Tetracaine hmoov, tseem hu ua lidocaine los yog lidocaine, yog ib qho kev sib xyaw nrog cov khoom siv tshuaj tshwj xeeb thiab yog ib qho tshuaj loog hauv zos tshuaj loog thiab tshuaj tua kab mob tsim nyog rau ntau yam koob punctures thiab phais tshuaj loog ntawm daim tawv nqaij thiab mucous daim nyias nyias. Lub hauv paus ntsiab lus yog tias nws tsim cov tshuaj loog los ntawm kev thaiv kev sib kis ntawm cov paj hlwb, ua haujlwm ntawm sodium channels ntawm cov cell membrane, tiv thaiv sodium ions los ntawm kev nkag mus rau paj hlwb, yog li inhibiting kev sib kis ntawm paj hlwb impulses. Nyob rau tib lub sijhawm, nws muaj qee qhov txaus ntshai, yog li cov cai tswj kev nyab xeeb thiab cov txheej txheem ua haujlwm yuav tsum tau ua raws li nruj me ntsis thaum khaws cia. Khaws kom deb ntawm qhov chaw taws teeb thiab khaws cia hauv qhov chaw txias, qhuav. Tsis tu ncua xyuas cov khoom kom ntseeg tau tias nws nyob rau hauv qhov zoo.
Peb muabtetracaine hmoov, thov xa mus rau lub vev xaib hauv qab no kom paub meej cov lus qhia tshwj xeeb thiab cov ntaub ntawv khoom.
tetracaine hmoov siv tau rau dab tsi?
Tetracaine hmoovfeem ntau yog siv rau qhov chaw tshuaj loog hauv ophthalmology, xws li corneal suturing thiab cataract phais; Kev siv tshuaj loog mucosal feem ntau yog siv hauv kev phais otolaryngology, xws li tonsillectomy thiab adenoidectomy. Nws cov nyhuv tshuaj loog tuaj yeem txo cov neeg mob qhov mob thiab tsis xis nyob, thiab txhim kho kev ua haujlwm zoo ntawm kev phais.
Nerve Block
Epidural thaiv:Tetracaine hmoovcov tshuaj uas nquag siv ntau ntawm {{0}}.15% 0.3% yog siv ua ke nrog lidocaine hydrochloride, nrog rau qhov siab tshaj plaws ntawm 0.3%. Qhov ntau npaum li cas yog 4050mg thiab qhov siab tshaj plaws yog 80mg.
Subarachnoid block: Feem ntau siv sib xyaw (1ml ntawm 1% lidocaine hydrochloride tov nrog 1ml ntawm 10% qabzib txhaj tshuaj thiab 1ml ntawm 3% ephedrine hydrochloride), nrog rau ntau npaum li cas ntawm 10mg, 15mg raws li qhov txwv, thiab 20mg raws li qhov ntau npaum li cas.
Nerve conduction block: Feem ntau siv cov ntsiab lus ntawm cov tshuaj no yog {{0}}.1% 0.2%, nrog rau ntau npaum li cas ntawm 4050mg thiab ntau npaum li cas ntawm 100mg.
Mucosal deg tshuaj loog: Qhov feem ntau siv concentration ntawm cov tshuaj no yog 1%. Ophthalmology siv 1% isotonic tov, thiab otolaryngology siv 1% ~ 2% tov. Qhov txwv rau ib koob tshuaj yog 40mg.
Dab tsi yog qhov zoo ntawm lidocaine hmoov piv rau lwm cov tshuaj loog hauv zos?
Cov nyhuv tshuaj loog muaj zog thiab ntev ntev
- Tetracaine hmoovyog ib qho tshuaj loog hauv zos ntev nrog cov tshuaj loog muaj zog thiab ntev ntev. Cov nyhuv feem ntau tshwm sim hauv 1 mus rau 3 feeb thiab tuaj yeem kav ntev li 2 mus rau 3 teev ntawm kev siv tshuaj loog.
