Chii chinonzi Succinylcholine: Zvayakashandiswa, Mishonga, Migumisiro Yemuviri, nezvimwe

Succinylcholine mushonga une simba unozorodza mhasuru unoshandiswa panguva yekuvhiwa uye maitiro ekukurumidzira kuti mhasuru dzive nemararamiro echinguvana. Mushonga uyu unoshanda nekukurumidza kubatsira vanachiremba kuita maitiro ekuchengetedza hupenyu sekupinza machubhu ekufema kana kugadzirira varwere kuvhiwa kana kuzorora kwemhasuru kuchikosha.

Chii chinonzi Succinylcholine?

Succinylcholine imishonga inovharisa tsinga nemhasuru inokonzera kumira kwemhasuru kwenguva pfupi. Iyo ndeyeboka remishonga inonzi depolarizing muscle relaxants, zvinoreva kuti inoshanda nekukanganisa zviratidzo zvenguva dzose pakati petsinga dzako nemhasuru.

Mushonga uyu unoshandiswa chete munzvimbo dzakadzorwa dzekurapa senge makamuri ekuvhiya, madhipatimendi ekukurumidzira, uye mayuniti ekuchengetedza zvakanyanya. Vanopa hutano vanoiisa kana vachida kuzorodza nekukurumidza mhasuru dzese dzemuviri wako, kusanganisira idzo dzinoshandiswa kufema, ndosaka ichigara ichipihwa nerutsigiro rwemhepo.

Mishonga inoshanda mukati memasekonzi makumi matatu kusvika makumi matanhatu uye inowanzo gara kwemaminitsi mashanu kusvika gumi. Nekuda kwekutanga kwayo nekukurumidza uye nguva pfupi, nyanzvi dzekurapa dzinowanzo idana kuti "sux" uye dzinofunga kuti yakakosha mumamiriro ekukurumidzira apo kuzorora kwemhasuru nekukurumidza kunogona kuponesa hupenyu.

Chii chinonzi Succinylcholine chinoshandiswa?

Succinylcholine inonyanya kushandiswa kufambisa endotracheal intubation, zvinoreva kubatsira vanachiremba kupinza chubhu yekufema mumhepo yako. Maitiro aya akakosha panguva yekuvhiwa kana iwe uchida kuve pane ventilator kana mumamiriro ekukurumidzira apo mumwe munhu asingakwanise kufema ega.

Mushonga uyu unobatsirawo panguva yemamwe maitiro ekuvhiya apo kuzorora kwemhasuru kwakakwana kunodiwa. Vachiremba vanogona kuda kuti mhasuru dzako dzimire zvachose kuti vaite mashandiro akapfava, kunyanya padumbu, chipfuva, kana kushanda pedyo nenhengo dzakakosha.

Vachiremba vekurapa nekukurumidza vanoshandisa succinylcholine kana mumwe munhu achida kutarisirwa kwemhepo nekukurumidza. Izvi zvinogona kuitika panguva yekumira kwemoyo, trauma yakakomba, kana kana mumwe munhu achinetseka kufema uye achida kupindira nekukurumidza kuti aponeswe.

Succinylcholine Inoshanda Sei?

Succinylcholine inoshanda nekudzivisa kutaurirana pakati petsinga dzako nemhasuru panzvimbo ye neuromuscular. Funga nezvazvo sekugura tambo yefoni kwenguva pfupi pakati peuropi hwako nemhasuru dzako, kudzivirira chero mirairo yekufamba kubva pakupinda.

Iri rinotariswa semushonga wakasimba kwazvo nekuti unokonzera kupera simba kwemhasuru dzese dzekuzvidira, kusanganisira idzo dzaunoshandisa kufema. Kupera simba kunoitika mumaitiro anofungidzirwa, kutanga nemhasuru diki pachiso chako nemaziso, wobva waenda kumativi ako, uye pakupedzisira kuchikanganisa diaphragm yako nemhasuru dzekufema.

Mushonga uyu unoputsika nekukurumidza nema enzymes muropa rako anonzi pseudocholinesterases. Kuparara uku nekukurumidza ndiko nei mhedzisiro ichipera nekukurumidza, kazhinji mukati memaminitsi mashanu kusvika gumi, zvichiita kuti zvive zvakachengeteka kune maitiro mapfupi.

