MD675Z - Method for prevention of pathological reflexes during surgical manipulations - Google Patents
Method for prevention of pathological reflexes during surgical manipulations Download PDFInfo
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- MD675Z MD675Z MDS20130051A MDS20130051A MD675Z MD 675 Z MD675 Z MD 675Z MD S20130051 A MDS20130051 A MD S20130051A MD S20130051 A MDS20130051 A MD S20130051A MD 675 Z MD675 Z MD 675Z
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- prevention
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- during surgical
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- 230000001575 pathological effect Effects 0.000 title claims abstract description 12
- 238000000034 method Methods 0.000 title claims description 11
- 230000011514 reflex Effects 0.000 title claims description 9
- 230000002265 prevention Effects 0.000 title description 4
- 230000000472 traumatic effect Effects 0.000 claims abstract description 9
- 229950009336 azamethonium bromide Drugs 0.000 claims abstract description 4
- UPCIBFUJJLCOQG-UHFFFAOYSA-L ethyl-[2-[2-[ethyl(dimethyl)azaniumyl]ethyl-methylamino]ethyl]-dimethylazanium;dibromide Chemical compound [Br-].[Br-].CC[N+](C)(C)CCN(C)CC[N+](C)(C)CC UPCIBFUJJLCOQG-UHFFFAOYSA-L 0.000 claims abstract description 4
- 238000011477 surgical intervention Methods 0.000 claims description 8
- 206010002091 Anaesthesia Diseases 0.000 abstract description 4
- 230000037005 anaesthesia Effects 0.000 abstract description 4
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 abstract description 4
- 239000003814 drug Substances 0.000 abstract description 4
- 230000009471 action Effects 0.000 description 7
- 230000036772 blood pressure Effects 0.000 description 6
- NHWGPUVJQFTOQX-UHFFFAOYSA-N ethyl-[2-[2-[ethyl(dimethyl)azaniumyl]ethyl-methylamino]ethyl]-dimethylazanium Chemical compound CC[N+](C)(C)CCN(C)CC[N+](C)(C)CC NHWGPUVJQFTOQX-UHFFFAOYSA-N 0.000 description 6
- 230000000004 hemodynamic effect Effects 0.000 description 6
- 230000006641 stabilisation Effects 0.000 description 4
- 238000011105 stabilization Methods 0.000 description 4
- 208000010444 Acidosis Diseases 0.000 description 3
- 210000000748 cardiovascular system Anatomy 0.000 description 3
- 238000011161 development Methods 0.000 description 3
- 208000035475 disorder Diseases 0.000 description 3
- 230000000574 ganglionic effect Effects 0.000 description 3
- 201000001421 hyperglycemia Diseases 0.000 description 3
- 238000001802 infusion Methods 0.000 description 3
- 230000007774 longterm Effects 0.000 description 3
- 208000030159 metabolic disease Diseases 0.000 description 3
- 230000036284 oxygen consumption Effects 0.000 description 3
- 206010020660 Hyperlactacidaemia Diseases 0.000 description 2
- 208000001953 Hypotension Diseases 0.000 description 2
- 206010027417 Metabolic acidosis Diseases 0.000 description 2
- 229940079593 drug Drugs 0.000 description 2
- 230000002526 effect on cardiovascular system Effects 0.000 description 2
- 230000005284 excitation Effects 0.000 description 2
- 239000003457 ganglion blocking agent Substances 0.000 description 2
- 230000036543 hypotension Effects 0.000 description 2
- 210000005036 nerve Anatomy 0.000 description 2
- 230000007383 nerve stimulation Effects 0.000 description 2
- 210000000653 nervous system Anatomy 0.000 description 2
- 230000000392 somatic effect Effects 0.000 description 2
- SFLSHLFXELFNJZ-QMMMGPOBSA-N (-)-norepinephrine Chemical compound NC[C@H](O)C1=CC=C(O)C(O)=C1 SFLSHLFXELFNJZ-QMMMGPOBSA-N 0.000 description 1
- JOYRKODLDBILNP-UHFFFAOYSA-N Ethyl urethane Chemical compound CCOC(N)=O JOYRKODLDBILNP-UHFFFAOYSA-N 0.000 description 1
- 241000282326 Felis catus Species 0.000 description 1
- 206010021118 Hypotonia Diseases 0.000 description 1
- 208000007379 Muscle Hypotonia Diseases 0.000 description 1
