Muaj ntau yam laj thawj vim li cas tus miv yuav tsum tau sedated los yog tshuaj loog, los ntawm aggressiveness los yog ntshai nyob rau hauv kev sab laj uas ua rau nws unexplorable, mus rau me me phais cov txheej txheem los yog loj caliber operations. tshuaj loog , tshwj xeeb tshaj yog kev siv tshuaj loog, is very safe, contrast to what many caregiers think, since with knowledge tam sim no tshuaj thiab kev nce qib hauv kev saib xyuas., qhov feem pua ntawm kev tuag los ntawm tshuaj loog yog tsawg dua 0.5%.
ZIB ZAUB Puas Tsuaj Rau Ib Tug miv kom rov qab los ntawm enseshesia?Nws yog ib qho ntawm ntau cov lus nug uas los txog rau miv cov neeg saib xyuas uas yuav ua raws li cov txheej txheem no. Hauv tsab xov xwm no hauv peb lub vev xaib peb qhia koj txhua yam txog tshuaj loog thiab sedation hauv miv, yuav ua li cas ua ntej, nws cov theem, cov teebmeem, tshuaj thiab rov zoo.
Dab tsi ntawm sedation thiab tshuaj loog
Ntau tus neeg tsis meej pem sedation nrog tshuaj loog, tab sis qhov tseeb yog tias lawv yog ob txoj kev sib txawv heev. sedation muaj ib lub xeev ntawm lub hauv paus paj hlwb kev nyuaj siab nyob rau hauv uas tsiaj poob pw tsaug zog nrog me ntsis los yog tsis teb rau sab nraud stimuli. Ntawm qhov tod tes, tshuaj loog tuaj yeem ua tau hauv zos lossis dav dav, nyob rau hauv rooj plaub tom kawg nrog qhov kev xav tsis zoo uas tshwm sim los ntawm hypnosis, nqaij so thiab analgesia.
Txawm li cas los xij, ua ntej koj tus miv yuav raug phais, koj tus kws kho tsiaj yuav tham txog Qhov no yog ib qho tseem ceeb heev rau kev ntsuas kev noj qab haus huv ntawm koj tus khub feline thiab npaj cov txheej txheem tshuaj loog zoo tshaj plaws rau lawv tus kheej. Qhov no suav nrog:
Tam Sim Ntshav (Cov Kab Mob
sedation ntev npaum li cas hauv miv?
Nws yuav nyob ntawm seb hom txheej txheem siv uas yuav sib txawv raws li lub sijhawm thiab qhov hnyav ntawm tus txheej txheem thiab tus kheej hloov pauv ntawm tus miv. Kev sib xyaw ntawm cov tshuaj sedatives, tranquilizers, thiab cov tshuaj tua kab mob tuaj yeem siv los kho tus miv, suav nrog cov hauv qab no:
Phenothiazine (acepromazine)
Nws yog ib qho tshuaj sedative uas siv sijhawm ntev tshaj 20 feeb los ua thiab sedation kav li 4 teev. Cov tsiaj yuav tsum tau oxygenated yog tias nws siv los ua sedative vim kev nyuaj siab plawv nws tsim. Nws yog characterized by:
- Antiemetic (tsis txhob ntuav).
- Siab sedation.
- Nws tsis muaj antagonist, yog li ntawd tus miv yuav sawv thaum cov tshuaj metabolized.
- Bradycardia (lub plawv dhia qis).
- Hypotension (tso ntshav siab) ntev txog 6 teev.
- Do not tsim analgesia.
- Nkauj kho siab heev.
Alpha-2 agonists (xylazine, medetomidine thiab dexmedetomidine)
Lawv yog cov tshuaj sedatives zoo uas siv sijhawm ntev li 15 feeb los ua thiab muaj lub sijhawm luv dua, tsuas yog li 2 teevLawv muaj tus antagonist (atipamezole), yog li yog tias nws siv lawv yuav sawv sai sai yam tsis tas yuav tos lub sijhawm tsim nyog kom txog thaum cov nyhuv sedative hnav tawm. Nws yuav tsum tau oxygenated vim yog mob plawv lawv tsim:
- Nkauj kho siab heev.
- Moderate analgesia.
- Emetic (ua kom ntuav).
- Bradycardia.
- Hypotension.
