Diethyl pulp

Chemical name

1,1-oksi-bis-etan

Gross

C4-H10-O

Characteristics

Colorless, transparent, it is very mobile, fly liquid with a smell and taste pepper. Ethylene glycol for narcosis contains 96-98% diethyl ether. Density ether narcosis to 0,713-0,714, ether medical 0.714 - 0.717, boiling point ^ 34-35 degrees and 34-36 degrees ^ respectively. When evaporation 1 ml ether narcosis to produce 230 ml steam; Density than air for narcosis 2.6, the relative molecular mass 74. Broken by the action of light, heat, air and moisture content with the formation of toxic aldehydes, peroxides and ketones, irritating the respiratory tract. Water solubility 1:12. Blending with alcohol, benzene, and essential fatty oils in all relationships. Easy to reach, including pair; in a relationship with oxygen, air or dinitrogen oxide pair ether for narcosis dangerous.

Of drugs

The drugs-publeanestezirutee. Nespecificski interacts with the cell membrane, mostly from dwuslanami lipidnami discs aksonov lead, oblong and spinal cord reversible change their ultrastrukturu and functions. Oppressing CNS : sinapticescuu blocks of the institution (mainly impoulsation blink), functionally desintegriruet korkov-podcorkove interaction while maintaining bulbarnah activity centres. It is clearly expressed classical stage narcosis, analgesia, arousal, surgical anaesthesia with three levels (light, medium, severe), and is characterized : the lack of awareness and all kinds of sensitivity, oppression Reflective reactions and relaxation skeletal Musculatura.v case Then, against a background of other inhaled or neingalih general anaesthetics classic picture narcosis is substantially changed. At the stage of analgesia reduces functional neuronal activity crust is amnesticeski effect. Under an oppressing bark brain turns subordinatip mechanisms controlling the subcortical structures (mostly from the middle brain). Increased activity subcortical entities is either motor, respiratory variation, AD pulse, etc.). This stage was more in adults than in children, less (or no), in the face Then base and narcosis. Annoyed mucous membranes, including of the oral cavity increases the secretion of salivary glands (gipersalivacia). The receptor troinicnogo zone, and gortang wandering nerves increases bronchial secretion; A cough, laringospazm, bronchial spasm (smeniatisa with deep anaesthesia expansion), respiratory disorders (Reflex Stimulation or oppression until patients) and heart (tachycardia or aetiology, cardiac arrest), hypertension. If your saliva or mucus, saturated ether, in the stomach irritates the mucous membrane, gift stimulates emetic centre of nausea and vomiting (at the start of narcosis and the awakening). Under surgical narcosis significantly inhibits mezhneironnuu transfer to the brain and spinal cord. Increases active divisions hypothalamus governing functions of the system-Gray napochechnikov bark, and the sympathetic nervous system, increases the secretion of glucocorticoids and catecholamines. Increases release of adrenaline think napochechnikov layer is giperglikemia, patients receptacles internal organs increases AD force heartbeat and curves (not sencibilisiruet miocard to kateholaminam). Activating the sympathetic nervous system suffers a dampening effect on tone receptacles AD and functions of the heart. Increases bleeding capillaries, oppressing irritative bowel (at the beginning of narcosis). Its skeletal muscles, as violates the central regulation of muscle strength and blocks of a local building postsinapticescoy membrane skeletal Mashtsy.v high concentrations directly inhibits breathing and sosudodwigatelny Centre (violation of pulmonary ventilation, gipotenzia), has a direct cardiodepressivne effect. The cooling lung tissue, which coupled with a concentration in the mucus bronchitis (because irritant effect) contributes to the development of pneumonia, more commonly in young children. Violate metabolism (loss of glycogen, fat infiltration), and the liver, including desintoksikatinuyu. Induces mikrosomaiona enzymes of zitohroma R450. Oppressing kidney function and reduces diurez, due to the release of antidiuretic hormone and reduce kidney receptacles. Many small breadth narkoznogo action (therapeutic index does not exceed 1.5), a relatively low toxicity organ (heart, liver, kidney). Elegant anaesthesia is a good controliruemostew and handling. In masernm way effect has been slow to develop, stage surgical narcosis is 15 to 20 minutes (the younger children sooner). Awakening

Indications

Ethylene glycol for narcosis : for inhalation narcosis (mixed or combined, potenzirovanny) incl. maintenance narcosis (usually mixed with oxygen and dinitrogen oxide, in the face of miorelaksantov, induction barbituratami narcosis, or dinitrogen oxide). Ethylene glycol Medicine : processing decayed cavities and root canals tooth (preparation for sealing).

