Пропофол-каби Эмульсия, 5 шт, 20 мл, 0,01/мл

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Общая анестезия у взрослыхВведение в общую анестезию: при введении в общую анестезию Пропофол Каби, 10 мг/мл, следует вводить дробно (примерно 20–40 мг пропофола каждые 10 с) до появления клинических признаков анестезии. Обычная доза для взрослых до 55 лет составляет 1,5–2,5 мг/кг. У пациентов старшего возраста и больных с III и IV степенью тяжести состояния по классификации Американского общества анестезиологов (ASA), особенно с нарушенной функцией сердца, требуемая доза обычно ниже. Общую дозу препарата Пропофол Каби, 10 мг/мл, можно снизить минимум до 1 мг/кг. Требуется более медленное введение препарата Пропофол Каби, 10 мг/мл — примерно по 1 мл (20 мг пропофола) каждые 10 с. Поддержание анестезии: для поддержания общей анестезии Пропофол Каби, 10 мг/мл, вводят непрерывно капельно или повторно в виде болюсов. Для поддерживающего наркоза пропофол применяют в дозе 4–12 мг/кг. При менее тяжелых хирургических вмешательствах, например малоинвазивных, возможно снижение поддерживающей дозы примерно до 4 мг/кг/ч. У пожилых людей, больных с нестабильным общим состоянием, пациентов с нарушенной функцией сердца или гиповолемией и больных с III–IV степенью тяжести состояния по классификации ASA доза может быть снижена еще в большей степени, с учетом тяжести состояния и техники анестезии. Общая анестезия у детей старше 3 лет Пропофол Каби, 10 мг/мл, не рекомендуется применять для общей анестезии у детей до 3 лет, поскольку концентрация эмульсии 10 мг/мл, трудно титруется, а маленьким детям необходим очень маленький объем препарата. Для детей от 1 мес до 3 лет рекомендуется применять Пропофол Каби, 10 мг/мл, при этом доза должна составлять менее 100 мг/ч. Введение в общую анестезию: при введении в общую анестезию рекомендуется медленное титрование дозы препарата Пропофол Каби, 10 мг/мл, до появления клинических признаков общей анестезии. Дозу выбирают с учетом возраста и/или массы тела. У детей старше 8 лет доза, необходимая для введения в общую анестезию, составляет примерно 2,5 мг/кг. У детей младшего возраста доза может оказаться выше. Применение препарата начинают с дозы 3 мг/кг. При необходимости можно вводить дополнительные дозы по 1 мг/кг. Детям из групп высокого риска (III–IV степень тяжести состояния по классификации ASA) рекомендуются более низкие дозы. Поддержание анестезии: для поддержания общей анестезии проводят непрерывную инфузию в дозе 9–15 мг/кг/ч. Данных относительно повторных инъекций пропофола для поддержания общей анестезии у детей нет. Дозу подбирают индивидуально. Необходимо уделять особое внимание адекватности обезболивания. Седация у взрослых в отделениях интенсивной терапииДля седации во время ИВЛ в отделениях интенсивной терапии Пропофол Каби, 10 мг/мл, рекомендуется вводить путем непрерывной инфузии. Дозу подбирают с учетом необходимой глубины седативного эффекта. Обычно адекватной седации удается достичь при скорости введения пропофола 0,3–4 мг/кг/ч. Увеличивать скорость введения более 4 мг/кг/ч не рекомендуется. Пропофол Каби, 10 мг/мл, не следует применять для седации в отделениях интенсивной терапии у пациентов 16 лет и младше. Способы введенияДля в/в введения. Пропофол Каби, 10 мг/мл, вводится в/в неразведенным в виде непрерывной инфузии. Пропофол Каби, 20 мг/мл, нельзя применять для повторной болюсной инъекции с целью поддержания анестезии. При введении препарата Пропофол Каби, 10 мг/мл, рекомендуется контролировать скорость инфузии с помощью бюретки, капельницы, шприцевого или инфузионного насоса. Флакон следует встряхнуть перед введением. Применять только гомогенный препарат из неповрежденного флакона. Перед применением резиновую мембрану флакона следует обработать спиртом. Поскольку Пропофол Каби, 10 мг/мл, представляет собой жировую эмульсию, не содержащую консерванты и не обладающую противомикробной активностью, препарат может служить благоприятной средой для быстрого роста микроорганизмов. Эмульсию следует набрать в стерильный шприц или капельницу сразу после вскрытия ампулы или флакона. Введение препарата необходимо начинать без задержки. В течение всего периода введения препарата Пропофол Каби, 10 мг/мл, должны соблюдаться правила асептической работы с препаратом и системой для парентерального введения. Другие ЛС или растворы, которые нужно ввести одновременно с введением препарата Пропофол Каби, 10 мг/мл, следует вводить в капельницу через Y-образный коннектор или клапан. Пропофол Каби, 10 мг/мл, нельзя смешивать с другими растворами для в/в введения. Однако через канюлю капельницы можно одновременно вводить 5% раствор глюкозы, 0,9 или 0,18% раствор