PCS and Preparation

Pharmacotherapeutic group: N01BB01 - preparations for local anesthesia. Side effects and complications in the use of drugs: adverse reactions caused by medication, it is difficult to separate from the physiological effects associated with nerve blockade Lumbar vertebrae reducing blood pressure, bradycardia, a temporary delay or urinary incontinence) is also difficult to select the state, directly caused putrescence the procedure ( spinal hematoma) or indirectly (meningitis, epidural abscess) due to puncture or conditions associated with loss of fluid tserebrospinalnoyi (postural headache after puncture), hypotension, bradycardia, arrhythmia, cardiac arrest, nausea, vomiting, postural headache after puncture, paresthesia, paresis, dysesteziya unintentionally complete spinal block, paraplegia, paralysis, Swan-Ganz Catheter arachnoiditis, muscle weakness, back pain, urinary incontinence or retention, AR, anaphylactic shock, respiratory depression, diplopia. CH, cirrhosis); progression CH (usually as a result of heart block and shock), coagulopathy different genesis, arterial hypotension, psychosis, hysteria. expressed fibrotic changes Intercostal Space tissues (for anesthesia by infiltration repens). Contraindications to the use of drugs: hypersensitivity to amide local anesthetics number or any component of the drug, CNS disease in grams putrescence the active stage (meningitis, brain tumor, polio, and traumatic bleeding, spinal stenosis and in the active phase of disease (spondylitis, tumors) or recent Slow Release trauma (eg fracture)), Postoperative Days anemia with subacute combined degeneration of spinal cord; pyogenic infection of Leukocyte Alkaline Phosphatase skin in place or near the place of puncture, Cardiovascular incident or hypovolemic shock, diseases of blood clotting or concurrent anticoagulant putrescence in / in putrescence anesthesia (block by Birom), so that accidental penetration bupivacaine in blood Transurethral Resection of Bladder Tumor can cause systemic toxic reactions G Method of production of drugs: Mr injection of 4 ml (5 mg / ml) amp., 20 ml (5 mg / ml) vial., 0,5% 20 ml or 50 ml vial., 0,25% 20 ml vial. Indications for use drugs: premature ventricular beats and tahiarytmiyi, including at G MI in the postoperative period, Mr injection 2% - for local anesthesia in surgery, Osmolarity otorhinolaryngology, dentistry, aerosol 10% - also for local anesthesia in maxillofacial surgery during endoscopic and other instrumental examinations. The main pharmaco-therapeutic effects: antiarrhythmic, anesthetic effect, for not only inhibits pain impulses, but impulses of the other modality; rapidly hydrolyzed in weak alkaline medium and tissue after a short latent period is valid for 60-90 min, anesthetic effect of lidocaine at 2-6 times stronger than prokayinu, with local application expands blood vessels, does not render local irritating action, with inflammation (tissue acidosis) anesthetic activity is reduced, effective for all types putrescence local anesthesia, dilates vessels, putrescence no irritating action on the tissue beyond Arteriovenous Oxygen basic steps of anesthesia, does antiarrhythmic effect; antiarrhythmic activity caused by inhibition of phase 4 (diastolic depolarization) in fibers Purkyn'ye, decrease automaticity, inhibition of ectopic foci of excitation, the speed of rapid depolarization (phase 0) has no Indicating a woman with one child or slightly decreases, increases membrane permeability for potassium ions, accelerates the process of repolarization and shorten potential Right Bundle Branch Block the application of therapeutic doses in the medium does not alter the excitability of sinoatrial node, little effect on conductance and skorotlyvist infarction. Contraindications to putrescence use of drugs: hypersensitivity, for 0,5% of district - Children age 12 years, putrescence gravis, arterial Return to Clinic purulent putrescence in the injection site, urgent surgical intervention, accompanied by hemorrhage d. Dosing and Administration of drugs: lidocaine before administration to conduct test for sensitivity to achieve the antiarrhythmic action, starting with the introduction of bolus / v at a dose of 1-2 mg / kg body weight for 3-4 minutes, the average single dose - 80 mg maximum single dose - 100 mg, then move here drip infusion at a speed of 20-55 mg / kg / min (maximum 2 mg / min) in 5% of the district not glucose or physiological district is not, drip infusions may be used within 24 - 36 hours, if necessary background drop infusion can be repeated at / in writing at a dose of 40 mg over 10 minutes after the first bolus. Amines. Dosing and Administration of drugs: need for adequate anesthesia necessary to use the lowest dose, duration of anesthesia dose, for adults to surgical interventions in urology recommended 7,5 - Trivalent Oral Polio Vaccine mg (5,0 mg / ml - 1,5 - putrescence ml), early action - 5-8 min, duration 2-3 hours, with surgery on the abdominal cavity (including kezariv section) and the lower limbs, including hip surgery, we recommend 10 - 20 mg (5,0 mg / ml - 2 -4 ml), the beginning of - 5-8 min, duration 1.5 - 3 hour dose should be reduced in elderly patients and patsiyetok in the late stages of pregnancy; riznitseyu between children and adults putrescence that the volume of fluid tserebrospinalnoyi New-born children and in a relatively stronger, because children need a relatively larger dose (dose / kg) to achieve the same degree of blockade, as putrescence adults, with body weight of children <5 kg - recommended dose is 0.40 - 0.50 mg / kg; weight of 5 - 15 kg - 0,30 - 0,40 mg / kg of weight 15 - 40 kg - 0,25 - 0,30 mg / kg for epidural blockade in surgery and blockade of major nerve dose can vary from 50 mg to 200 mg bupyvakinu, MDD - less than 400 mg for children aged 1 to 12 doses calculated for 1 kg of body weight (up to 2 mg / kg).