Restrictions on the use of

Operation for the maxillofacial area (the explosion); Maserngo of narcosis using only ester; Children age, pregnancy, breast-feeding.

Pregnancy and lactation

Be wary of pregnancy (adequate clinical research has not been done), and during lactation (data on excretion in the women's milk is not available).

Contraindications

Pulmonary tuberculosis, acute respiratory disease, increased intracranial pressure, cardiovascular disease with a significant increase in AD, including hypertension, cardiac decompensation of severe liver disease and kidney, the total depletion, thyrotoxicosis and diabetes, the institute expressed disorders, transactions with elektrohirurgicakih tools, including elektrokoagulyatsii.

Side-Effects

From the respiratory system : hypersecretion bronchial glands, a cough, and laringo- bronhospazm, violations of pulmonary ventilation, or showing respiratory depression until patients, pneumonia and pneumonia (in aftercare period), diffusion hypoxia (in the background of the lungs and heart, or long-term use in high concentrations). From the circulatory system and blood (blood, gemostaz) : tachycardia or aetiology until cardiac arrest; Already; hyper or gipotenzia; collapse; Krovotochivosti.so part of the intestine : gipersalivacia, nausea, vomiting, muscle loss and gastrointestinal motor, paralytic ileus (with the long-term anaesthesia), tranzitornaya jaundice, liver change Prob.so the nervous system and sensory organs : arousal, the engine activity rarely convulsions in children, drowsiness, depression (after the operation). Other : metabolic acidosis, gipoalbuminemia, gipogammaglobulinemia, reduction of urine, albuminurija.

Specific guidance

There is a need to observe safety measures and take into account that in the transaction, in the floor-can accumulate легковоспламеняющийс я Layer (as ether is heavier than air). Every six months of compulsory checking for impurities.

Patient interaction

Potenziruet the funds oppressive central nervous system (each), the effect nedepoliarizuth miorelaksantov like tubokurarina, the gipotenzivne бета-адреноблокаторо��. Lowers gipoglikemiceski effect of insulin and sulfonylureas derivatives, oxytocin and other hormonal stimulants uterus Nesovmestim with analeptikami and Psychostimulants. MAO inhibitors hurt metabolism (increased narkoznoe effect); Epinephrine and eufillin increase the risk of arrhythmias, m-holinoblokatora and antihistamines to reduce the side effects, muscle doubled reduce the ether.

Overdosing

Symptoms : oppression and breathing sossoudodwigatelnogo point movements, asphyxiation, gipotenzia, collapse, cardiac failure, cardiac arrest, Koma.lechenie : Halt narcosis, the road respiratory tract IVL with giperventilaciei, transfuzionnaya therapy, the introduction of hydrocortisone, dopamine (0.2 g in 500 ml izotoniceski solution of sodium chloride at a speed of 2.5 µ g / kg / min), caffeine (1 ml of 20% solution of p / j), bemegrida (5-10 ml of 0.5% solution in / in slow); activities for the prevention of pneumonia, including warm patient.

Precautions

Then to use narcotic analgesics (trimeperidin) neiroleptiki (chlorpromazine), protivogistaminne funds (difengidramin, promethazine), in order to prevent vomiting and other Reflective reactions, including gipersecretia apply m-holinolitiki (atropine, metoqinia iodide). Avoid contact with skin and eyes by open applications.

Dosing and Administration

Inhalation : on open (drip, fraktin, hardware), poluotkrytoi, poluzakratoi and closed systems. The concentration depends on the way narcotizirovania and sensitivity of the patient; Usually begin after adjusting to the smell of 15-20% (if necessary, in order to keep using up to 25% of), and then after the turn of consciousness until about 10%, for the maintenance of narcosis of the 2-12%; Poluotkrytoi the system for the maintenance of narcosis : 2-4% of the analgesia, 4-8% of the surface and about 4-12% at deep anaesthesia.

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