Analogs, cov lus qhia rau kev siv "Naropin". neeg xyuas

Anesthetics hu ua tshuaj uas muaj lub peev xwm los ntxias kom tsaug zog kiag.

Tshuaj loog - ib tug txo nyob rau hauv lub rhiab heev ntawm lub cev los yog nws qhov chaw. Tsis tas li ntawd, rau xws li ib tug lub xeev yog yus muaj los ntawm ib tug ua tiav tas ntawm xaav ntawm cov ntaub ntawv hais txog lub xeev ntawm tus kab mob thiab qhov ib puag ncig.

Nyob rau hauv kev kho mob xyaum, raws li ib tug ua kom loog yog feem ntau siv tshuaj "Naropin." Cov lus qhia rau kev siv, tiag tiag cov tub txawg yuav tau piav rau hauv qab no.

Muaj pes tsawg leeg, Muaj pes tsawg leeg thiab Packaging

Kev npaj "Naropin" qhia uas yog muaj nyob rau hauv ib tug duab los qhia nras yog tawm nyob rau hauv daim ntawv ntawm ib tug tshuaj tov. Nws yuav muaj xws li 2, 5, 7.5 los yog 10 mg ntawm no active ingredient li ropivacaine hydrochloride.

Nrog kev xav txog ntxiv Cheebtsam, ces siv rau lawv raws li hydrochloric acid los yog sodium hydroxide, thiab dej rau txhaj tshuaj thiab sodium tshuaj dawb.

Nyob rau hauv lub qhov muag ntawm lub tsev no yog nkag rau hauv vials.

Lub pharmacological cov yam ntxwv ntawm cov tshuaj

Yuav ua li cas yog cov tshuaj raws li "Naropin"? Cov lus qhia rau Siv hais tias qhov no ua kom loog amide series, uas yog tsim los rau mob nyem thiab ntawm lub zos tshuaj loog.

Kev siv cov me me koob tshuaj ntawm ropivacaine blockade tswj kev lub cev ib feem nrog txo rhiab heev uas tsis yog-progressive lub cev muaj zog ua si.

Nyob rau hauv siab noj tshuaj npaum cas ntawm cov tshuaj ua rau kev phais tshuaj loog.

thaj chaw ntawm cov tshuaj

Yuav ua li cas yog zoo tshaj plaws tshuaj "Naropin"? Cov lus qhia rau kev siv ntawd hais tias cov hauj lwm zoo ntawm no lub cuab tam yog vim nws muaj peev xwm reversibly txo cov permeability ntawm lub week ntawm paj fibers. Vim li no cov cawv, thiab tsub kom lub excitability Harbor depolarization tus nqi txo, uas nyob rau hauv lem ua rau lub zos thaiv cov hlab paj impulses.

Thaum uas siv cov ntau dua koob tshuaj sau tseg rau nws cov inhibitory nyhuv rau hauv lub plawv thiab Cns (deteriorating conductivity txo automatism thiab excitability).

Rau ropivacaine yam ntxwv ntev-lub sij hawm cov nyhuv. Lub duration ntawm lub kho nyhuv ntawm cov tshuaj ntau npaum yuav raug tom.

Thaum lub epidural thawj coj ntawm ib tug yeeb tshuaj yog nws ob-theem thiab ua kom tiav haum los ntawm lub epidural qhov chaw. Lub concentration ntawm ropivacaine nyob rau hauv cov ntshav nyob rau hauv tus qauv ntawm daim ntawv thov.

Lub kinetics ntawm yeeb tshuaj

Daim ntawv thov lus qhia ( "Naropin" yuav tsum tau muab nkaus xwb los ntawm ib tug tej anesthetist) qhia tias lub cuab tam muaj linear tshuaj. Vim rau qhov no, nws siab tshaj plaws nyob rau hauv concentration cov ntshav yog xwm yeem mus rau muab koob tshuaj.

Kev sib txuas lus nrog ntshav cov nqaijrog yog 94%.

Epidural thawj coj ntawm lub medicament rau ib ntev lub sij hawm tsub kom tag nrho cov ntshav concentration ntawm ropivacaine.

Lub active tshuaj yog suav tias yog txhais tau tias undergoes sai metabolic hloov dua siab tshiab. Nyob rau hauv thawj zaug rau theem nrab-lub neej lub sij hawm yog sib npaug zos mus rau ¼ xoob moos, thiab nyob rau hauv lub davhlau ya nyob twg - 240 feeb.

Thaum tso dej npaj 86% ntawm cov tshuaj yog tas los ntawm ob lub raum.

zaj lus tim khawv

Yuav ua li cas thaum xaus siv ib tug yeeb tshuaj raws li "Naropin"? Cov lus qhia rau kev siv (nyob rau hauv kev kho hniav, tshuaj no yog muab heev heev) hais tias cov tshuaj yog npaj rau tshuaj loog thaum phais:

• Yuav kom blockade loj qab haus huv thiab paj plexus.
• Nyob rau hauv kev txiav txim infiltration tshuaj loog thiab paj blockade neeg fibers.
• Rau epidural blockade nyob rau hauv kev txiav txim rau kev ua hauj lwm, xws li caesarean seem.