натрия хлорида и 4% раствор глюкозы. Пропофол Каби, 10 мг/мл, нельзя вводить через антибактериальный фильтр. Пропофол Каби, 10 мг/мл, и другие инфузионные системы, содержащие пропофол, предназначены только для однократного применения и только одному пациенту индивидуально. Любые остатки эмульсии Пропофол Каби, 20 мг/мл, после применения следует уничтожить. Как и при применении других жировых эмульсий, длительность введения препарата Пропофол Каби, 10 мг/мл, с помощью одной системы для инфузии не должна превышать 12 ч. Через 12 ч систему для инфузии и резервуар с препаратом Пропофол Каби, 10 мг/мл, следует заменить. Чтобы уменьшить боль при инъекции, инфузию следует проводить в более крупную вену или непосредственно перед началом инфузии препарата Пропофол Каби, 10 мг/мл, можно ввести раствор лидокаина. Миорелаксанты, такие как атракурий и мивакурий, можно вводить через тот же катетер только после струйного промывания. Длительность применения не должна превышать 7 дней."}}]},{"id":8,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Распространенными побочными эффектами Пропофола Каби 10 мг/мл являются снижение артериального давления и подавление функции дыхания. Эти эффекты зависят от дозы пропофола, а также типа премедикации и сопутствующей терапии. В рамках каждой группы нежелательные эффекты представлены в порядке убывания их клинической значимости:- иммунные нарушения. Редкие: анафилактические реакции, в том числе отек Квинке, бронхоспазм, эритема и снижение артериального давления.- метаболические нарушения. Частые: гипертриглицеридемия- психические расстройства. Редкие: эйфория и повышение сексуальной функции во время восстановительного периода.- неврологические расстройства. Частые: спонтанные движения и миоклонус во время введения в анестезию, минимальное возбуждение. Редкие: головная боль, головокружение, озноб и ощущения холода во время восстановительного периода. Эпилептиформные припадки, включая судороги и опистотонус. Очень редкие: поздние эпилептиформные припадки, развивающиеся через несколько часов или дней. Риск развития судорог у пациентов с эпилепсией после введения пропофола. Случаи отсутствия сознания после операции.- изменения со стороны сердца/сосудистые нарушения. Частые: во время введения в анестезию снижение артериального давления, брадикардия, тахикардия, \"приливы\". Нечастые: выраженное снижение артериального давления. Может потребоваться снижение скорости введения Пропофола Каби 10 мг/мл и/или заместительное введение жидкости, при необходимости - сосудосуживающих средств. Следует учитывать возможность резкого снижения АД у пациентов с нарушенным коронарным или церебральным кровотоком или больных с гиповолемией. Нарастающая брадикардия, вплоть до асистолии, во время общей анестезии. Возможно внутривенное введение м-холиноблокаторов во время введения в общую анестезию или во время поддерживающего наркоза. Редкие: аритмия в восстановительный период. Тромбоз и флебит.- изменения со стороны системы дыхания, грудной клетки и средостения. Частые: при введении в анестезию гипервентиляция, преходящее апноэ, кашель, икота. Нечастые: кашель во время поддерживающего наркоза. Редкие: кашель во время восстановительного периода. Очень редкие: отек легких.- желудочно-кишечные нарушения. Редкие: тошнота и рвота во время восстановления. Очень редкие: после введения пропофола описаны случаи панкреатита, хотя причинно-следственная связь не установлена.- изменения со стороны кожи и подкожных тканей. Очень редкие: тяжелые изменения тканей после случайного паравенозного введения.- изменения со стороны почек и мочевых путей. Редкие: изменение цвета мочи после длительного применения пропофола.- общие и местные реакции. Очень частые: боль в месте инъекции. Боль в месте инъекции пропофола можно свести к минимуму путем одновременного введения лидокаина или инфузии препарата в более крупную вену предплечья или локтевую ямку. При введении лидокаина редко (от \u003e1: 10 000 до\u003c1: 1000) наблюдались следующие нежелательные эффекты: головокружение, рвота, сонливость, судороги, брадикардия, аритмии сердца и шок. Редкие: послеоперационная лихорадка. Очень редкие: описаны отдельные случаи тяжелых нежелательных эффектов в виде комплекса симптомов: рабдомиолиз, метаболический ацидоз, гиперкалиемия и сердечная недостаточность, иногда с летальным исходом. В большинстве случаев эти симптомы наблюдались в отделениях интенсивной терапии у больных, получавших дозу, превышающую 4 мг/кг/ч."}}]},{"id":9,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Передозировка может привести к угнетению функций сердечно-сосудистой системы и дыхания. При подавлении системы дыхания проводят искусственную вентиляцию легких. При нарушении функции сердечно-сосудистой системы следует опустить головной конец кровати и начать введение плазмозаменителей и/или вазопрессорных средств."