Remifentanil

Chemical name

4-(Метоксикарбонил)-4-[(1 -оксопропил)фениламин о]-1-пиперидинпропанов ой acid methyl ester (as hydrochloride)

Gross

C20-H28-N2-O5

Characteristics

Liofilizirovanny powder white, or nearly white.

Indications

As analgeticski component in the opening anaesthesia and / or for the maintenance of general anesthesia in surgical interventions (including surgery), extension of pain immediately after the operation (under strict medical supervision), with the transition to analgesia drugs for long periods.

Pregnancy and lactation

Perhaps if the effect of therapy outweighs the potential risk to the fetus and newborn.

Contraindications

Hypersensitivity, incl. other fentanyl analogs, and epiduralnaya spinalnaya anaesthesia (because of the glycine).

Specific guidance

The possible only in offices, fully equipped of monitoring and maintenance of the respiratory and cardiovascular systems. Continued cefuroxim conducted with the help of special infuzing sized device (perfuzor, infuzomat) and / in kanuli. Designed for on / in Wvedenia.patienta expressed with impaired liver may become more susceptible to ugnettemu Effects remifentanil with respiratory function. Weak, the elderly or patients with gipovolemiei more sensitive to the Effects of remifentanil on cardiovascular system.

Patient interaction

Inconsistent (not to be confused) in one capacity infuzionna Solutions Ringer-laktata, Ringer-laktata, with the addition of 5% dekstrozy, propofola but compatible with these solutions with the introduction of one Magistral.pri sharing with those oppressive central nervous system may increase the frequency of side effects of these funds (to reduce the dose). Funds reduce airway diseases (beta-adrenoblokatora, blockers calcium channels, etc.) increased influence on the cardiovascular system (arterial gipotenzia, aetiology).

Overdosing

Symptoms : increased side effects (likely to occur only once a) : patients, linking voice cracks, aetiology, gipotenzia, gipoksemia, rigidity skeletal Myshc.lechenie : an introduction, the maintenance of vehicles respiratory tract, or supporting IVL, the maintenance functions of the circulatory system, in the case of hypotension, sossoudossoujiwate funds. If respiratory depression combined with the rigidity of muscles, a means of blocking neiro-myshecnuu transfer (to facilitate transportation). Specific antidote-opioid antagonist (naloxone); Give / 386/1989

Precautions

Not recommended for children under 1 year, in the opening anesthesia and surgery in children under 12 years of age (the clinical data are insufficient for a рекомендаций).Вызывае т Drug dependence. In the case of early discharge from the hospital should not be driving and the work related to the high concentration Vnimania.ne be confused with other PP. There should enter through one line with blood / serum / plasma as contained therein nonspecific esterase can cause hydrolysis products.

Dosing and Administration

In / in infuzionno, adults. Induction anaesthesia : cefuroxim Quick 0.5-1 g / kg / min after the previous bolusna injections in the dose of 1 g / kg for a period of not less than 30 with or without (if intubatia trachea spend more than 10 minutes from start Infusion ремифентанила).Поддер жание general anesthesia with IVL : after tracheal intubations speed infusions reduced, in accordance with the methodology used; speed can be a titrovti, increasing it to 100% or reduced to 25-50% every 2-5 minutes to achieve the required level of anaesthesia. The surface anaesthesia possible extra bolusnoe introduction dose of 0.5-1 g / kg every 2-5 Min.ublaya anaesthesia with independent spirits : initial speed Infusion 0.04 µ g / kg / min c followed by SAC in the range of doses 0,025-0,1 µ g / kg / min (bolusnoe introduction would not рекомендуется).Поддер жание analgesia early aftercare period : Patient in IVL and the individual speed of development impact; in the self-breathing will reduce speed infusions to 0.1 µ g / kg / min, and then titruut it in the range of doses 0,025-0,2 µ g / kg / min, changing no more than 0,025 µ g / kg / min every 5 minutes (bolusnoe a deprecated). In cardiovascular surgery : with the opening anaesthesia cefuroxim-at the rate of 1 µ g / kg / min (intubatia trachea should be no earlier than five minutes after the start of infusions), a bolusnoe not �екомендуется.Поддерж ание general anesthesia : speed picked individually, depending on the impact of development, as appropriate, in the form of bolusa. For patients with a high risk of complications bolusnaya maximum dose of 0.5 µ g / Cg.podderjanie analgesia early aftercare period (after ekstubation) : before being transferred to the House post a speed Infusion, the end of the operation, then at the rate of 1 µ g / kg / min until disconnected IVL. Termination infuziu recommended in the 3-4 intervals 10 minutes by reducing the rate of 50% on each Etape.u patients older initial dose half the usual recommended correction doses are needed at all stages Anestesia.detam aged 1-12 years : for the maintenance of anesthesia, in the form of bolusa for at least 30 seconds, at the rate of 1 µ g / kg; then continued cefuroxim (including within 5 minutes prior to the start of the operation, if not used bolusnoe introduction) with an initial velocity 0,25-0,4 µ g / kg / min (normal speed to maintain anesthesia 0,05-1,3 µ g / kg / min, depending on the time of anestetika).

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