Ndingatora Sei Succinylcholine?

Hauzombotori succinylcholine iwe pachako - inongopihwa nevashandi vehutano vakadzidziswa munzvimbo dzekuchipatara. Mushonga unopihwa kuburikidza ne intravenous (IV) mutsara zvakananga muropa rako kana se intramuscular jekiseni mumhasuru hombe.

Usati wagamuchira succinylcholine, iwe unowanzo kupihwa general anesthesia kuti usazive. Izvi zvakakosha nekuti mushonga unongoparadza mhasuru dzako asi haukanganisi kuziva kwako kana kunzwa kurwadziwa, saka unofanirwa kurara kutanga.

Vapi vehutano vachave nemidziyo yese inodiwa yakagadzirira vasati vakupa mushonga uyu, kusanganisira ventilators, okisijeni, uye mishonga yekukurumidzira. Vachatarisawo rhythm yemoyo wako, BP, uye mazinga eokisijeni panguva yese yekuita.

Ndingatora Succinylcholine Kwenguva Yakareba Sei?

Succinylcholine haimbotorwa kwenguva yakareba - mushonga unotorwa kamwe chete unoshandiswa chete kune maitiro chaiwo. Mhedzisiro yacho inowanzo gara pakati pe5 kusvika ku10 maminitsi, izvo zvinowanzoita nguva yakakwana yachiremba kuti vapedze maitiro anodiwa.

Kana nguva yakareba yekuzorora kwemhasuru ichidiwa, timu yako yezvokurapa ichachinja kune imwe mhando yekuzorora kwemhasuru kunogara kwenguva refu. Succinylcholine inonyanya kusarudzwa kana chiremba achida kutanga nekukurumidza asi asingade mhedzisiro inogara kwenguva refu.

Kureba kunogona kusiyana zvishoma kubva kumunhu nemunhu zvichienderana nezvinhu zvakaita sehuremu hwako, basa reitsvo, uye nekukurumidza kwemuviri wako unoputsa mushonga. Vanhu vazhinji vanodzorera basa rakajairika remhasuru mukati me10 kusvika ku30 maminitsi mushure mekutora mushonga.

Ndezvipi Zvakaipa zveSuccinylcholine?

Zvakashata zvakajairika zve succinylcholine zvine chekuita nezvinhu zvaro zvekuzorora kwemhasuru. Unogona kusangana nekutambudzika kwemhasuru kana kuoma mushure mekuita, zvakafanana nekuti unonzwa sei mushure mekuita maekisesaizi akasimba.

Vamwe vanhu vanosangana nekutinhwa kwemhasuru kwenguva pfupi kana fasciculations mushure mekutora mushonga. Izvi zvinoita sezvinonetsa asi zvakajairika uye zvinoratidza kuti mushonga uri kushanda sezvaitarisirwa.

Heano mamwe emhedzisiro yakajairika yaungasangana nayo:

• Kutambudzika kwemhasuru kana kurwadziwa kunogara 1-2 mazuva
• Kuwedzera kugadzirwa kwemate
• Kuchinja kudiki mukurova kwemoyo
• Kuwedzera kwenguva pfupi mukumanikidzwa kwemaziso
• Kuwedzera kudiki kwemazinga e potassium muropa rako

Mhedzisiro iyi inowanzoita nyoro uye inogadzirisa yega sezvo mushonga uchibuda muhurongwa hwako.

Kunyange zvazvo zvisingawanzoitiki, mamwe mhedzisiro yakakomba inogona kuitika uye inoda kutariswa kwekurapa nekukurumidza. Izvi zviitiko zvinonyatso tariswa nechikwata chako chezvokurapa panguva yekuita.

Zvakashata zvakakomba asi zvisingawanzoitiki zvinosanganisira:

• Malignant hyperthermia - kuwedzera kunotyisa kwekupisa kwemuviri
• Kusangana kwakanyanya kweallergy nekutadza kufema kana kuzvimba
• Kuwedzera kunotyisa kwemazinga e potassium (hyperkalemia)
• Kuchinja kukuru mumoyo rhythm
• Kuremara kwenguva refu kunogara kwenguva refu kupfuura zvaitarisirwa

Chikwata chako chekurapa chakadzidziswa zvakakosha kuziva nekubata matambudziko aya nekukasira kana akaitika.

