tailieunhanh - KEY QUESTIONS IN SURGICAL CRITICAL CARE - PART 7

Đó là sử dụng cho an thần như tiêm truyền và các viên thức ăn. Nó ĐÃ thời gian tương đối ngắn của hành động như một mục đích tích lũy Khi viên thức ăn dễ dàng Với bởi truyền Dẫn đến tình trạng hôn mê kéo dài. Ngăn chặn bệnh nhân này nên được đánh giá thường xuyên và an thần điều chỉnh của họ. | Principles of Intensive Care SCC A 13. A. true B. false C. true D. true E. false Midazolam is a water soluble benzodiazepine which is used for sedation as infusion and bolus. It has a relatively short duration of action as a bolus but cumulates readily when given by infusion leading to prolonged coma. To prevent this patients should be assessed frequently and their sedation adjusted. Midazolam is popular by infusion because it is cheap water soluble can be given in relatively concentrated infusions and is reasonably familiar to use. One arm-brain circulation time is about 30 seconds and sedatives used for rapid sequence induction should have their effects within this. pp 203-205 A 14. A. true B. true C. true D. false E. false Despite their similar elimination half lives of about 4 hours morphine is longer acting because of the rapid redistribution of the more lipid soluble fentanyl. Alfentanil has the shortest duration of action of the commonly used sedatives on ICU. Fentanyl and Alfentanil infusions can continue for prolonged periods without precipitating prolonged coma. Morphine has two active metabolites which can cause prolonged sedation and apnoea. Morphine causes histamine release and should be used with care in asthmatic patients. pp 203-205 A 15. A. true B. false C. true D. false E. true All opioids have the tendency to cause chest wall rigidity to some degree. Fentanyl and the new ultra-short acting opioid remifentanil seem to be more responsible than the others. All opioid effects are reversed by naloxone including respiratory depression euphoria and nausea. Morphine 3 and 6 sulphate are both active metabolites and tend to accumulate with prolonged infusions. This is particularly true in patients with hepatic or renal failure where fentanyl or alfentanil would be a more sensible choice. All opioids cause some degree of vasodilatation by a central action the amount of accompanying hypotension depends on the individual drug. Morphine tends to cause more .