe mu gihe cyo kubagwa.

Abantu benshi barwaye indwara z'umutima bakira propofol mu buryo bwizewe buri munsi. Ikintu cy'ingenzi ni ukugira umuvuzi w'indwara zo mu mutwe ufite uburambe ushobora kugukurikiranira hafi no guhindura imiti uko bikwiye.

Nkwiriye gukora iki niba mbonye propofol nyinshi mu buryo butunganye?

Ntabwo ukeneye guhangayika ku bijyanye no kubona propofol nyinshi mu buryo butunganye, kuko abantu bafite ubumenyi mu by'ubuvuzi babifitiye uburenganzira bwo gutanga uyu muti mu bitaro bigenzurwa. Umuvuzi w'indwara zo mu mutwe abara neza urugero rwawe kandi akagukurikiranira buri gihe mu gihe cyo kubagwa.

Niba byaba ngombwa ko umuntu arenga urugero rwawo, ikipe yawe y'ubuvuzi ifite ibikoresho n'imiti byihuse yo gufasha guhumeka kwawe n'imitsi. Batojwe guhangana n'ibibazo byose bishobora kuvuka.

Umuti utangwa hakoreshejwe ibikoresho byihariye bifasha kwirinda amakosa mu gupima imiti. Umutekano wawe niwo uza imbere, hakoreshwa uburyo bwinshi bwo kugenzura umutekano.

Nkwiriye gukora iki niba nciweho urugero rwa Propofol?

Iki kibazo ntikireba propofol kuko atari umuti ufata mu rugo cyangwa ku gihe giteganyijwe. Propofol itangwa gusa mu gihe cyo kuvurwa mu bitaro cyangwa ahantu hakorerwa imirimo yo kubaga.

Niba ufite uburyo bwo kuvurwa buteganyijwe bukenera propofol, ukurikiza gusa amabwiriza y'ibanze yerekeye kurya, kunywa, no gufata imiti yawe isanzwe. Gera ku gihe cyagenwe.

Niba ukeneye gusubika uburyo bwo kuvurwa, vugana n'ibiro bya muganga wawe kugirango utegure igihe gishya. Propofol izatangwa nshya mu gihe cyo kuvurwa kwimuriwe.

Nshobora guhagarika ryari gufata Propofol?

Ntabwo ari wowe ugenzura igihe propofol ihagarikwa - umuganga wawe w'indwara z'ubuvuzi niwe ufata iki cyemezo ashingiye ku buryo bwo kuvurwa kwawe no gukira. Uyu muti uhagarikwa igihe kubaga kwawe cyangwa uburyo bwo kuvurwa burangiye kandi byemewe ko ukanguka.

Ubusanzwe, gutanga uyu muti birahagarara buhoro buhoro aho guhagarara icyarimwe, bikagufasha gukanguka neza. Itsinda ryawe ry'abaganga rizakomeza kugukurikiranira hafi uko umuti ugenda ushiramo imbaraga.

Mu buryo bwo kwita ku barwayi barembye, icyemezo cyo guhagarika propofol giterwa n'uburwayi bwawe n'imikurire yo gukira. Itsinda ryawe ryo kwita ku barwayi barembye rizagena igihe cyiza cyo kugabanya cyangwa guhagarika imiti igabanya ubwenge.

Nshobora gutwara imodoka nyuma yo guhabwa Propofol?

Oya, ntugomba gutwara imodoka nibura amasaha 24 nyuma yo guhabwa propofol. Nubwo wenda wumva umeze neza vuba nyuma yo gukanguka, uyu muti ushobora kugira ingaruka ku buryo witwara no gutekereza mu masaha menshi.

Uzakenera umuntu ugutwara nyuma yo kuvurwa kandi akagumana nawe amasaha make. Ibikorwa byinshi by'ubuvuzi bisaba ko ugira umuntu mukuru uguherekeza mbere yo kugusezerera.

Teganya gukora ibintu byoroheje uyu munsi wose, wirinda gufata ibyemezo bikomeye, gukoresha imashini, cyangwa gusinya inyandiko z'amategeko kugeza ejo. Ubwenge bwawe n'ubushobozi bwo guhuza ibintu bizasubira uko byari bisanzwe, ariko bifata igihe kugira ngo ingaruka zose zishire burundu.