Анестетики общие

Анестетики общие - введения        |                            |                                 |                                   |                               | список А           | |                             | препарата                 |                            |                                 |                                   |                               |                          | |                             | мышечный тонус       |                            |                                 |                                   |                               |                          | |                             | сохраняется,             |                            |                                 |                                   |                               |                          | |                             | гортанные и              |                            |                                 |                                   |                               |                          | |                             | глоточные рефлексы |                            |                                 |                                   |                               |                          | |                             | повышаются,            |                            |                                 |                                   |                               |                          | |                             | слюноотделение       |                            |                                 |                                   |                               |                          | |                             | усиливается.             |                            |                                 |                                   |                               |                          | |                             | Оказывает                |                            |                                 |                                   |                               |                          | |                             | выраженный              |                            |                                 |                                   |                               |                          | |                             | аналгетический         |                            |                                 |                                   |                               |                          | |                             | эффект,                    |                            |                                 |                                   |                               |                          | |                             | сохраняющийся в     |                            |                                 |                                   |                               |                          | |                             | посленаркозном        |                            |                                 |                                   |                               |                          | |                             | периоде                    |                            |                                 |                                   |                               |                          | |------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | Натрия                | Нетоксичный             | Для достижения  | Вводный наркоз,       | Миастения,                | Тремор,                  | Порошок;          | | оксибутират,      | анестетик с низкой    | наркотического    | базисный наркоз в    | гипокалиемия             | двигательное         | ампулы по 10    | | Natrii oxybutyras    | наркотической           | эффекта             | сочетании с              |                                   | возбуждение,         | мл 20%             | |                             | активностью.            | препарат вводят  | ингаляционными       |                                   | рвота,                    | раствора; 5%    | |                             | Аналгетический         | внутривенно        | анестетиками или     |                                   | гипокалиемия         | сироп во           | |                             | эффект слабо           | (медленно) из      | средствами              |                                   |                               | флаконах по     | |                             | выражен. Обладает   | расчета 0,07—    | нейролептаналгезии. |                                   |                               | 400 мл.             | |                             | седативным,             | 0,12 г/кг               | Мононаркоз при        |                                   |                               | Хранение:         | |                             | снотворным,             | (ослабленным      | неполостных             |                                   |                               | список Б; в       | |                             | антигипоксическим    | больным —         | операциях с              |                                   |                               | защищенном от | |                             | действием.               | 0,05—0,07 г/кг);   | сохранением            |                                   |                               | света месте.     | |                             | Сознание                  | внутримышечно   | спонтанного              |                                   |                               | Вскрытые          | |                             | выключается через   | — 0,12—0,15 г/кг | дыхания.                  |                                   |                               | флаконы           | |                             | 5—7 мин (при            | или внутрь —      | Обезболивание         |                                   |                               | хранят в            | |                             | внутривенном           | 0,1—0,2 г/кг. Для | родов.                      |                                   |                               | холодильнике    | |                             | введении),                | обезболивания    | Предпочтителен у     |                                   |                               |                          | |                             | хирургический           | родов обычно      | ослабленных            |                                   |                               |                          | |                             | наркоз вызывает       | вводят в вену      | больных с                 |                                   |                               |                          | |                             | через 30—40 мин.     | 15 мл 20%           | гипоксическими        |                                   |                               |                          | |                             | Продолжительность  | раствора с 20 мл | явлениями, в            |                                   |                               |                          | |                             | наркоза — до 2—4    | 40% раствора      | педиатрии,               |                                   |                               |                          | |                             | ч. Снижает                | глюкозы или        | акушерстве              |                                   |                               |                          | |                             | содержание калия в  | дают внутрь в     |                                 |                                   |                               |                          | |                             | крови                        | дозе 2—4 г          |                                 |                                   |                               |                          | |------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | Преднон,            | Обладает слабой      | Вводят в вену в  | Вводный наркоз,       | Тромбофлебиты         | Раздражение и       | Ампулы и          | | Predionum             | наркотической           | виде 5%              | базисный наркоз в    |                                   | болезненность по   | флаконы           | | (синоним:             | активностью.            | раствора в дозах | сочетании с              |                                   | ходу вен, флебит   | емкостью 20     | | виадрил,               | Малотоксичен. При   | из расчета           | ингаляционными       |                                   |                               | мл)                    | | пресурен,             | внутривенном           | 0,01—0,012 г/кг   | анестетиками           |                                   |                               | содержащие по | | гидроксидион и     | введении наркоз       | (для вводного      | (эфиром,                  |                                   |                               | 0,5 г                  | | др.)                      | наступает через 3—  | наркоза) или        | фторотаном,             |                                   |                               | препарата.        | |                             | 5 мин и                     | 0,015—0,02 г/кг   | закисью азота),        |                                   |                               | Хранение:         | |                             | продолжается в        | (для моно- и        | мононаркоз               |                                   |                               | список Б; в       | |                             | среднем 30—40 мин  | базисного            |                                 |                                   |                               | защищенном от | |                             | (иногда до 2—3 ч).    | наркоза).             |                                 |                                   |                               | света месте      | |                             | Оказывает слабый    | Растворы            |                                 |                                   |                               |                          | |                             | аналгетический         | препарата           |                                 |                                   |                               |                          | |                             | эффект                     | готовят                |                                 |                                   |                               |                          | |                             |                                  | непосредственно |                                 |                                   |                               |                          | |                             |                                  | перед                  |                                 |                                   |                               |                          | |                             |                                  | употреблением    |                                 |                                   |                               |                          | |                             |                                  | на                       |                                 |                                   |                               |                          | |                             |                                  | изотонических     |                                 |                                   |                               |                          | |                             |                                  | растворах           |                                 |                                   |                               |                          | |                             |                                  | натрия хлорида   |                                 |                                   |                               |                          | |                             |                                  | или глюкозы, а    |                                 |                                   |                               |                          | |                             |                                  | так же на воде    |                                 |                                   |                               |                          | |                             |                                  | для инъекций.     |                                 |                                   |                               |                          | |                             |                                  | До введения        |                                 |                                   |                               |                          | |                             |                                  | предиона             |                                 |                                   |                               |                          | |                             |                                  | рекомендуют       |                                 |                                   |                               |                          | |                             |                                  | ввести в вену      |                                 |                                   |                               |                          | |                             |                                  | 0,25—0,5%          |                                 |                                   |                               |                          | |                             |                                  | раствор               |                                 |                                   |                               |                          | |                             |                                  | новокаина, а        |                                 |                                   |                               |                          | |                             |                                  | после предиона   |                                 |                                   |                               |                          | |                             |                                  | вену                    |                                 |                                   |                               |                          | |                             |                                  | «промывают»      |                                 |                                   |                               |                          | |                             |                                  | растворителем    |                                 |                                   |                               |                          | |                             |                                  | (для                    |                                 |                                   |                               |                          | |                             |                                  | профилактики      |                                 |                                   |                               |                          | |                             |                                  | боли и                 |                                 |                                   |                               |                          | |                             |                                  | раздражения       |                                 |                                   |                               |                          | |                             |                                  | стенки вены)       |                                 |                                   |                               |                          | |------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | Пропанидид,      | Является                  | Вводят                | Мононаркоз при        | Печеночная и             | Учащение дыхания | Ампулы по 10    | | Propanididum        | препаратом               | внутривенно        | кратковременных      | почечная                    | с последующим     | мл 5%               | | (синоним:             | ультракороткого        | (медленно) из      | операциях (в т.ч. в    | недостаточность,       | угнетением,            | раствора.          | | сомбревин,           | действия. При           | расчета 0,005—   | амбулаторных          | выраженная               | тахикардия,            | Хранение:         | | эпонтол и др.)       | внутривенном           | 0,01 г/кг               | условиях),                | сердечная и               | стимуляция            | список Б           | |                             | введении наркоз       | (ослабленным      | диагностических и    | коронарная                | моторной                |                          | |                             | развивается в           | больным из         | лечебных                  | недостаточность.       | активности             |                          | |                             | течение 20—40 с.      | расчета 0.003—   | манипуляциях.          | гипертензия. Не         | (вздрагивания,       |                          | |                             | Продолжительность  | 0,004 г/кг).           | Вводный наркоз        | рекомендуется           | непроизвольные     |                          | |                             | наркоза — 3—5         | Взрослым            |                                 | детям младше 4 лет   | движения), рвота в |                          | |                             | мин. Полное              | вводят в виде     |                                 |                                   | посленаркозном     |                          | |                             | восстановление        | 5% раствора,      |                                 |                                   | периоде,                |                          | |                             | через 20—30 мин      | детям, пожилым  |                                 |                                   | аллергические        |                          | |                             |                                  | и ослабленным    |                                 |                                   | реакции                  |                          | |                             |                                  | лицам — в виде  |                                 |                                   |                               |                          | |                             |                                  | 2,5% раствора.    |                                 |                                   |                               |                          | |                             |                                  | При повторном    |                                 |                                   |                               |                          | |                             |                                  | введении дозу     |                                 |                                   |                               |                          | |                             |                                  | препарата           |                                 |                                   |                               |                          | |                             |                                  | снижают на 1/4—  |                                 |                                   |                               |                          | |                             |                                  | 1/3                       |                                 |                                   |                               |                          | |------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | Тиопевтал-         | По основным             | Вводят                | Те же, что у              | Те же, что у               | Те же, что у           | Во флаконах,    | | натрий,               | свойствам близок к   | внутривенно        | гексенала                 | гексенала. Кроме       | гексенала, а также  | содержащих по | | Thiopentalum-        | гексеналу, но            | (медленно)          |                                 | того, препарат            | ларингоспазм и      | 0,5 и 1 г            | | natrium (синоним:  | несколько активнее   | взрослым в виде |                                 | противопоказан при    | бронхоспазм          | препарата.        | | пентотал-натрий,  | его. Вызывает           | 2—2,5%              |                                 | бронхообструктивных |                               | Хранение:         | | тионембутал и      | наркоз в течение       | растворов,          |                                 | заболеваниях             |                               | список Б; в       | | др.)                      | нескольких секунд.   | детям,                 |                                 |                                   |                               | прохладном,     | |                             | Продолжительность  | ослабленным       |                                 |                                   |                               | защищенном от | |                             | наркоза — 20—25     | больным и лицам |                                 |                                   |                               | света месте      | |                             | мин. Угнетает            | преклонного        |                                 |                                   |                               |                          | |                             | дыхание при             | возраста — в      |                                 |                                   |                               |                          | |                             | сохранении               | виде 1%              |                                 |                                   |                               |                          | |                             | гортанных и              | раствора.            |                                 |                                   |                               |                          | |                             | глоточных                 | Наркотическая    |                                 |                                   |                               |                          | |                             | рефлексов.               | доза для             |                                 |                                   |                               |                          | |                             | Аналгетический         | взрослых             |                                 |                                   |                               |                          | |                             | эффект                     | составляет 20—  |                                 |                                   |                               |                          | |                             | незначителен.           | 30 мл 2%             |                                 |                                   |                               |                          | |                             | Активирует               | раствора.            |                                 |                                   |                               |                          | |                             | вагусные реакции,     | Высшая разовая  |                                 |                                   |                               |                          | |                             | повышает секрецию  | доза для             |                                 |                                   |                               |                          | |                             | слизи, тонус              | взрослых в вену  |                                 |                                   |                               |                          | |                             | бронхов.                   | — 1 г. Растворы  |                                 |                                   |                               |                          | |                             | Гемодинамические    | препарата           |                                 |                                   |                               |                          | |                             | эффекты выражены  | готовят                |                                 |                                   |                               |                          | |                             | слабее, чем у            | непосредственно |                                 |                                   |                               |                          | |                             | гексенала, а              | перед                  |                                 |                                   |                               |                          | |                             | миорелаксирующий   | употреблением    |                                 |                                   |                               |                          | |                             | эффект сильнее.      | на воде для         |                                 |                                   |                               |                          | |                             | Вызывает                  | инъекций.            |                                 |                                   |                               |                          | |                             | длительный               | Растворы            |                                 |                                   |                               |                          | |                             | посленаркозный сон  | препарата           |                                 |                                   |                               |                          | |                             |                                  | нельзя                 |                                 |                                   |                               |                          | |                             |                                  | смешивать в       |                                 |                                   |                               |                          | |                             |                                  | одном шприце с  |                                 |                                   |                               |                          | |                             |                                  | дитилином,          |                                 |                                   |                               |                          | |                             |                                  | аминазином,        |                                 |                                   |                               |                          | |                             |                                  | пентамином,        |                                 |                                   |                               |                          | |                             |                                  | арфонадом и       |                                 |                                   |                               |                          | |                             |                                  | дипразином         |                                 |                                   |                               |                          | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Библиогр.: Бунятян А.А., Рябов Г.А. и Маневич А.З. Анестезиология и реаниматология, М., 1984; Справочник по анестезиологии, под ред. Л.П. Чепкого, с. 69, 78, Киев, 1987