In Waaxyada Gurmadka dunida oo dhan, Isticmaalka waa la qabtaa waana habsocod xasaasi ah duruufaha jira awgiis iyo dabcan, sababtoo ah culayska bukaanka.

Waxyaabaha 'intubation ED' caadi ahaan waxay ka kooban yihiin unugyo isku xigxig ah oo degdeg ah, oo ay weheliso isku duwaha wakiilka dawada iyo dawada curyaanka ah, si kastaba ha ahaatee waxaa jira hab kale oo lagu baaro, taas oo ah adeegsiga succinylcholine iyo rokuronium.

Si loo fududeeyo guusha deg-degga ah ee koowaad iyo in la yareeyo dhacdooyinka xun-xun, helitaanka deg-degga ah ee xaaladaha xiisaha leh ayaa muhiim ah. Curyaanka ayaa saameyn ku yeelan kara heerka guusha haddii la isticmaalo succinylcholine iyo rocuronium. In kasta oo suugaanta suuxinta suuxdinta ay soo jeedineyso shuruudo ka wanaagsan oo loogu talagalay isku xigxig deg deg ah nidaamka succinylcholine marka loo eego rocuronium, curyaaminta ugu wanaagsan ee taxanaha degdega ah ee ED wali lama oga.

Dariiqooyinka

Waxaan falanqaynay si ku-talagal ah xog looga soo uruuriyay Diiwaanka Wadada Wadnaha ee Degdegga ah, oo ah diiwaan diiwaangeliyayaal badan oo lagu soo uruurinayo xogta dhammaan hawlihii lagu qabtay 22 Eds

Waxaan ku darnay bukaannada ka weyn 14 sano kuwaas oo qaatay succinylcholine ama rocuronium inta lagu gudajiray 2016. Waxaan isbarbar dhigeynaa guushii ugu horreysay ee ku-meelgaarka ah ee u dhexeysa bukaannada qaata succinylcholine iyo kuwa hela rocuronium.

Waxaan sidoo kale is barbar dhignay dhacdooyinka dhacdooyinka xun (wadnaha, dhaawaca ilkaha, dhaawaca tooska ah ee marin-haweedka, dysrhythmias, epistaxis, intubation hunguriga, hypotension, hypoxia, dhiigbaxa iatrogenic, laryngoscope failure, laryngospasm, jeexjeexa dibnaha, xididdada bronchus ee ugu weyn, hyperthermia malignant, hyperthermia malignant. khaladka dawada, jeexjeexa xuubka xuubka, pneumothorax, tuubada endotracheal cuff cuff, iyo matag).

Waxaan sameynay falanqeyn koox hoosaadyo ah oo lagu xoojiyay qiyaasta ku saleysan culeyska curyaannimo.

Natiijooyinka

Waxaa jiray 2,275 isku-xigxig dhaqso leh isku xigxig Waxa fududeeyey succinylcholine iyo 1,800 oo loo yaqaan 'rocuronium'. Bukaanka qaadanaya succinylcholine way da 'yaraayeen waxayna u badan tahay inay qalliinka ku mari doonaan fiidiyowga laryngoscopy-ga iyo bixiyeyaasha khibradda leh.

Heerka guusha ugu horreysa wuxuu ahaa 87.0% iyadoo succinylcholine uu ka sii hooseeyo 87.5% oo leh rocuronium (saamiga saamiga 0.9; 95% kalsoonida dhexdhexaadka 0.6 ilaa 1.3). Dhacdada dhacdo kasta oo xun waxay sidoo kale ahayd isbarbar dhig wakiiladan: 14.7% succinylcholine oo kahooseysa 14.8% rocuronium (saamigel udhexeeya saamiga 1.1; 95% farqiga kalsoonida 0.9 ilaa 1.3). Waxaan aragnay natiijooyin la mid ah markii ay culays ku saareen culeys ku saleysan curyaannimo.

Ugu Dambeyn

Taxanahan weyn ee indha indheeynta ah, maanaan helin xiriir ka dhexeeya doorashada curyaannimada iyo guusha deg degga ah ee taxanaha deg-degga ah ama dhacdooyinka foosha xun.

qorayaal

• • Michael D. April, MD, DPhil
  • Allyson Arana, PhD
  • Daniel J. Pallin, MD, MPH
  • Steven G. Schauer, DO, MS
    
  • Andrea Fantegrossi, MPH
  • Jessie Fernandez, BS
  • Joseph K. Maddry, MD
  • Shane M. Summers, MD
  • Mark A. Antonacci, MD