}}]},{"id":10,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Пропофол Каби 10 мг/мл не снижает тонуса блуждающего нерва, и его применение в ряде случаев сопровождается брадикардией (иногда выраженной), а также асистолией. Перед индукцией или в процессе поддержания общей анестезии Пропофолом Каби 10 мг/мл следует рассмотреть возможность внутривенного введения м-холиноблокаторов, особенно в случаях предположительно усиленного тонуса блуждающего нерва или при применении Пропофола Каби 10 мг/мл совместно с другими препаратами, способными вызывать брадикардию. Для ослабления боли в месте инъекции при индукции общей анестезии Пропофолом Каби 10 мг/мл перед введением эмульсии препарата можно ввести лидокаин. При применении лидокаина следует учитывать, что его нельзя применять у больных с наследственной порфирией. Пропофол Каби 10 мг/мл могут применять только врачи, прошедшие подготовку по анестезиологии или интенсивной терапии. Пропофол Каби 10 мг/мл не должен вводиться персоналом, проводящим хирургические манипуляции. Эффективность и безопасность Пропофола Каби 10 мг/мл для (фоновой) седации детей моложе 16 лет не изучена. При несанкционированном применений препарата для (фоновой) седации детей моложе 16 лет зарегистрированы случаи серьезных побочных эффектов, включая смерть, хотя причинно-следственная связь в этих случаях не установлена. В частности, отмечены случаи метаболического ацидоза, гиперлипидемии, рабдомиолиза и/или сердечной недостаточности. Эти эффекты чаще всего наблюдались у детей с инфекциями дыхательных путей, получавших в условиях отделений интенсивной терапии дозы препарата, превышающие дозы для взрослых. Аналогично, у взрослых, получавших препарат дольше 58 часов со скоростью более 5 мг/кг/час, отмечены редкие случаи метаболического ацидоза, рабдомиолиза, гиперкалиемии и/или быстро прогрессирующей сердечной недостаточности (в некоторых случаях со смертельным исходом). Эта скорость превышает максимальную скорость 4 мг/кг/час, рекомендованную для применения препарата с целью седации больных в условиях отделений интенсивной терапии. Сердечная недостаточность в таких случаях обычно не чувствительна к поддерживающей терапии инотропными препаратами. По возможности не следует превышать дозу 4 мг/кг/час, обычно достаточную для седации больных, находящихся на искусственной вентиляции легких в условиях отделений интенсивной терапии (при длительности лечения более 1 дня). Врачи должны проявлять настороженность в отношении указанных побочных эффектов, и при первых признаках их появления снизить дозу или перейти на другие седативные препараты. Скорость введения Пропофола Каби 10 мг/мл должна быть снижена у больных с врожденным слабоумием, больных эпилепсией, при нарушениях функции сердца, легких, печени и почек, при гиповолемических состояниях. В отдельных случаях после применения Пропофола Каби 10 мг/мл отмечался период послеоперационного бессознательного состояния больного, сопровождающийся повышенным мышечным тонусом. Хотя сознание самостоятельно возвращалось, за больными, находящимися в бессознательном состоянии, требуется тщательное наблюдение. Перед выпиской пациента из клиники следует убедиться в его полном восстановлении после общей анестезии. Пропофол Каби 10 мг/мл содержит соевое масло, которое в редких случаях может вызывать тяжелые аллергические реакции. Этот лекарственный препарат содержит менее 1 ммоль натрия (23 мг натрия) в 100 мл, что практически позволяет его считать препаратом, не содержащим натрий. В течение всего периода инфузии следует соблюдать принципы асептики как в отношении препарата Пропофол Каби 10 мг/мл, так и в отношении инфузионного оборудования. Параллельное введение других препаратов через инфузионную систему для Пропофола Каби 10 мг/мл следует осуществлять как можно ближе к канюле. Пропофол Каби 10 мг/мл и все инфузионное оборудование для его введения может использоваться только один раз и только для одного больного."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Общеанестезирующее.","substance":[{"id":474,"title":"Пропофол","title_latin":"Propofolum","slug":"propofol_474"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Пропофол-каби - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/7653/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/7653/share_default/"}},"diseases":[{"id":"1400","title":"Подготовительные процедуры для последующего лечения или обследования, не классифицированные в других 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