Nws yuav tsum tau muab sau tseg kuj tau hais tias cov tshuaj "Naropin" yog feem ntau siv rau cov nyem ntawm cov tsos mob ntawm mob mob:

• Rau heev blockade ntawm peripheral qab haus huv.
• Rau intra-articular kev txhaj tshuaj.
• Nyob rau hauv kev txiav txim infiltration tshuaj loog thiab paj blockade neeg fibers.
• Thaum lub caij nyoog epidural Txoj kev lis ntshav, bolus periodicity los yog kev tiv thaiv kev mob nyob rau hauv ib tug postoperative lub sij hawm, raws li tau zoo raws li rau tshuaj loog thaum lub sij hawm ua hauj lwm rau.

Nws yuav tsum tau muab sau tseg tias cov tshuaj yog "Naropin" qhia nyob rau kev siv uas yog qhia hauv qab no, yog muaj kev koom siv rau lub nyem ntawm cov tsos mob ntawm mob mob nyob rau hauv xyuas cov neeg mob:

• rau caudal epidural thaiv nyob rau hauv cov me nyuam yau tshaj 12 xyoos, nrog rau me nyuam mos mos ab;
• rau heev epidural Txoj kev lis ntshav nyob rau hauv cov me nyuam mus txog 12 xyoo, nrog rau me nyuam mos cov me nyuam mos.

Contraindications

Yuav ua li cas yog cov contraindications ua kom loog yog "Naropin"? Cov lus qhia rau kev siv (rau cov leeg nrob tshuaj loog yog ib lub cuab tam yuav tsum tau muab nkaus xwb los ntawm tej anesthesiologists) hais hauv qab no txwv:

• Npau taws me ntsis thiab, tau qhia los ntawm anesthetics ntawm lub amide series (xws li keeb kwm).
• Npau taws me ntsis rau ropivacaine thiab lwm yam ntawm cov formulation.

Nws yuav tsum tau muab sau tseg tias medicament "Naropin", ntau npaum yuav tsum tau xaiv uas tsuas ib tug kws, ceev faj nyob rau hauv cov neeg laus thiab debilitated cov neeg mob thiab kuj nyob rau hauv cov neeg mob uas muaj mob loj qhov xwm ntawm tus kab mob, nrog rau intracardiac conduction blockade, daim siab thiab lub raum pathology.

Huab ceev faj yuav tsum tau muab ib lub zos ua kom loog nyob rau hauv lub taub hau thiab lub caj dab vim hais tias ntawm qhov raug mob ntawm kev mob loj cov nyom tshua.

Nws yuav tsum tau kev pab tshwj xeeb thaum qhia cov tshuaj intra, tshwj xeeb tshaj yog nyob rau hauv loj poob plig thiab phais. Txwv tsis pub, tej zaum nws yuav ua rau nce haum ntawm cov tshuaj thiab ua rau kom nws cov ntshav concentration.

Vim lub underdevelopment ntawm lub zog thiab lub cev ntawm cov me nyuam rau lub hlis rau kev tshuaj loog nyob rau hauv no muaj hnub nyoog pab pawg neeg yuav tsum tau nqa tawm nrog huab ceev faj.

Cov tshuaj yog "Naropin": cov lus qhia rau kev siv rau cov me nyuam

Comments txog yam tshuaj no yuav tsum tau muab nthuav hauv qab no.

Thaum caudal epidural thawj coj rau lub nyem ntawm qhov mob syndromes me nyuam uas mus txog 25 kg nqa blockade injectable daws nyob rau hauv ib koob tshuaj 2 mg / kg.

Epidural Txoj kev lis ntshav los yog bolus txhaj tshuaj ntawm cov tshuaj yog nqa tawm nyob rau hauv raws li cov hnub nyoog ntawm cov me nyuam:

• 6-12 lub hlis: Txoj kev lis ntshav - 0.4 mg / kg / hr, ib tug bolus - 1 mg / kg;
• mus txog rau lub hlis: Txoj kev lis ntshav - 0.2 mg / kg / hr, ib tug bolus - 1 mg / kg.
• 1-12 xyoo: Txoj kev lis ntshav - 0.4 mg / kg / hr, ib tug bolus - 2 mg / kg.

Cov tshuaj "Naropin": cov lus qhia rau kev siv

Lub ampoules kev ua kom loog yog muag nyob rau hauv tag nrho cov khw muag tshuaj.

Rau cov neeg laus, ntau npaum ntawm cov tshuaj yog xaiv tshwj xeeb. Lub anesthesiologist yuav tsum tau ua los ntawm lawv cov kev soj ntsuam raws li tau zoo raws li mus rau hauv tus account tus neeg lub xeev ntawm cov neeg mob.

Rau epidural thawj coj thaum phais siv 15-25 ml ntawm cov kua. Yog li pib ntawm kev txiav txim cai tom qab 20 feeb thiab kav rau 5 teev.

Ib tug zoo xws li cov nqi ntawm cov tshuaj siv thiab phais plab seem.