Ndiani Asingafaniri Kutora Succinylcholine?

Vanhu vakati wandei havafaniri kugamuchira succinylcholine nekuda kwekuwedzera njodzi yematambudziko akakomba. Chikwata chako chekurapa chichanyatsoongorora nhoroondo yako yekurapa usati wafunga mushonga uyu.

Vanhu vane mamiriro akati wandei e genetic anokanganisa maitiro avano putsa mushonga vanogona kusangana nekuremara kwenguva refu. Izvi zvinosanganisira avo vane pseudocholinesterase kushomeka, mamiriro apo muviri wako usina ma enzymes anodiwa kuti aputse succinylcholine nekukurumidza.

Mamiriro anoita kuti succinylcholine ive njodzi inosanganisira:

• Muscular dystrophy kana dzimwe denda remhasuru
• Mabasa akakomba achangobva kuitika kana trauma
• Kukuvara kwemuzongoza
• Denda rakakomba reitsvo
• Nhoroondo ye malignant hyperthermia
• Mamwe mamiriro e neurological senge ALS kana multiple sclerosis
• Kuzorora kwenguva refu pamubhedha kana kusashanda achangobva kuitika

Mamiriro aya anogona kuwedzera njodzi yekukwira kwepotassium kunotyisa kana mamwe matambudziko akakomba anogona kuva anotyisa upenyu.

Succinylcholine Mazita eBrand

Succinylcholine inowanikwa pasi pemazita akati wandei ebrand, neAnectine iri imwe yeanowanzo shandiswa. Mamwe mazita ebrand anosanganisira Quelicin naSucostrin, kunyangwe vhezheni ye generic ichishandiswa zvakanyanya muzvipatara zvakawanda.

Zvisinei nezita rebrand, ese mavhezheni ane chinhu chimwe chete chinoshanda - succinylcholine chloride. Kusarudzwa kwebrand kunowanzoenderana nezviri kuwanikwa muchipatara chako kana nzvimbo yekurapa.

Zvimwe Zvinogona Kushandiswa Panzvimbo peSuccinylcholine

Mishonga yakati wandei inozorodza mhasuru inogona kushandiswa panzvimbo pe succinylcholine, zvichienderana nemamiriro ezvinhu chaiwo ekurapa. Zvimwe zvinogona kushandiswa izvi zvinowanzoita zvishoma nezvishoma asi zvinogara kwenguva refu kupfuura succinylcholine.

Zvimwe zvinowanzo shandiswa zvinosanganisira rocuronium, vecuronium, uye atracurium. Rocuronium inowanzo sarudzwa nekuti inoshanda nekukurumidza sekunge succinylcholine asi haina njodzi imwechete yekukwira kwakanyanya kwe potassium.

Sarudzo yezvimwe zvinoshandiswa inoenderana nezvinhu zvakaita sekuti kuzorora kwemhasuru kunodiwa nekukurumidza sei, kuti maitiro acho achatora nguva yakareba sei, uye mamiriro ako chaiwo ekurapa. Anesthesiologist wako achasarudza sarudzo yakachengeteka uye yakakodzera mamiriro ako.

Succinylcholine Zviri Nani Here Kupfuura Rocuronium?

Succinylcholine uye rocuronium imwe neimwe ine zvainobatsira zvichienderana nemamiriro ekiriniki. Succinylcholine inoshanda nekukurumidza, kazhinji mukati memasekonzi makumi matatu kusvika makumi matanhatu, nepo rocuronium ichitora masekonzi makumi matanhatu kusvika makumi mapfumbamwe kuti iwane kuzorora kwemhasuru kwakafanana.

Chinhu chikuru chinobatsira succinylcholine ndiyo nguva yayo shoma yekuita. Kana chimwe chinhu chikaenda zvisina kumira zvakanaka panguva ye intubation, kupera muviri kunopera nekukurumidza, zvichibvumira kufema kwemuviri kudzoka. Izvi zvinoita kuti ive yakakosha mumamiriro ezvinhu ekukurumidzira uko nzira yemhepo ingave yakaoma kubata.