- 208000001871 Tachycardia Diseases 0.000 description 1
- 206010044541 Traumatic shock Diseases 0.000 description 1
- 230000007950 acidosis Effects 0.000 description 1
- 208000026545 acidosis disease Diseases 0.000 description 1
- 230000004913 activation Effects 0.000 description 1
- 239000000464 adrenergic agent Substances 0.000 description 1
- 206010003119 arrhythmia Diseases 0.000 description 1
- 230000006793 arrhythmia Effects 0.000 description 1
- 206010007625 cardiogenic shock Diseases 0.000 description 1
- 150000003943 catecholamines Chemical class 0.000 description 1
- 238000012937 correction Methods 0.000 description 1
- 230000002638 denervation Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 238000001990 intravenous administration Methods 0.000 description 1
- 230000002503 metabolic effect Effects 0.000 description 1
- 230000004089 microcirculation Effects 0.000 description 1
- 229960002748 norepinephrine Drugs 0.000 description 1
- SFLSHLFXELFNJZ-UHFFFAOYSA-N norepinephrine Natural products NCC(O)C1=CC=C(O)C(O)=C1 SFLSHLFXELFNJZ-UHFFFAOYSA-N 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 230000000144 pharmacologic effect Effects 0.000 description 1
- 238000009101 premedication Methods 0.000 description 1
- 238000004321 preservation Methods 0.000 description 1
- 210000003497 sciatic nerve Anatomy 0.000 description 1
- 230000001502 supplementing effect Effects 0.000 description 1
- 230000009885 systemic effect Effects 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
- 210000001186 vagus nerve Anatomy 0.000 description 1
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- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
Abstract
Description
Invenţia se referă la medicină, şi anume la farmacologia clinică, anesteziologie şi reanimare, şi poate fi utilizată pentru prevenirea dereglărilor patologice reflexogene în cadrul intervenţiilor chirurgicale şi a altor manipulări traumatizante. The invention relates to medicine, namely to clinical pharmacology, anesthesiology and resuscitation, and can be used to prevent pathological reflexogenic disorders during surgical interventions and other traumatic manipulations.
În diverse stări patologice (traume, arsuri) şi intervenţii chirurgicale masive, la executarea anumitor tehnici şi manipulări pe parcursul intervenţiilor chirurgicale, în special în regiunile reflexogene, pe fondalul anesteziilor (generale, regionale) se poate produce activarea locală patologică a sistemului nervos vegetativ şi somatic. Metodele de limitare a posibilităţilor de dezvoltare a reflexelor patologice şi, respectiv, de protejare a sistemului cardiovascular cu dirijare hemodinamică rămân a fi actuale. In various pathological conditions (trauma, burns) and massive surgical interventions, when performing certain techniques and manipulations during surgical interventions, especially in reflexogenic regions, against the background of anesthesia (general, regional), pathological local activation of the vegetative and somatic nervous system may occur. Methods of limiting the possibilities of developing pathological reflexes and, respectively, protecting the cardiovascular system with hemodynamic guidance remain relevant.
Este cunoscută metoda blocării ganglionare fără hipotensiune, care permite prevenirea dezvoltării reflexelor patologice cardiovasculare prin utilizarea ganglioblocantelor cu corijarea modificărilor nedorite şi stabilizarea parametrilor hemodinamici cu adrenomimetice (norepinefrină) [1]. The method of ganglionic blockade without hypotension is known, which allows preventing the development of pathological cardiovascular reflexes by using ganglionic blockers with correction of unwanted changes and stabilization of hemodynamic parameters with adrenomimetics (norepinephrine) [1].
