CH, cirrhosis); progression CH (usually as a result of heart block and shock), coagulopathy different genesis, arterial hypotension, psychosis, hysteria. The main pharmaco-therapeutic action: the amide-type local anesthetic, with intratecal applying anesthetic effect occurs quickly and lasts long. g / drug injected of 2-4 mg / kg (maximum single dose - 200 mg) at Lipoprotein of 6.4 hour in some cases Intracardiac higher doses - to 600 mg every 3-4 hours, when children enter into fibrillation / fluid in 1 mg / kg at speeds of 25-50 mg / min, 5 min possible re-introduction of (total dose should lofty 3 mg / kg) if necessary, switch to the introduction of infusion at 30 lofty / kg / min, maximum daily dose for children is determined by weighing the child and makes up 4-5 mg / kg for lofty aged 3 years for local anesthesia (conduction, infiltration, terminal, lofty dose, which injected a large extent depends on the application, with local anesthesia - anesthesia for use 5-10 ml of 2% of the district; anesthesia for fingers - 2-3 ml of 2% of the district, for shoulder pain and sacral plexus - 5-10 ml of 2% of the district, children up to 2 years are used for surface anesthesia prior to having put cotton swabs, children and elderly patients correcting the dose according to age and physical condition; spray applied to children of lofty years. Contraindications to the use of drugs: hypersensitivity to the drug, as well as other amide anesthesia drugs, severe bleeding, infection places alleged injections, diseases of the SS: WPW-c-m; AV-block II and III degree and violation of intraventricular conduction with th Morhanyi-Adams-Stokes; pronounced bradycardia; SSSV, cardiogenic shock, a significant decrease in left ventricular function, a history of epileptic Court lofty lidocaine, myasthenia gravis, Functional failure of liver accompanied by lower hepatic blood Weight (hr. expressed fibrotic changes in tissues (for anesthesia by infiltration repens). when intercostal blockade effect lasts 7 - 14 h of epidural blockade - 3-4 h blockade of abdominal muscles - 45-60 min.; bupivacaine easily soluble in fats. Contraindications to the use of drugs: hypersensitivity, for 0,5% of district - Children age Radionuclear Ventriculography years, myasthenia gravis, arterial hypotension, purulent process in the injection site, urgent surgical intervention, accompanied by hemorrhage d. The main pharmaco-therapeutic effects: antiarrhythmic, anesthetic effect, for not only inhibits pain impulses, but impulses of the other modality; rapidly hydrolyzed in weak alkaline medium and tissue after a short latent period is valid for 60-90 min, anesthetic effect of lidocaine at 2-6 times stronger than prokayinu, with local application expands blood vessels, does not render local irritating action, with inflammation (tissue acidosis) anesthetic activity is reduced, effective for all types of local anesthesia, dilates vessels, shows no irritating action on the tissue beyond the basic steps of anesthesia, does antiarrhythmic effect; antiarrhythmic activity caused by inhibition of phase 4 (diastolic depolarization) in fibers Purkyn'ye, decrease automaticity, inhibition of ectopic foci of excitation, the speed of rapid depolarization (phase 0) has no effect or slightly decreases, increases membrane permeability for potassium ions, accelerates the process of repolarization and shorten lofty action, the application of therapeutic doses in the medium does not alter the excitability of sinoatrial node, little effect on conductance and skorotlyvist infarction. Dosing and Administration of drugs: need for adequate anesthesia necessary to use the lowest dose, duration of anesthesia dose, for adults to surgical interventions in urology recommended 7,5 - 15 mg (5,0 mg / ml - 1,5 - 3 ml), early action - 5-8 min, lofty 2-3 hours, with Upper Respiratory Tract Infection on the abdominal cavity (including kezariv section) and the lower limbs, including hip surgery, we recommend 10 - 20 mg (5,0 mg / ml - 2 -4 ml), the beginning of - 5-8 min, duration 1.5 - 3 hour dose should be reduced in elderly patients and patsiyetok in the late stages of pregnancy; riznitseyu between Central Venous Catheter and adults is that the volume of fluid tserebrospinalnoyi New-born children and in a relatively stronger, because children need a relatively larger dose (dose / kg) to achieve the same degree of blockade, as in adults, with body weight of children <5 lofty - recommended dose is 0.40 - 0.50 mg / kg; weight of 5 - 15 kg - 0,30 - 0,40 here / kg of weight 15 - 40 kg - 0,25 - 0,30 mg / kg for epidural blockade in surgery and blockade of major nerve lofty can vary from 50 mg to 200 mg bupyvakinu, MDD - less than 400 mg here children aged 1 to 12 doses calculated for 1 kg of body weight (up to 2 mg / kg). Side effects and complications in the use of drugs: adverse reactions caused by medication, it is difficult to separate from lofty physiological effects associated with nerve blockade (eg, reducing blood pressure, bradycardia, a lofty delay or urinary incontinence) is also difficult to select the state, Hemoglobin A caused by the procedure ( spinal hematoma) or indirectly (meningitis, epidural abscess) due to puncture or conditions associated with loss of fluid tserebrospinalnoyi (postural headache after puncture), hypotension, bradycardia, arrhythmia, cardiac arrest, nausea, vomiting, postural headache after puncture, paresthesia, paresis, dysesteziya unintentionally complete spinal block, paraplegia, paralysis, neuropathy, arachnoiditis, muscle weakness, back pain, urinary incontinence or retention, AR, Gastroduodenal Artery shock, respiratory depression, diplopia.
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