Rocuronium, zvisinei, yakachengeteka kune vanhu vane mamiriro ekurapa. Haisi kukonzera kukwira kwakanyanya kwe potassium kunogona kuitika ne succinylcholine, zvichiita kuti ive sarudzo iri nani kune varwere vane kutsva, trauma, kana zvirwere zvemuviri.

Sarudzo pakati pemishonga iyi inoenderana nemamiriro ako chaiwo ekurapa, kukurumidza kwemaitiro, uye njodzi dzako dzega. Chikwata chako chekurapa chichasarudza sarudzo yakachengeteka uye yakakodzera iwe.

Mibvunzo Inowanzo Bvunzwa Pamusoro peSuccinylcholine

Succinylcholine Yakachengeteka Here Kune Zvirwere Zvemwoyo?

Succinylcholine inogona kushandiswa zvakachengeteka muvanhu vane chirwere chemoyo, asi zvinoda kunyatsoongororwa. Mushonga uyu unogona kukonzera shanduko dzenguva pfupi mumoyo uye kuwedzera zvishoma muzvikamu zvepotassium, izvo chikwata chako chekurapa chichanyatso tarisa.

Vanhu vane kukundikana kwemoyo kwakanyanya kana matambudziko mamwe emoyo vanogona kuda mishonga imwe. Chiremba wako wemoyo uye anesthesiologist vachashanda pamwechete kuti vaone nzira yakachengeteka yechirwere chako chemoyo.

Ndingaita Sei Kana Ndikawana Succinylcholine Yakawandisa Netsaona?

Haugone netsaona kuwana succinylcholine yakawandisa nekuti inongopiwa chete nevashandi vezvokurapa vakadzidziswa munzvimbo dzakadzorwa. Kana overdose ikaitika, inozivikanwa nekukurumidza uye kurapwa nechikwata chako chekurapa.

Kurapa kukuru kwe succinylcholine overdose ndiko kutarisirwa kunotsigira, kusanganisira kuenderera mberi kwe mechanical ventilation kusvikira mhedzisiro yemushonga yapera. Chikwata chako chekurapa chine mitemo yakatarwa uye midziyo yakagadzirira kubata chero matambudziko.

Ndingaita Sei Kana Ndikarasikirwa neDose yeSuccinylcholine?

Mubvunzo uyu haushande ku succinylcholine nekuti haisi mushonga waunotora pane chirongwa. Inongopiwa kamwe chete panguva yezvinhu zvakatarwa zvekurapa munzvimbo dzekuchipatara.

Kana uine mibvunzo pamusoro pemishonga yaunotora kumba, unofanira kubata chiremba wako wenguva dzose kana pharmacist kuti uwane gwara pamusoro pemadosi akarasika.

Ndingamira Rini Kutora Succinylcholine?

Succinylcholine inorega kushanda yega mukati memaminitsi mashanu kusvika gumi mushure mekubviswa. Haufaniri kuita chero chinhu kuti umise mhedzisiro yayo - muviri wako unoparadza mushonga wacho zvakasikwa.

Kana uri kubvunza nezvekumisa mimwe mishonga usati waita maitiro uko succinylcholine ingashandiswa, chiremba wako achakupa mirairo yakatarwa pamusoro pemishonga yekupfuurira kana kumisa kwenguva pfupi.

Ndingatyaira Mushure meKuwana Succinylcholine?

Hamufaniri kutyaira kwemaawa angangoita 24 mushure mekuwana succinylcholine, sezvo ichigara ichipiwa pamwe chete neanesthesia yakajairika panguva yezvipatara. Iyo anesthesia inokanganisa kutonga kwako, reflexes, uye kubatana kwenguva refu mushure mekunge succinylcholine yapera.

Muchada mumwe munhu kuti akutyairire kumba mushure mekuvhiyiwa kwako, uye munofanira kudzivisa kuita zvisarudzo zvakakosha kana kushandisa michina kusvikira mapora zvizere kubva ku anesthesia.