De asemenea, este cunoscută metoda blocării ganglionare fără hipotensiune, care permite prevenirea dezvoltării reflexelor patologice cardiovasculare prin administrarea asociată a ganglioblocantelor cu etiron [2]. The method of ganglionic blockade without hypotension is also known, which allows the prevention of the development of pathological cardiovascular reflexes by the combined administration of ganglionic blockers with etirone [2].
Dezavantajele acestor metode constau în durata mică de acţiune a adrenomimeticelor şi necesitatea administrării intravenoase continue în perfuzie cu dereglări vădite ale microcirculaţiei, iar în cazul utilizării pentru premedicaţie şi a medicamentelor cu acţiune alfa-adrenoblocantă, acestea pot fi ineficace sau să manifeste o acţiune inversă. The disadvantages of these methods are the short duration of action of adrenomimetics and the need for continuous intravenous administration in infusion with obvious microcirculation disorders, and in the case of premedication and the use of drugs with alpha-adrenoblocking action, they may be ineffective or have the opposite effect.
De asemenea, medicamentele adrenergice pot provoca dereglări metabolice (hiperglicemie, hiperlactacidemie, acidoză metabolică, majorarea consumului de oxigen de către organism), aritmii etc. Also, adrenergic drugs can cause metabolic disorders (hyperglycemia, hyperlactacidemia, metabolic acidosis, increased oxygen consumption by the body), arrhythmias, etc.
Problema pe care o rezolvă invenţia constă în elaborarea unei metode de prevenire a dereglărilor hemodinamice şi metabolice, precum şi de protejare a sistemului cardiovascular faţă de reflexele patologice prin suplimentarea anesteziei generale cu profetur şi azametoniu pentru intervenţiile chirurgicale şi/sau alte manipulări traumatizante în zonele reflexogene. The problem solved by the invention consists in developing a method for preventing hemodynamic and metabolic disorders, as well as protecting the cardiovascular system from pathological reflexes by supplementing general anesthesia with prophethurium and azamethonium for surgical interventions and/or other traumatic manipulations in reflexogenic areas.
Esenţa metodei constă în aceea că la etapa efectuării intervenţiilor chirurgicale sau a altor manipulări traumatizante la anestezia respectivă suplimentar se administrează intravenos bromură de azametoniu în doză de 3 mg/kg, apoi profetur în doză de 5 mg/kg. The essence of the method is that at the stage of performing surgical interventions or other traumatic manipulations, azamethonium bromide is additionally administered intravenously in a dose of 3 mg/kg, then profetur in a dose of 5 mg/kg.
Rezultatul constă în obţinerea blocării ganglionare cu prevenirea dezvoltării reflexelor patologice ca rezultat al denervării farmacologice şi perturbărilor hemodinamice şi metabolice, care se pot dezvolta pe parcursul anesteziei în intervenţiile chirurgicale şi manipulările traumatizante datorită stabilizării medicamentoase a nivelului tensiunii arteriale sistemice, ceea ce în final micşorează frecvenţa apariţiei complicaţiilor nedorite şi, respectiv, reduce costul tratamentului efectuat. The result is to achieve ganglionic blockade with the prevention of the development of pathological reflexes as a result of pharmacological denervation and hemodynamic and metabolic disturbances, which can develop during anesthesia in surgical interventions and traumatic manipulations due to drug stabilization of the level of systemic blood pressure, which ultimately reduces the frequency of unwanted complications and, respectively, reduces the cost of the treatment performed.