- Piv nrog rau lwm cov tshuaj loog hauv zos xws li procaine, uas muaj cov teebmeem tsis muaj zog lossis luv luv, tetracaine muaj qhov zoo ntawm cov tshuaj loog qhov tob thiab ntev.
Muaj zog mucosal penetration muaj peev xwm
- Cov tshuaj no muaj peev xwm nkag mus rau mucosal muaj zog thiab tuaj yeem nkag mus rau cov ntaub so ntswg sai, ua rau cov tshuaj loog.
- Cov yam ntxwv no ua rau nws tshwj xeeb tshaj yog siv tshuaj loog rau ntawm qhov chaw mucosal, xws li lub qhov muag, qhov ntswg, caj pas, thiab cov zis.
Kev siv dav dav
- Cov tshuaj no tuaj yeem siv tsis tau tsuas yog rau cov tshuaj loog ntawm qhov chaw mos, tab sis kuj rau cov hlab ntsha thaiv cov tshuaj loog, epidural tshuaj loog, thiab lwm yam.
- Hauv kev kho mob, cov tshuaj no tuaj yeem siv rau kev npaj tshuaj loog ua ntej ntau yam kev phais thiab kev kuaj mob, xws li kev kho hniav, otolaryngology, ophthalmology, nrog rau subarachnoid block, paj hlwb, thiab lwm yam.
Dab tsi yog qhov tsis zoo ntawm cov tshuaj no piv rau lwm cov tshuaj loog hauv zos?
Toxic teebmeem:
- Cov tshuaj muaj toxicity siab thiab muaj qhov tshwm sim ntawm cov tshuaj lom neeg. Cov tshuaj lom neeg feem ntau yog qaug dab peg thiab lwm yam hauv nruab nrab paj hlwb tshwm sim, uas cuam tshuam rau nws cov lipid solubility siab thiab cov yam ntxwv nqus sai.
- Thaum nws nqus tau sai thiab loj heev, cov ntshav plasma concentration yuav nce sai, uas yuav ua rau muaj kev cuam tshuam hauv nruab nrab.
Tsis siv tau rau qee txoj kev siv tshuaj loog:
- Cov tshuaj no feem ntau tsis siv rau infiltration anesthesia vim tias nws muaj qhov pib qeeb, tsis zoo diffusion, thiab ua rau muaj tshuaj lom.
- Nws kuj tsis tsim nyog rau kev txhaj tshuaj rau hauv cov hlab ntsha thiab cov hlab ntsha hauv cov hlab ntsha, vim tias nws qhov nqus tau nrawm, thiab yog tias nws nkag mus rau hauv cov hlab ntsha thiab qhov ntau npaum li cas, cov tshuaj lom neeg tuaj yeem tshwm sim.
Nws muaj cov nyhuv inhibitory ntawm lub plawv:
- Cov tshuaj no muaj quinidine zoo li cuam tshuam rau lub plawv, uas tuaj yeem cuam tshuam cov myocardium, txo qis myocardial contractility, nce diastolic ntim, thiab txo cov ntshav siab.
- Thaum muaj siab ntau, lidocaine tuaj yeem cuam tshuam cov myocardium, thiab thaum mob hnyav, nws tuaj yeem ua rau lub plawv tsis ua haujlwm, ventricular fibrillation, lossis mob plawv.
Kev tsis haum tshuaj:
- Tetracaine tuaj yeem ua rau cov tsos mob ua xua xws li pob khaus, thiab cov neeg mob uas muaj kev fab tshuaj hnyav tuaj yeem ua rau tuag sai tom qab siv.
Kev txwv tshuaj:
- Vim muaj cov tshuaj lom thiab inhibitory cuam tshuam rau lub plawv ntawm tetracaine, nws cov koob tshuaj thiab concentration yuav tsum tau tswj nruj me ntsis.
- Cov neeg mob uas muaj lub plawv thiab lub raum tsis ua haujlwm, nrog rau cov neeg uas muaj kev fab tshuaj hnyav, yuav tsum tsis txhob siv cov tshuaj no.