- Hypothermia (lub cev kub qis).
- Diuresis (ua kom zis ntau lawm).
benzodiazepines (diazepam thiab midazolam)
Lawv yog cov so kom txaus uas siv sijhawm ntev li 15 feeb los ua thiab kav txij li 30 feeb txog 2 teev. Lawv muaj cov antagonist (flumazenil) thiab tsim cov teebmeem hauv qab no:
- Paj ntaub so ntswg.
- Nws tsis muaj kev cuam tshuam rau cov hlab plawv.
- No sedan.
- Do not tsim analgesia.
Opioids (butorphanol, morphine, methadone, fentanyl, thiab pethidine)
Lawv yog cov tshuaj kho mob zoo uas feem ntau siv ua ke nrog cov tshuaj sedatives los pab txhawb kev sedation lossis npaj cov miv rau tshuaj loog. Lawv nyiam ua rau lub plawv cardiorespiratory chaw me ntsis thiab qee qhov, zoo li morphine, yog emetic. Opioids xws li morphine yav tas los ntseeg tias yuav tsum tau contraindicated nyob rau hauv miv vim lawv stimulant los. Nws yog tam sim no paub tias ntau tshaj li contraindicated, tuaj yeem siv yam tsis muaj teeb meem tab sis tswj kev noj ntau npaum li cas, txoj kev, lub sijhawm thiab kev sib xyaw ntawm cov tshuaj, txij li cov teeb meem tshwm sim yog overdosed., ua rau dysphoria, delirium, lub cev muaj zog excitability, thiab qaug dab peg.
Ntawm qhov tod tes, thaum butorphanol ua rau txo qis kev ua xua thiab siv rau hauv sedation los yog rau premedication ua ntej tshuaj loog, methadone thiab fentanyl yog cov feem ntau siv nyob rau hauv hom no rau control mobthaum lub sij hawm phais vim nws lub zog analgesic ntau dua. Lawv muaj cov antagonist los thim lawv cov teebmeem hu ua naloxone.
Yog li ntawd, lub sij hawm ntawm sedation yuav nyob ntawm seb cov metabolism thiab lub xeev ntawm tus miv nws tus kheej. Qhov nruab nrab yog kwv yees li 2 teev yog hais tias lub sedation tsis thim rov qab nrog tus antagonist. Los ntawm kev sib txuas ob lossis ntau cov tshuaj los ntawm cov chav kawm sib txawv, nws tso cai rau txhim kho qhov xav tau cov tshuaj pharmacological thiab yog li txo cov koob tshuaj thiab cov kev mob tshwm sim. Piv txwv li, kev sib xyaw ua ke ntawm butorphanol nrog midazolam thiab dexmedetomidine feem ntau yog qhov zoo heev hauv kev ua kom muaj kev ntxhov siab, mob, ntxhov siab lossis ntxhov siab hauv chaw ua haujlwm, thiab muaj tus antagonist thim cov teebmeem, cia lawv rov qab los tsev los yog tsaug zog me ntsis.
Tshuaj loog ntev npaum li cas rau tus miv?
Cov txheej txheem tshuaj loog muaj plaub theem:
Phase 1: Premedication
Nws lub hom phiaj tseem ceeb yog los tsim ib qho " tshuaj loog cushion"kom txo cov tshuaj loog tom qab, txo cov tshuaj loog, txo qhov kev ntxhov siab, ntshai thiab mob ntawm tus miv. Nws yog ua los ntawm kev tswj cov kev sib txawv ntawm cov tshuaj sedative, cov leeg nqaij so thiab cov tshuaj tua kab mob uas peb tau tham hauv ntu dhau los.
Phase 2: tshuaj loog induction
Los ntawm kev txhaj tshuaj inducing tshuaj loog xws li alfaxalone, ketamine los yog propofol ua rau tus miv poob reflexes thiab yog li tso cai rau intubation (qhia ib lub raj rau hauv feline trachea rau introduction inhalation anesthetic) mus ntxiv tshuaj loog. txheej txheem.
Cov theem no feem ntau kawg li 20-30 feeb tag nrho kom txog thaum cov tshuaj siv tau thiab tso cai rau cov kauj ruam tom ntej.
