Yini i-Succinylcholine: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Succinylcholine iyisidambisi semisipha esinamandla esisetshenziswa ngesikhathi sokuhlinzwa nezinqubo eziphuthumayo ukuze kuvaleke imisipha okwesikhashana. Lo muthi usebenza ngokushesha ukusiza odokotela ukuthi benze izinqubo ezisindisa impilo njengokufaka amashubhu okuphefumula noma ukulungiselela iziguli ukuhlinzwa lapho ukuphumula kwemisipha kubalulekile.

Yini i-Succinylcholine?

I-Succinylcholine iyisithiyo se-neuromuscular esibangela ukukhubazeka kwemisipha okwesikhashana. Ingaphansi kohlobo lwemithi ebizwa ngokuthi ama-depolarizing muscle relaxants, okusho ukuthi isebenza ngokuphazamisa amasignali ajwayelekile phakathi kwemizwa yakho nemisipha.

Lo muthi usetshenziswa kuphela ezindaweni zezokwelapha ezilawulwayo njengamakamelo okuhlinzela, iminyango esesimweni esiphuthumayo, kanye namayunithi okunakekelwa okukhulu. Abahlinzeki bezempilo bayawusebenzisa uma kudingeka ukuthi baphumule ngokushesha yonke imisipha yomzimba wakho, okuhlanganisa naleyo esetshenziselwa ukuphefumula, yingakho ihlale inikezwa ngosekelo lokungenisa umoya ngomshini.

Umuthi usebenza phakathi kwemizuzwana engama-30 kuya kwengama-60 futhi uvame ukuhlala imizuzu emi-5 kuya kweli-10. Ngenxa yokuqala kwayo okusheshayo nobude obufushane, ochwepheshe bezokwelapha bavame ukuyibiza ngokuthi "sux" futhi bayibheka njengengabalulekile ezimweni eziphuthumayo lapho ukuphumula kwemisipha okusheshayo kungasindisa izimpilo.

Isetshenziselwani i-Succinylcholine?

I-Succinylcholine isetshenziswa ikakhulukazi ukwenza lula ukufakwa kwe-endotracheal intubation, okusho ukusiza odokotela ukuthi bafake ishubhu lokuphefumula emoyeni wakho. Le nqubo ibalulekile ngesikhathi sokuhlinzwa uma udinga ukuba ku-ventilator noma ezimweni eziphuthumayo lapho othile engakwazi ukuphefumula yedwa.

Lo muthi futhi usiza ngesikhathi sezinqubo ezithile zokuhlinzwa lapho ukuphumula okuphelele kwemisipha kudingekile. Odokotela abahlinzayo bangase badinge ukuthi imisipha yakho inganyakazi nhlobo ukuze benze imisebenzi ebuthaka, ikakhulukazi ngaphandle kwesisu, isifuba, noma uma besebenza eduze kwezitho ezibalulekile.

Odokotela bezokwelapha eziphuthumayo basebenzisa i-succinylcholine uma umuntu edinga ukuphathwa komgudu womoya ngokushesha. Lokhu kungenzeka ngesikhathi sokuboshwa kwenhliziyo, ukulimala okukhulu, noma uma umuntu enobunzima bokuphefumula futhi edinga ukungenelela ngokushesha ukuze asinde.

Isebenza Kanjani I-Succinylcholine?

I-Succinylcholine isebenza ngokuvimba ukuxhumana phakathi kwemizwa yakho nemisipha yakho endaweni yokuxhumana yemisipha. Cabanga ngayo njengokunqamula okwesikhashana ucingo phakathi kobuchopho bakho nemisipha yakho, ukuvimbela noma yimiphi imiyalo yokunyakaza ukuthi ingangeni.

Lokhu kuthathwa njengomuthi onamandla kakhulu ngoba kubangela ukukhubazeka okuphelele kwayo yonke imisipha yokuzithandela, okuhlanganisa naleyo oyisebenzisela ukuphefumula. Ukukhubazeka kwenzeka ngendlela elindelekile, kuqala ngemisipha emincane ebusweni bakho nasemehlweni, bese idlulela ezingalweni zakho, futhi ekugcineni ithinte i-diaphragm yakho nemisipha yokuphefumula.

