Amakuru

Amateka Yintego-Igenzurwa

Intego-Kugenzurwa Kugenzurwa (Tci) Nubuhanga bwo kwinjiza ibiyobyabwenge bya IV kugirango tugere ku mukoresha-wasobanuwe ("intego") kwibanda ku biyobyabwenge mu gice cyihariye cyangwa ahantu hashimishije. Muri iri suzuma, dusobanura amahame ya farumasikokitike ya TCI, guteza imbere sisitemu ya TCI, hamwe nibibazo bya tekiniki nubuyobozi byakemuwe mugutezimbere prototype. Turasobanura kandi gutangiza sisitemu yo kuboneka.

Intego yuburyo bwose bwo gutanga ibiyobyabwenge igerwaho no kubungabunga igihe cyo kuvura inzira yibiyobyabwenge, mugihe twirinda ingaruka mbi. Ibiyobyabwenge bya IV mubisanzwe bitangwa ukoresheje umurongo ngenderwaho. Mubisanzwe umurwayi wenyine wihangana yinjijwe muri dose ni metero yindwara yubunini, mubisanzwe uburemere bwa anesthetike. Ibiranga umurwayi nko mu bihe, igitsina, cyangwa ibiremwa biremwa birimo gushyirwaho kubera umubano wimibare igoye kuri iyi covariates kuri Dove. Mu mateka habaye uburyo 2 bwo kuyobora ibiyobyabwenge muri IV mugihe cya Anesthesia: Bolus dose hamwe no gukomeza kwiyuhagira. Ibikorwa bya bolus mubisanzwe bikorwa hamwe na syringe yashushanyije. Gutera ubusanzwe bitangwa hamwe na pompe ya infundo.

Ibiyobyabwenge byose anengengo birundanya muri tissue mugihe cyo gutanga ibiyobyabwenge. Iyi kirego iterana isano iri hagati yikigereranyo cyashizweho na clinician hamwe nubushake bwibiyobyabwenge mumurwayi. Igipimo cya Propofol cya 100 μg / kg / min bifitanye isano no kuba umuhanga hafi iminota 3 muzuba cyangwa umurwayi upakurura cyane cyangwa usinziriye nyuma yamasaha 2. Mu gukoresha amahame ya Pharumacucinet neza (PK), mudasobwa irashobora kubara ibiyobyabwenge byakusanyije mubice mugihe cyo guhungabanya kandi bishobora guhindura igipimo cyizuba kugirango ukomeze kwibanda ku plasma cyangwa uturere twinyungu, ubwonko. Mudasobwa irashobora gukoresha icyitegererezo cyiza mubitabo, kubera ko imibare yo gushiramo imiterere yumurwayi (uburemere, uburebure, ibitsina, hamwe nishingiro ryubwoko bwa mudasobwa itangwa na anesthetic, tci). Hamwe na sisitemu ya TCI, umuganga yinjiye kwifuza kwibanda. Mudasobwa irabara umubare wibiyobyabwenge, byatanzwe nkibisobanuro no gutera inshinge, bisabwa kugirango ugere kubitekerezo kandi bikayobora pompe ya infusi kugirango utange bolus ibarwa cyangwa kwinjiza. Mudasobwa buri gihe ibarwa ibiyobyabwenge biri muri tissue kandi neza uburyo ibyo bigira ingaruka kubiyobyabwenge bisabwa ukoresheje icyitegererezo cya PKS cicyitegererezo cyatoranijwe na Covariates Covariates.

Mugihe cyo kubaga, urwego rwo kubaga rushobora guhinduka vuba, rusaba neza, imigambi yihuse yo kugirirwa ibiyobyabwenge. Gutunga bisanzwe ntibishobora kongera ibitekerezo byibiyobyabwenge bihagije kugirango ubaze ubwiyongere butunguranye mubyuka cyangwa kugabanya kwibanda ku buryo buhagije bwo kubara igihe cyo kubara. Gutunga bisanzwe ntibishobora no gukomeza kwibanda ku biyobyabwenge cyangwa ubwonko mugihe cyo guhora tungura. Mugushiraho moderi ya PK, sisitemu ya TCI irashobora gusangira byihuse igisubizo nkuko bikenewe kandi kimwe no gukomeza kwibanda cyane mugihe bibaye ngombwa. Inyungu zishobora kuba clonicique nicyiciro cyukuri cyukuri cyingaruka za anesthetic.3

Muri iri suzuma, dusobanura amahame ya TCI, guteza imbere sisitemu ya TCI, hamwe nibibazo bya tekiniki nubuyobozi byakemuwe mugutezimbere prototype. Babiri baherekeza Ingingo zikubiyemo imikoreshereze ku isi n'ibibazo by'umutekano bijyanye n'iri koranabuhanga.4,5

Nkuko sisitemu ya TCI yahindutse, abashakashatsi bahisemo amagambo adashizweho na Methodoology. Sisitemu ya TCI yerekeje ku gihe cyagenwe na mudasobwa ya IV anesthesia (catia), 6 mu manota ya IV na Mudasobwa (TIAC), yagerwaho na mudasobwa ya mudasobwa. Kwemerwa nkibisobanuro rusange byikoranabuhanga.10