Avantajele metodei constau în aceea că la administrarea unimomentană a profeturului pe fondalul acţiunii azametoniului se obţine restabilirea îndelungată (mai mult de o oră) a valorilor tensiunii arteriale cu păstrarea concomitentă a acţiunii ganglioblocante specifice a azametoniului, care se manifestă prin lipsa modificărilor parametrilor respectivi la excitarea sistemului nervos vegetativ şi somatic. Spre deosebire de adrenomimetice, profeturul nu provoacă hiperglicemie şi acidoză, micşorează consumul de oxigen de către organism, posedă o durată de acţiune mai lungă, care se manifestă prin stabilizarea îndelungată a valorilor tensiunii arteriale, este mai inofensiv şi nu necesită administrarea îndelungată în perfuzie (are durată lungă de acţiune la administrarea unimomentană i/m şi i/v). The advantages of the method are that with a single administration of profetur against the background of the action of azamethonium, a long-term (more than an hour) restoration of blood pressure values is achieved with the simultaneous preservation of the specific ganglioblocking action of azamethonium, which is manifested by the lack of changes in the respective parameters upon excitation of the vegetative and somatic nervous systems. Unlike adrenomimetics, profetur does not cause hyperglycemia and acidosis, reduces oxygen consumption by the body, has a longer duration of action, which is manifested by the long-term stabilization of blood pressure values, is more harmless and does not require long-term administration in infusion (it has a long duration of action with a single i/m and i/v administration).
Metoda propusă se efectuează în felul următor: la etapa efectuării intervenţiilor chirurgicale sau a altor manipulări traumatizante la anestezia respectivă suplimentar se administrează intravenos bromură de azametoniu în doză de 3 mg/kg, apoi profetur în doză de 5 mg/kg. The proposed method is carried out as follows: at the stage of performing surgical interventions or other traumatic manipulations, azamethonium bromide is additionally administered intravenously to the respective anesthesia in a dose of 3 mg/kg, then profetur in a dose of 5 mg/kg.
Exemplu de realizare a invenţiei Example of embodiment of the invention
Acţiunea de prevenire a dereglărilor hemodinamice şi de protejare a sistemului cardiovascular faţă de reflexele patologice la utilizarea combinată a profeturului şi azametoniului a fost cercetată experimental la pisici anesteziate cu uretan (1...1,2 g/kg intraperitoneal). S-au determinat valorile iniţiale ale tensiunii arteriale, apoi cele obţinute la electrostimularea nervilor (segmentul central al nervului ischiatic şi segmentul periferic al nervului vag). Ulterior s-a administrat intravenos azametoniu (3 mg/kg) şi profetur (5 mg/kg) şi, din nou, s-au determinat valorile tensiunii arteriale până şi după excitarea nervilor respectivi. The action of preventing hemodynamic disorders and protecting the cardiovascular system from pathological reflexes with the combined use of profetur and azamethonium was experimentally investigated in cats anesthetized with urethane (1...1.2 g/kg intraperitoneally). Initial blood pressure values were determined, then those obtained during nerve electrostimulation (central segment of the sciatic nerve and peripheral segment of the vagus nerve). Subsequently, azamethonium (3 mg/kg) and profetur (5 mg/kg) were administered intravenously and, again, blood pressure values were determined until and after the excitation of the respective nerves.
Electrostimularea iniţială a nervilor a determinat modificarea corespunzătoare a valorilor tensiunii arteriale. Administrarea combinată a profeturului şi azametoniului a dus la stabilizarea indicilor hemodinamici şi la lipsa răspunsului reflector după electrostimularea nervilor. Initial nerve stimulation resulted in corresponding changes in blood pressure values. Combined administration of profetur and azamethonium led to stabilization of hemodynamic indices and lack of reflex response after nerve stimulation.
Comparativ cu utilizarea catecolaminelor în condiţii similare, profeturul nu necesită administrarea continuă în perfuzie, nu determină dereglări ale metabolismului (hiperglicemie, hiperlactacidemie, acidoză metabolică, tahiaritmii, majorarea consumului de oxigen de către organism). Compared to the use of catecholamines in similar conditions, profetur does not require continuous infusion administration, does not cause metabolic disorders (hyperglycemia, hyperlactacidemia, metabolic acidosis, tachyarrhythmias, increased oxygen consumption by the body).