Cov tshuaj lom ntawm Tetracaine hmoov yog dab tsi?
Cov tshuaj no yog cov tshuaj ester ntev hauv zos, thiab nws cov tshuaj toxicity feem ntau suav nrog cov hauv qab no:
Neurological teb
Central nervous system suppression: Ntau lidocaine yuav hla cov ntshav-hlwb teeb meem, ua rau txo qis membrane stability ntawm paj hlwb thiab ua rau paj hlwb impulse conduction teeb meem. Qhov no tuaj yeem ua rau muaj qhov tshwm sim loj xws li tsis nco qab, tsis nco qab, thiab txawm tuag.
Cov leeg tremors: Tetracaine kuj tseem tuaj yeem cuam tshuam qhov kev tso tawm ib txwm muaj thiab xa cov neurotransmitters, nce postsynaptic membrane excitability thiab ua rau cov leeg nqaij. Qhov no yuav ua rau mob hnyav dua lossis ua rau tsis xis nyob, ua rau tus mob hnyav ntxiv.
Cardiovascular system teb
Lub plawv dhia qeeb: Tetracaine tuaj yeem ua ncaj qha rau ntawm lub plawv, cuam tshuam nrog cov haujlwm electrophysiological ntawm myocardial cells, ua rau lub plawv dhia qeeb. Txawm li cas los xij, thaum mob hnyav, nws tuaj yeem ua rau bradycardia, mob plawv, thiab lwm yam kev phom sij rau lub neej.
Ntshav siab poob: Cov tshuaj no muaj cov txiaj ntsig ntawm dilating cov hlab ntsha, txo qis peripheral vascular tsis kam, thiab txo cov ntshav rov qab, yog li cuam tshuam rau kev ua haujlwm ntawm lub plawv. Qhov no tuaj yeem ua rau cov tsos mob xws li kiv taub hau thiab xeev siab, thiab thaum mob hnyav, kev poob siab yuav tshwm sim.
Respiratory system teb, mob plawv
Ua pa tsis ua haujlwm: Nws muaj cov tshuaj loog rau hauv nruab nrab lub paj hlwb thiab tej zaum yuav ua rau lub cev ua pa tsis zoo, ua rau muaj xwm txheej kub ntxhov xws li ua pa nyuaj thiab ua tsis taus pa. Yuav tsum tau kho cov pa oxygen tam sim thiab kev kho mob txhawb nqa.
Respiratory system teb, mob plawv
Kev txo qis hauv plawv: Kev siv lidocaine ntau dhau tuaj yeem ua rau txo qis myocardial contractility, txo qis hauv plawv, thiab hauv cov mob hnyav, lub plawv tsis ua haujlwm thiab lwm yam kab mob. Lub caij no, vim nws qhov excitatory thiab inhibitory cuam tshuam rau hauv nruab nrab paj hlwb, kev nqus ntau dhau tuaj yeem ua rau qaug dab peg. Yog tias cov neeg mob ua xua rau cov tshuaj, lawv kuj yuav muaj kev tsis haum tshuaj xws li pob khaus thiab urticaria, thiab thaum mob hnyav, yuav tshwm sim sai sai.
Xaus
Thaum sivTetracaine hmoov, nws yog ib qho tsim nyog yuav tsum nruj me ntsis tswj cov koob tshuaj thiab ua tib zoo saib xyuas tus neeg mob cov cim tseem ceeb. Thaum muaj qhov txawv txav tshwm sim, cov tshuaj yuav tsum raug tso tseg tam sim ntawd thiab yuav tsum tau siv cov kev ntsuas kub ceev. Nyob rau tib lub sijhawm, cov neeg mob ua xua rau tetracaine, cov neeg uas muaj lub plawv thiab lub raum tsis ua haujlwm, thiab cov neeg uas muaj kev tsis haum tshuaj loj yuav tsum tsis txhob siv cov tshuaj no.