Nkhani

Mbiri ndi Chisinthiko cha Anesthesia Yam'mitsempha

Kupereka mankhwala kudzera m'mitsempha kunayamba m'zaka za m'ma 1700 pamene Christopher Wren anabaya opium mwa galu pogwiritsa ntchito chipolopolo cha goose quill ndi chikhodzodzo cha nkhumba ndipo galuyo 'anasokonezeka maganizo'. M'zaka za m'ma 1930, hexobarbital ndi pentothal zinayamba kugwiritsidwa ntchito kuchipatala.

Mu 1960, Pharmacokinetic inapangidwa mitundu ndi ma equation a ma IV infusions ndipo mu 1980, makina oyendetsera ma IV infusions oyendetsedwa ndi kompyuta anayambitsidwa. Mu 1996, makina oyamba oyendetsera ma IV infusions ('Diprufusor') anayambitsidwa.

TANTHAUZO

A kulowetsedwa kolamulidwa ndi cholingandi kulowetsedwa komwe kumayendetsedwa m'njira yoti munthu ayesere kupeza kuchuluka kwa mankhwala komwe wogwiritsa ntchito amafunikira m'thupi kapena minofu yomwe akufuna. Lingaliro ili linayambitsidwa koyamba ndi Kruger Thiemer mu 1968.

Mankhwala

Kuchuluka kwa kugawa.

Uwu ndi kuchuluka komwe mankhwala amagawidwa. Amawerengedwa pogwiritsa ntchito njira iyi: Vd = mlingo/kuchuluka kwa mankhwala. Mtengo wake umadalira ngati amawerengedwa pa nthawi ya zero - pambuyo pa bolus (Vc) kapena pamlingo wokhazikika pambuyo pa kulowetsedwa (Vss).

Chilolezo.

Kuchotsa mankhwala kumayimira kuchuluka kwa plasma (Vp) komwe mankhwala amachotsedwa pa unit nthawi iliyonse kuti awerengere kuchuluka kwa kuchotsedwa kwake m'thupi. Kuchotsa mankhwala = Kuchotsa X Vp.

Pamene kuchotsedwa kwa theka la moyo kumawonjezeka, theka la moyo limachepa, ndipo pamene kuchuluka kwa kugawidwa kumawonjezeka, theka la moyo limachepanso. Kuchotsedwa kungagwiritsidwenso ntchito kufotokoza momwe mankhwala amayendera mwachangu pakati pa zipinda. Mankhwalawa amayamba kugawidwa m'chipinda chapakati asanagawidwe m'zipinda zozungulira. Ngati kuchuluka koyambirira kwa kugawidwa (Vc) ndi kuchuluka komwe kukufunika kuti munthu alandire chithandizo (Cp) zimadziwika, n'zotheka kuwerengera mlingo wokweza kuti mupeze kuchuluka kumeneko:

Mlingo wokweza = Cp x Vc

Ingagwiritsidwenso ntchito kuwerengera mlingo wa bolus womwe umafunika kuti muwonjezere mwachangu kuchuluka kwa mankhwalawa panthawi yoperekera mankhwala mosalekeza: Mlingo wa Bolus = (Cnew - Cactual) X Vc. Mlingo wa kulowetsedwa kuti ukhalebe wokhazikika = Cp X Clearance.

Njira zosavuta zothira mankhwala sizimafika pamlingo wokhazikika wa plasma mpaka kufika pa ma multiples asanu a theka la moyo wa munthu. Kuchuluka komwe mukufuna kumatha kupezeka mwachangu ngati mlingo wa bolus ukutsatiridwa ndi kuchuluka kwa mankhwala.