Xov xwm

Keeb Kwm thiab Evolution ntawm INTRAVENOUS ANESTHESIA

Kev tswj hwm ntawm cov tshuaj muaj hnub nyoog rov qab mus rau xyoo pua 17th thaum Christopher Wren txhaj tshuaj yeeb tshuaj rau tus dev siv lub goose quill thiab npua zais zis thiab tus dev ua 'stupefied'. Hauv xyoo 1930s hexobarbital thiab pentothal tau nkag mus rau hauv kev kho mob.

Nws yog nyob rau xyoo 1960s Pharmacokinetic uas cov qauv thiab qhov sib npaug rau IV infusions tau tsim thiab hauv xyoo 1980, computer tswj IV infusion systems tau qhia. Nyob rau hauv 1996 thawj lub hom phiaj tswj infusion system ('Diprufusor') tau qhia.

DEFINITION

A phiaj tswj infusionyog ib qho infusion tswj nyob rau hauv xws li kev sim ua kom tiav cov neeg siv cov tshuaj concentration nyob rau hauv lub cev compartment ntawm kev txaus siab los yog cov ntaub so ntswg ntawm kev txaus siab. Lub tswv yim no tau pom thawj zaug los ntawm Kruger Thiemer hauv xyoo 1968.

PHARMACOKINETICS

Volume ntawm kev faib tawm.

Qhov no yog qhov pom meej ntim uas cov tshuaj tau muab faib. Nws yog xam los ntawm cov mis: Vd = koob tshuaj / concentration ntawm tshuaj. Nws tus nqi nyob ntawm seb nws puas yog xam thaum lub sij hawm xoom - tom qab ib qho bolus (Vc) los yog nyob rau hauv lub xeev khov kho tom qab infusion (Vss).

Clearance.

Clearance sawv cev rau qhov ntim ntawm plasma (Vp) uas cov tshuaj raug tshem tawm hauv ib chav tsev ib lub sijhawm kom suav rau nws tshem tawm ntawm lub cev. Clearance = Elimination X Vp.

Raws li kev tshem tawm nce ib nrab-lub neej txo, thiab raws li qhov ntim ntawm kev faib tawm nce li ntawd, ib nrab-lub neej. Kev tshem tawm kuj tuaj yeem siv los piav qhia tias cov tshuaj txav nrawm npaum li cas ntawm cov khoom siv. Cov tshuaj yog pib faib mus rau hauv nruab nrab compartment ua ntej muab faib mus rau peripheral compartments. Yog tias qhov pib ntim ntawm kev faib tawm (Vc) thiab qhov xav tau qhov xav tau rau kev kho cov nyhuv (Cp) paub, nws tuaj yeem suav cov tshuaj thauj khoom kom ua tiav qhov concentration:

Loading dose = Cp x Vc

Nws kuj tseem tuaj yeem siv los suav cov koob tshuaj bolus uas yuav tsum tau ua kom ceev cov concentration thaum lub sijhawm ua haujlwm tas mus li: Bolus koob = (Cnew – Cactual) X Vc. Tus nqi ntawm infusion kom ruaj khov lub xeev = Cp X Clearance.

Cov txheej txheem yooj yim infusion tsis ua tiav lub xeev cov ntshav plasma concentration kom txog thaum tsawg kawg tsib qhov kev tshem tawm ib nrab ntawm lub neej. Qhov xav tau qhov xav tau tuaj yeem ua tiav sai dua yog tias cov koob tshuaj bolus tau ua raws li tus nqi infusion.