Blockade loj paj plexus ua los ntawm epidural thawj coj ntawm medicament nyob rau thoracic theem nyob rau hauv ib tug npaum li ntawm 5-15 ml.

Conduction thiab infiltration tshuaj loog nrog 1-30 ml ntawm cov tshuaj tau nyob rau hauv lub qhov pib ntawm cov nyhuv tom qab 5-15 feeb nrog ib tug ntev ntawm 2-6 teev.

tej tswv yim pom zoo

Ntau npaum "Naropin" tshuaj rau cov leeg nrob tshuaj loog yog tom nyob rau ntawm tus neeg mob mob. Tib yam siv rau lub blockade ntawm paj fibers.

Tshuaj loog brachial plexus yuav tsum tau nrog los ntawm kev phiv loj heev.

Nrog simultaneous siv lwm yam anesthetics tshaj plaws ntau npaum "Naropin" yuav tsum tsis txhob muaj ntau tshaj li 225 mg.

Yuav kom tiv thaiv txhob txwm txhaj tshuaj ntawm cov tshuaj mus rau hauv cov hlab ua ntej pib ntawm tus txheej txheem thiab thaum lub sij hawm nws yuav tsum tau yuav tsum tau nqa tawm aspiration xeem.

Cov kev taw qhia ntawm cov tshuaj no yog pom tau hais tias ib ntus intravascular heev lub plawv dhia. Thaum tsom kwm lom txiav txim yuav tsum tam sim ntawd cuam tshuam cov kev taw qhia ntawm cov tshuaj.

Thaum lub sij hawm tshuaj loog yog tsim nyog los saib xyuas cov lag luam uas tseem ceeb heev nruab nrog cev thiab tshuab ntawm tus neeg mob. Nws tseem yog tsim nyog los tswj nrog nws tsis tu ncua cov lus hu.

phiv

Phiv tshua uas tau raug cai nyob rau hauv daim ntawv thov xam tau tias yog txhais tau tias zoo ib yam li cov neeg thaum uas siv cov lwm amide anesthetics series. Yog li ntawd nws yog tsim nyog los paub qhov txawv cov kev phiv rau lub physiological cov tsos mob uas tshwm sim vim txhaws ntawm sympathetic qab haus huv.

Cov tshuaj yog "Naropin" rau cov leeg nrob tshuaj loog yuav ua bradycardia thiab hypotension. Tsis tas li ntawd nyob rau hauv lub chav kawm ntawm tshuaj loog nyob rau hauv cov neeg mob muaj kev nram qab no phiv tshua:

• xeev siab, tachycardia, mob taub hau, hypothermia;
• txos cov ntshav siab, tu-sauv, rov qab mob, ua tsis taus pa;
• ntuav, syncope, kub siab, kub taub hau;
• paresthesia, dysarthria, ua daus no, ntxhov siab vim;
• kiv taub hau, co, urinary tuav tseg.
• hypoesthesia, ua tsis taus pa, xws li loog loog ntawm tus nplaig;
• qaug dab peg, tingling, ua xua;
• perioral paresthesia nyob rau hauv lub cheeb tsam, arrhythmia, qhov muag plooj tsis pom kev;
• Angioedema, cardiac ntes, nqaij tu-sauv;
• anaphylactic tshwm sim.

analogs

Yuav ua li cas yuav hloov tau ua kom loog xws li "Naropin"? Cov lus qhia rau kev siv yuav muab cov lus teb rau lo lus nug no. Qab nws koj yuav tsum tau hu rau ib tug tej anesthesiologist.

Raws li ib tug txoj cai, es tsis txhob "Naropin" kws txawj feem ntau siv tshuaj xws li "Articaine", "Bupivacaine", "BlokkoS", "Alfakain SP", "lidocaine", "Brilokain-adrenaline", "mepivacaine," "Piromekain" "marcaine", "Skandonest", "Ultrakain", "Tsitokartin", "Trimekain", "Hirokain" thiab lwm tus neeg.

Nws yuav tsum tau sai li sai tau muab sau tseg tias txoj kev saib xyuas thiab noj tshuaj npaum cas hais txhais tau tias tej zaum yuav txawv ntau heev los ntawm cov neeg ntawm ib tug medicament "Naropin".

Xyuas

Tam sim no uas koj paub yuav ua li cas thiab vim li cas cov tshuaj tua kab siv xws li "Naropin." Cov lus qhia rau kev siv, tshuaj analogs uas tau raug hais saum toj no.

Ntau zaus tshaj tsis suav tias yog ib tug txhais tau tias cia lawv cov txheeb xyuas anesthetist. Thiab qhov no yog vim li, vim hais tias cov tshuaj no yog npaj rau me me thiab loj loj ua hauj lwm.

Feem coob ntawm cov lus teb tshwj xeeb zoo. Ntsiab lus lub tswvyim ntawm cov kws kho mob, ua kom loog yuav piav raws li ib lub sij hawm-mus soj ntsuam, txhim khu kev qha thiab muaj mob pesnrab pheej yig tshuaj.

Raws li rau cov neeg mob, lawv cov txheeb xyuas ntawm lub tsev no yuav luag yeej tsis tshwm sim.