Phase 3: kho
muaj qhov Tam Sim Yees Duab
Nyob Rau Hauv Daim Ntawv:
- Inhalation: (xws li isoflurane) nrog rau kev ua xua (opioids xws li fentanyl, methadone lossis morphine) thiab / lossis NSAIDs, xws li meloxicam, uas yuav txhim kho qhov mob thiab mob hauv lub sijhawm postoperative. Cov tshuaj tom kawg kuj tseem tuaj yeem muab tshuaj loog thaum kawg ua ke nrog tshuaj tua kab mob los tiv thaiv kev kis kab mob.
- Intravenous: propofol thiab alfaxalone nyob rau hauv tas li infusion los yog rov boluses ua ke nrog ib tug muaj zog opioid xws li fentanyl los yog methadone. Kev siv ntau tshaj li ib mus rau ob teev hauv miv tsis pom zoo kom tsis txhob rov qab qeeb, tshwj xeeb tshaj yog nrog propofol.
- Intramuscular: Ketamine thiab opioid rau luv 30-feeb kev phais. Yog xav tau sijhawm ntxiv me ntsis, txhaj tshuaj thib ob ntawm ketamine tuaj yeem muab tau, tab sis tsis pub ntau tshaj 50% ntawm thawj koob tshuaj.
Lub sij hawm ntawm lub sijhawm no hloov pauv thiab yuav nyob ntawm hom kev phais koj tus miv yuav raug mob. Yog tias nws yog kev ntxuav, ib ncig ntawm ib teev; ib qho castration, me ntsis tsawg, nrog rau tau txais biopsies; Yog tias lub cev txawv teb chaws xws li cov plaub hau ua haujlwm, nws tuaj yeem siv sijhawm ntev me ntsis, thaum lawv ua haujlwm traumatology, lawv tuaj yeem kav ntev li ob peb teev. Nws kuj yog nyob ntawm tus kws phais qhov kev txawj ntse thiab muaj peev xwm ua rau muaj teeb meem intraoperative.
Phase 4: Rov Qab
Tom qab kawg ntawm kev tshuaj loog, resuscitation pib, uas yuav tsum ceev, maj, tsis muaj kev ntxhov siab thiab tsis mob yog hwm tus txheej txheem, kev sib xyaw ua ke thiab cov koob tshuaj uas siv. Nws yuav yog qhov tsim nyog los saib xyuas koj qhov tsis tu ncua, koj tus mob, koj qhov kub thiab txias tom qab muaj teeb meem tshwm sim, xws li kub taub hau thiab ntuav, uas yuav qhia tau tias muaj kab mob. Feem ntau, tus miv laus noj qab nyob zoo, noj zoo, txhaj tshuaj tiv thaiv thiab dewormed feem ntau rov qab los ntawm tshuaj loog 2 hnub tom qab kev cuam tshuam thiab nws cov sequelae10 hnub tom qab
Yog li lub sijhawm ntawm kev siv tshuaj loog yog qhov sib txawv nyob ntawm lub sijhawm ntawm kev phais, lub xeev thiab cov metabolism hauv tus tsiaj, kev txawj ntse ntawm tus kws phais, cov teeb meem, cov tshuaj siv thiab lub sijhawm resuscitation. Yog li, thaum qee qhov tshuaj loog siv sijhawm ib teev lossis tsawg dua, lwm tus tuaj yeem kav ntev li ob peb teev Tab sis tsis txhob txhawj, nrog cov txheej txheem tshuaj loog kom raug, tshuaj loog, tswj cov cim tseem ceeb. thiab kub los ntawm tus kws tshuaj loog, koj tus miv yuav muaj kev nyab xeeb thiab tsis hnov mob lossis kev ntxhov siab txawm tias lub sijhawm siv tshuaj loog.
