Izindaba

Umlando wokufakwa okulawulwa okuqondiwe

Ukufakwa okulawulwa okuqondiwe (I-TCI) Indlela yokusebenzisa kabi izidakamizwa ze-IV ukufeza ukubikezelwa okuchazwe ngumsebenzisi ("okuhlosiwe") okuhlushwa izidakamizwa endaweni ethile noma izicubu zomzimba. Kulesi sibuyekezo, sichaza imigomo ye-TCI ye-TCI, ukuthuthukiswa kwezinhlelo ze-TCI, kanye nezinkinga zobuchwepheshe nezobuchwepheshe ezibhekiswe ekuthuthukisweni kwe-prototype. Siphinde sichaze ukwethulwa kwezinhlelo zamanje ezikhona emtholampilo.

Umgomo wazo zonke izinhlobo zokulethwa kwezidakamizwa uzuza futhi ulondoloze inkambo yokwelapha yezokwelapha yomphumela wezidakamizwa, ngenkathi ugwema imiphumela emibi. Izidakamizwa ze-IV zivame ukunikezwa kusetshenziswa imihlahlandlela ejwayelekile ye-dosing. Imvamisa okuwukuphela kwendawo yesiguli efakwa kudosi okufakiwe ku-metric kasayizi wesiguli, isisindo ngokujwayelekile se-IV Anesthetics. Izici zeziguli ezinjengobudala, ubulili, noma imvume ye-creatinine imvamisa ayifakwanga ngenxa yobudlelwano obunzima bezibalo balezi zikhundla ezizothambisa. Ngokomlando kube nezindlela ezi-2 zokuphatha izidakamizwa ze-IV ngesikhathi se-anesthesia: umthamo we-bolus kanye nokufakwa okuqhubekayo. Imithamo ye-bolus imvamisa ilawulwa nge-syringe ephathwayo. I-infusions ngokuvamile ilawulwa ngepompo ye-infusion.

Njalo umuthi wezinzwayo uqongelela izicubu ngesikhathi sokulethwa kwezidakamizwa. Lokhu kuqongelela kudida ubudlelwano phakathi kwesilinganiso sokumnika esibekwe ngumtholampilo kanye nokuhlushwa izidakamizwa esigulini. Izinga lokufundwa kwe-propofol le-100 μg / kg / min ehlotshaniswa neziguli ezi-3 ezisheshayo zingenele ukumnika kanye nesiguli esidilini esidukile kakhulu noma esilele ngemuva kwesikhathi. Ngokusebenzisa imigomo eqondakala kahle ye-pharmacokinetic (PK), amakhompyutha angabala ukuthi angakanani umuthi oqongelele izicubu ngesikhathi sokufuhlazeka futhi angaguqula isilinganiso sokumnika ukuze silondoloze ukugxila okuzinzile ku-plasma noma izicubu zomzimba, ikakhulukazi ubuchopho. Ikhompyutha iyakwazi ukusebenzisa imodeli enhle kakhulu ezincwadini, ngoba ubunzima bezibalo bokufaka iziguli (isisindo, ukuphakama, ubudala, ubulili kanye nezibalo ezingezekile) ze-computer.1,2 Lesi yisisekelo se Uhlobo lwesithathu lokulethwa kwezidakamizwa zokubulala izinzwa, infusions elawulwa ngokuqondile (i-TCI). Ngezinhlelo ze-TCI, udokotela ungena ekuhlushwa okuhlosiwe okufunayo. Ikhompyutha ibala inani lesidakamizwa, elethwa njengezinoli kanye ne-infusions, edingekayo ukufeza ukugxila okuhlosiwe futhi liqondise impompo yokufaka okuhlosiwe futhi iqondise ipompo yokumnika ukuletha i-bolus noma ukumnika okubaliwe. Ikhompyutha ihlala ibala ukuthi ingakanani isidakamizwa esizidakamizwa futhi ukuthi lokho kuthonya kanjani inani lesidakamizwa esidingekayo ukufeza ukugxila okuhlosiwe ngokusebenzisa imodeli yama-PKS akhethiwe kanye ne-radiates yesiguli.

Ngesikhathi sokuhlinzwa, izinga lokukhuthaza kakhulu lingashintsha ngokushesha okukhulu, lidinga ukuthathwa okuqondile, okusheshayo komphumela wezidakamizwa. I-infuvation evamile ayikwazi ukwandisa ukugxila kwezidakamizwa ngokwanele ukuze iphendulele ukwenyuka okungazelelwe ekuvuseleleni noma ukwehlisa ukugxila ngokushesha ngokwanele ukuba kuphendule isikhathi sokuvuselelwa okuphansi. I-infusions evamile ayikwazi ngisho nokugcina ukugxila kwezidakamizwa okuqinile ku-plasma noma ebuchosheni ngezikhathi zokukhuthaza njalo. Ngokufaka amamodeli we-PK, amasistimu we-TCI angashesha asheshe impendulo njengoba kunesidingo futhi ngokufanayo alondoloze ukugxila okuqhubekayo lapho kufaneleka. Inzuzo engaba khona kodokotela kungukuphakanyiswa okunembile kakhulu kwemithi yokubulala izinzwa.3

Kulesi sibuyekezo, sichaza izimiso ze-PK ze-TCI, ukuthuthukiswa kwezinhlelo ze-TCI, kanye nezinkinga zobuchwepheshe nezolawulo ezibhekiswe ekuthuthukisweni kwe-prototype. Izindatshana zokubuyekezwa ezimbili ezihambisana nazo zihlanganisa izindaba zokusetshenziswa nokuphepha emhlabeni wonke ezihlobene nale tekkhnoloji.4,5

Njengoba amasistimu we-TCI avela, abaphenyi bakhetha amagama e-idiosyncratic ngendlela. Izinhlelo ze-TCI zibizwa ngokuthi yi-IV Anesthesia ephelele ye-IV ye-IV (Cacia), Ukuphakanyiswa okungu-6 kwama-ejenti we-IV nge-computer (TIAC), ukumnika okuqhubekayo kwekhompyutha okungu-7, i-8 kanye ne-computer elawulwa yiPump.9 kulandela isiphakamiso ngu-Iain Glen, uWhite noKenny basebenzise igama le-TCI ezincwadini zabo ngemuva kuka-1992. Kufinyelelwe ku-1997 phakathi kwabaphenyi abasebenzayo ukuthi leli gama I-TCI yamukelwa njengencazelo ejwayelekile ye-Technology.10