Umuthi uhlakazwa ngokushesha ngama-enzyme egazini lakho abizwa ngokuthi ama-pseudocholinesterases. Lokhu kuhlakazeka okusheshayo yikho okwenza imiphumela iphele ngokushesha, ngokuvamile phakathi kwemizuzu emi-5 kuya kweli-10, okwenza kuphephe ezinhlelweni ezimfushane.

Kufanele Ngiyithathe Kanjani I-Succinylcholine?

Ngeke nanini uzithathele wena i-succinylcholine - iphethwe kuphela ochwepheshe bezokwelapha abaqeqeshiwe ezindaweni zasemtholampilo. Umuthi unikezwa ngomugqa we-intravenous (IV) ngokuqondile egazini lakho noma njengomjovo we-intramuscular emsipheni omkhulu.

Ngaphambi kokuthola i-succinylcholine, ngokuvamile uzonikezwa i-anesthesia ejwayelekile ukukwenza ungaqapheli. Lokhu kubalulekile ngoba umuthi ukhubaza kuphela imisipha yakho kodwa awuthinti ukuqaphela kwakho noma ukuzwa ubuhlungu, ngakho-ke udinga ukulala kuqala.

Abahlinzeki bezempilo bazoba nayo yonke imishini edingekayo ngaphambi kokukunika lo muthi, okuhlanganisa ama-ventilator, i-oxygen, nemithi ephuthumayo. Bazophinda baqaphe isigqi senhliziyo yakho, umfutho wegazi, namazinga e-oxygen kuyo yonke inqubo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Succinylcholine?

I-Succinylcholine ayithathwa isikhathi eside - iyisidakamizwa esithathwa kanye kuphela esisetshenziselwa izinqubo ezithile. Imiphumela ngokuvamile ihlala phakathi kwemizuzu emi-5 kuya kweli-10, okuyisikhathi esanele odokotela ukuthi baqede inqubo edingekayo.

Uma kudingeka isikhathi eside sokuphumuza imisipha, ithimba lakho lezokwelapha lizoshintshela kolunye uhlobo lwemithi ephumuza imisipha ehlala isikhathi eside. I-Succinylcholine ikhethwa ngokuqondile lapho odokotela bedinga ukuqala ngokushesha kodwa bengafuni imiphumela ehlala isikhathi eside.

Isikhathi singahluka kancane kumuntu nomuntu ngokuya ngezinto ezinjengesisindo somzimba wakho, ukusebenza kwezinso, nokuthi umzimba wakho uyihlukanisa ngokushesha kangakanani imithi. Abantu abaningi babuyela ekusebenzeni okujwayelekile kwemisipha phakathi kwemizuzu eyi-10 kuya kwengama-30 ngemva kokuthola umthamo.

Yiziphi Imiphumela Eceleni Ye-Succinylcholine?

Imiphumela ejwayelekile kakhulu ye-succinylcholine ihlobene nezakhiwo zayo zokuphumuza imisipha. Ungase uzwe ubuhlungu bemisipha noma ukuqina ngemva kwenqubo, okufana nendlela ongazizwa ngayo ngemva kokuzivocavoca okukhulu.

Abanye abantu bazwa ukuthuthumela kwemisipha okufushane noma ama-fasciculations ngemva nje kokuthola imithi. Lokhu kubukeka kukhathaza kodwa empeleni kujwayelekile futhi kubonisa ukuthi umuthi usebenza njengoba kulindelekile.

Nawa imiphumela ejwayelekile ongase uyizwe:

• Ubuhlungu bemisipha noma izinhlungu ezihlala izinsuku eziyi-1-2
• Ukwanda kokukhiqizwa kwamathe
• Ushintsho oluncane esigqi senhliziyo
• Ukwanda kwesikhashana kwengcindezi yamehlo
• Ukwanda okuncane kwamazinga e-potassium egazini lakho

Le miphumela ngokuvamile imnene futhi iyazixazulula yodwa njengoba imithi isuka emzimbeni wakho.

Nakuba kungavamile, eminye imiphumela emibi ingenzeka futhi idinga ukunakekelwa kwezokwelapha ngokushesha. Lezi zimo ziqashwe eduze ithimba lakho lezokwelapha kuyo yonke inqubo.