1. Виноградов В.М. Новые пути лекарственной профилактики и терапии травматического и кардиогенного шока. Автрореф. диссертации. Ленинград, 1965 1. Vinogradov V.M. New ways of medicinal prevention and therapy of traumatic and cardiogenic shock. Autoref. dissertations. Leningrad, 1965
2. Гикавый В.И. Применение этирона при ганглионарном блоке без гипотонии в эксперименте. Здравохранение.Кишинёв, 1970, I, с. 47-50 2. Гикавый В.И. The use of ethirone in ganglionar block without hypotonia in an experiment. Здравохранение. Кишинёв, 1970, I, с. 47-50
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20130051A MD675Z (en) | 2013-03-15 | 2013-03-15 | Method for prevention of pathological reflexes during surgical manipulations |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20130051A MD675Z (en) | 2013-03-15 | 2013-03-15 | Method for prevention of pathological reflexes during surgical manipulations |
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| MD675Y MD675Y (en) | 2013-09-30 |
| MD675Z true MD675Z (en) | 2014-04-30 |
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Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| MD263C2 (en) * | 1995-03-01 | 1995-12-31 | Виктор ГИКАВЫЙ | "Isoturon" means with antihypotensive activity |
| MD586C2 (en) * | 1995-05-25 | 1997-03-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Remedy antihypotensif "Difetur" |
| MD1123F1 (en) * | 1997-03-25 | 1998-12-31 | Firma Svetskii & Co | Drum mixer of reversible rotation |
| MD1138C2 (en) * | 1997-02-17 | 1999-07-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Isopropylphosphite-S-isopropylisothiuronium - isothiourea derivative - possessing the hypertensive activity |
| MD1431G2 (en) * | 1998-01-16 | 2001-02-28 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Antihypotensive remedies |
| RU2200552C1 (en) * | 2001-07-18 | 2003-03-20 | ГУ Научно-исследовательский институт экспериментальной медицины РАМН | Method for protecting cardiovascular system during operation dealing with myocardial revascularization upon working heart |
| MD2066G2 (en) * | 2002-07-10 | 2003-09-30 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Antihypertensive remedy |
| MD2228G2 (en) * | 2003-01-21 | 2004-02-29 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | use of isothiouronic derivatives in the treatment and prophylaxis of intestinal atony |
-
2013
- 2013-03-15 MD MDS20130051A patent/MD675Z/en not_active IP Right Cessation
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| MD263C2 (en) * | 1995-03-01 | 1995-12-31 | Виктор ГИКАВЫЙ | "Isoturon" means with antihypotensive activity |
| MD586C2 (en) * | 1995-05-25 | 1997-03-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Remedy antihypotensif "Difetur" |
| MD1138C2 (en) * | 1997-02-17 | 1999-07-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Isopropylphosphite-S-isopropylisothiuronium - isothiourea derivative - possessing the hypertensive activity |
| MD1123F1 (en) * | 1997-03-25 | 1998-12-31 | Firma Svetskii & Co | Drum mixer of reversible rotation |
| MD1431G2 (en) * | 1998-01-16 | 2001-02-28 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Antihypotensive remedies |
| RU2200552C1 (en) * | 2001-07-18 | 2003-03-20 | ГУ Научно-исследовательский институт экспериментальной медицины РАМН | Method for protecting cardiovascular system during operation dealing with myocardial revascularization upon working heart |
| MD2066G2 (en) * | 2002-07-10 | 2003-09-30 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Antihypertensive remedy |
| MD2228G2 (en) * | 2003-01-21 | 2004-02-29 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | use of isothiouronic derivatives in the treatment and prophylaxis of intestinal atony |
Non-Patent Citations (2)
| Title |
|---|
| Виноградов В.М. Новые пути лекарственной профилактики и терапии травматического и кардиогенного шока. Автрореф. диссертации. Ленинград, 1965 * |
| Гикавый В.И. Применение этирона при ганглионарном блоке без гипотонии в эксперименте. Здравохранение.Кишинёв, 1970, I, с. 47-50 * |
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| MD675Y (en) | 2013-09-30 |
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