Kuv tus miv tsis zoo los ntawm tshuaj loog
Lub sij hawm uas tus tsiaj yuav siv kom rov zoo los ntawm tshuaj loog yuav nyob ntawm tus nqi uas tau muab, hom tshuaj loog uas lawv tau ua haujlwm thiab tus miv nws tus kheej. Txawm hais tias koj tus menyuam yaus tau yoo mov ua ntej kev phais, lawv tuaj yeem tshem tawm qee cov kua tsib los yog cov zaub mov seem ntawm lawv lub plab lossis xeev siab. Tsis txhob txhawj, nws yog qhov qub yog tias alpha-2 sedatives lossis qee cov tshuaj opioids tau siv. Nws kuj yog ib txwm zoo uas, tom qab sawv los, tus miv mus rau sab disoriented los yog meows tsis yog vim li cas, nws yuav siv sij hawm ob peb teev los xav noj los yog tso zis ntau hnub ntawd kom tshem tawm cov kua dej ntxiv thaum lub sij hawm. tshuaj loog. Thaum lub sij hawm rov qab los, miv yuav tsum tau nyob rau hauv ib qho sov, tsaus, nyob ntsiag to
Qee zaum miv yuav siv sij hawm ntev los sawv. Nco ntsoov tias miv txawv ntawm cov dev ntau txoj hauv kev. Nyob rau hauv tshuaj loog lawv yuav tsis tsawg. Tshwj xeeb, cov metabolism hauv cov tshuaj hauv miv yog qeeb dua li cov dev, yog li lawv tuaj yeem siv sijhawm ntev dua los sawv. Koj tus miv yuav siv sij hawm ntev dua kom rov zoo los ntawm kev siv tshuaj loog rau cov laj thawj hauv qab no:
Enzyme deficiency
Ib txoj hauv kev tseem ceeb tshaj plaws rau cov tshuaj metabolism hauv kev tshem tawm tom ntej yog kev sib txuas nrog glucuronic acid. Txawm li cas los xij, miv muaj deficiency ntawm enzyme glucuronyltransferase, uas yog lub luag haujlwm rau qhov no. Vim li no, cov metabolism ntawm cov tshuaj uas siv txoj kev no qeeb qeeb dua thaum siv lwm txoj hauv kev: sulfoconjugation. Lub hauv paus chiv keeb ntawm qhov tsis txaus no muaj nyob rau hauv feline noj tus cwj pwm. Ua nruj carnivores lawv tsis tau hloov zuj zus los tsim cov txheej txheem los metabolize cov nroj tsuag phytoalexin. Yog li ntawd, nyob rau hauv miv tej yam tshuaj (ibuprofen, aspirin, acetaminophen, thiab morphine) yuav tsum tau zam los yog siv ntau npaum li cas qis dua cov dev uas tsis muaj qhov teeb meem no.
Propofol as anesthetic
Siv propofol ua tshuaj loog kho mob rau ntau tshaj ib teev yuav ua kom ntev lub sij hawm rov zoo nyob rau hauv miv. Tsis tas li ntawd, rov ua tshuaj loog nrog propofol hauv felines tuaj yeem ua rau oxidative puas tsuaj thiab tsim cov Heinz lub cev (suav nrog cov hauv nruab nrab ntawm cov qe ntshav liab vim kev puas tsuaj ntawm hemoglobin).
Drug overdose
Miv feem ntau hnyav me ntsis, tshwj xeeb tshaj yog tias lawv me me, yog li lawv tuaj yeem overdosed yooj yim dua nrog rau qhov kev ncua ntev ntawm cov txheej txheem rov qab los ntawm lawv siv sijhawm ntev mus rau metabolize txwv tsis pub lawv ua. Hauv cov xwm txheej no, tsuas yog cov tshuaj antagonist yuav raug qhia, tab sis nco ntsoov tias awakenings tuaj yeem ua sai sai thiab dysphoric Qhov tseeb, txoj kev xav yog sim ua kom muaj kev vam meej ntxiv thiab qeeb, nrog kev pab ntawm cov tshuaj so xws li benzodiazepines yog tias tsim nyog.
Hypothermia
Hypothermia hauv miv los yog poob hauv lub cev kub yog tshwm sim vim lawv qhov me me thiab qhov hnyav. Qhov kub thiab txias, qhov nyuaj dua rau cov tshuaj metabolize vim txo qis enzyme muaj nuj nqi, lengthening rov qab thiab tsaug zog los ntawm tshuaj loog. Tus mob no yuav tsum tau tiv thaiv los ntawm kev siv cov ntaub ntawv insulating rau tsiaj thiab npog nws nrog pam vov los yog siv cov rooj phais uas muaj cua sov, siv cov kua dej tempered, nrog rau kev tswj qhov kub ntawm chav ua haujlwm ntawm ib ncig ntawm 21-24 ºC..