Imiphumela emibi kodwa engavamile ihlanganisa:

• I-Malignant hyperthermia - ukwanda okuyingozi kwezinga lokushisa lomzimba
• Ukungezwani okukhulu komzimba okunezinkinga zokuphefumula noma ukuvuvukala
• Ukwanda okuyingozi kwamazinga e-potassium (i-hyperkalemia)
• Ushintsho olukhulu esigqi senhliziyo
• Ukuqina kwesitho esithile somzimba okuthatha isikhathi eside kunokulindelekile

Ithimba lakho lezokwelapha liqeqeshwe ngokukhethekile ukubona nokwelapha lezi zinkinga ngokushesha uma zenzeka.

Ubani Ongafanele Athathe I-Succinylcholine?

Abantu abathile akufanele bathole i-succinylcholine ngenxa yengozi eyengeziwe yezinkinga ezingathi sína. Ithimba lakho lezokwelapha lizobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokucabangela lo muthi.

Abantu abanezimo ezithile zofuzo ezithinta indlela abawuchitha ngayo umuthi bangase bahlangabezane nokuqina kwesitho esithile somzimba esithatha isikhathi eside. Lokhu kuhlanganisa nalabo abanokuntuleka kwe-pseudocholinesterase, isimo lapho umzimba wakho ungenayo ama-enzyme adingekayo ukuze uchithe i-succinylcholine ngokushesha.

Izimo ezenza i-succinylcholine ibe yingozi ikakhulukazi zihlanganisa:

• I-Muscular dystrophy noma ezinye izifo zemisipha
• Ukwasha okukhulu kwamuva noma ukulimala
• Ukulimala komgogodla
• Isifo esibi sezinso
• Umlando we-malignant hyperthermia
• Izimo ezithile ze-neurological njenge-ALS noma i-multiple sclerosis
• Ukuphumula embhedeni isikhathi eside noma ukunganyakazi kwamuva

Lezi zimo zingakhuphula ingozi yokukhuphuka okuyingozi kwe-potassium noma ezinye izinkinga ezingathi sína ezingase zibe yingozi ekuphileni.

Amagama Omkhiqizo we-Succinylcholine

I-Succinylcholine itholakala ngaphansi kwamagama amaningana omkhiqizo, i-Anectine ingelinye elisetshenziswa kakhulu. Amanye amagama omkhiqizo afaka i-Quelicin ne-Sucostrin, nakuba inguqulo ejwayelekile isetshenziswa kabanzi ezikhungweni eziningi zezokwelapha.

Kungakhathaliseki igama lomkhiqizo, zonke izinguqulo ziqukethe isithako esifanayo esisebenzayo - i-succinylcholine chloride. Ukukhethwa komkhiqizo kuvame ukuncika kulokho isibhedlela sakho noma isikhungo sezokwelapha esinakho.

Ezinye izindlela ze-Succinylcholine

Kunezindlela eziningi zokuthulisa imisipha ezingasetshenziswa esikhundleni se-succinylcholine, kuye ngesimo esithile sezokwelapha. Lezi zindlela ezihlukile ngokuvamile zisebenza kancane kodwa zihlala isikhathi eside kune-succinylcholine.

Ezinye izindlela ezivamile zihlanganisa i-rocuronium, i-vecuronium, ne-atracurium. I-Rocuronium ivame ukukhethwa ngoba isebenza cishe ngokushesha njenge-succinylcholine kodwa ayinazo izingozi ezifanayo zokunyuka kwe-potassium okuyingozi.

Ukukhetha enye indlela kuncike ezintweni ezifana nokuthi ukuthulisa imisipha kudingeka ngokushesha kangakanani, ukuthi inqubo izothatha isikhathi esingakanani, nezimo zakho zezokwelapha ezithile. Udokotela wakho we-anesthesiologist uzokhetha inketho ephephe kakhulu nefanele isimo sakho.

Ingabe i-Succinylcholine Ingcono Kune-Rocuronium?

I-Succinylcholine ne-rocuronium ngamunye unamathuba ahlukile ngokuya ngesimo somtholampilo. I-Succinylcholine isebenza ngokushesha, ngokuvamile ngemizuzwana engama-30-60, kuyilapho i-rocuronium ithatha imizuzwana engama-60-90 ukuze izuze ukuthulisa imisipha okufanayo.

Inzuzo enkulu ye-Succinylcholine ukuthi isebenza isikhathi esifushane kakhulu. Uma kukhona okungahambi kahle ngesikhathi sokufaka i-intubation, ukukhubazeka kuyaphela ngokushesha, okuvumela ukuphefumula kwemvelo ukuthi kubuyele. Lokhu kuyenza ibaluleke ikakhulukazi ezimweni eziphuthumayo lapho indlela yomoya ingase ibe nzima ukuyilawula.

I-Rocuronium, nokho, iphephe kakhulu kubantu abanezimo ezithile zezokwelapha. Ayibangeli ukunyuka kwe-potassium okuyingozi okungenzeka nge-succinylcholine, okuyenza ibe yindlela engcono ezigulini ezinokusha, ukulimala, noma izifo zemisipha.

Ukukhetha phakathi kwale mithi kuncike esimweni sakho sezokwelapha esithile, ukuphuthuma kwenqubo, nezici zakho eziyingozi. Ithimba lakho lezokwelapha lizokhetha inketho ephephe kakhulu nefanele wena.

Imibuzo Evame Ukubuzwa Nge-Succinylcholine

Ingabe i-Succinylcholine iphephile ezigulini ezinokugula kwenhliziyo?

I-Succinylcholine ingasetshenziswa ngokuphepha kubantu abanezifo zenhliziyo, kodwa idinga ukuqashwa ngokucophelela. Umuthi ungabangela izinguquko zesikhashana esigqi senhliziyo nokukhuphuka okuncane kwamazinga e-potassium, okuzoqashwa ngokusondela ithimba lakho lezokwelapha.

Abantu abanenhliziyo ehlulekayo kakhulu noma izifo ezithile zesigqi senhliziyo bangase badinge imithi ehlukile. Udokotela wakho wenhliziyo kanye nodokotela we-anesthesiologist bazosebenzisana ukuze banqume indlela ephephe kunazo zonke yesimo sakho senhliziyo esithile.

Kufanele ngenzeni uma ngithola i-Succinylcholine eningi ngengozi?

Awukwazi ukuthola i-succinylcholine eningi ngengozi ngoba inikezwa kuphela ochwepheshe bezokwelapha abaqeqeshiwe ezindaweni ezilawulwayo. Uma i-overdose ingenzeka, izobonwa ngokushesha futhi iphathwe ithimba lakho lezokwelapha.

Ukwelashwa okuyinhloko kwe-succinylcholine overdose ukunakekelwa okusekelayo, okuhlanganisa ukuqhubeka nokungenisa umoya ngomshini kuze kube yilapho imiphumela yomuthi iphela. Ithimba lakho lezokwelapha linemithetho ethile kanye nemishini elungele ukubhekana nanoma yiziphi izinkinga.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Succinylcholine?

Lo mbuzo awusebenzi ku-succinylcholine ngoba akuyona imithi oyithatha ngeshejuli. Inikezwa kanye kuphela ngesikhathi sezinqubo ezithile zezokwelapha ezindaweni zasemtholampilo.

Uma unemibuzo mayelana nemithi oyithatha ekhaya, kufanele uxhumane nodokotela wakho ovamile noma usokhemisi ukuze uthole isiqondiso mayelana nemithamo ephuthelwe.

Ngingayeka nini ukuthatha i-Succinylcholine?

I-Succinylcholine iyeka ukusebenza yodwa phakathi kwemizuzu emi-5-10 ngemva kokunikezwa. Akudingeki ukuthi wenze lutho ukuze umise imiphumela yayo - umzimba wakho ngokwemvelo uhlukanisa umuthi.

Uma ubuza mayelana nokuyeka eminye imithi ngaphambi kwenqubo lapho i-succinylcholine ingase isetshenziswe, udokotela wakho uzokunikeza imiyalelo ethile mayelana nokuthi iyiphi imithi okufanele uyiqhubeke noma uyiyeke okwesikhashana.

Ngingashayela ngemva kokuthola i-Succinylcholine?

Akufanele uqhube imoto okungenani amahora angama-24 ngemuva kokuthola i-succinylcholine, njengoba ihlala inikezwa ngaphansi kwe-anesthesia ejwayelekile ngesikhathi sezinqubo zezokwelapha. I-anesthesia ithinta ukwahlulela kwakho, ama-reflex, nokuxhumana ngemuva kokuthi i-succinylcholine isiphelile.

Uzodinga umuntu ozokuqhuba ekhaya ngemuva kwenqubo yakho, futhi kufanele ugweme ukwenza izinqumo ezibalulekile noma ukusebenzisa imishini kuze kube yilapho usululame ngokugcwele ku-anesthesia.