Пропофол (2,6- диизопропилфенол) является короткодействующим... Инструкция
Показания к применению
Для индукции и поддержания общей анестезии . для обеспечения седативного эффекта у взрослых больных, которые получают интенсивную терапию и которым проводится искусственная вентиляция легких (ИВЛ) . в целях обеспечения седативного эффекта у больных, находящихся в сознании, для проведения хирургических и диагностических процедур.
Противопоказания
Аллергическая реакция на Диприван в анамнезе . детский возраст до 3-х лет. Для обеспечения седативного эффекта во время интенсивной терапии противопоказан при следующих заболеваниях для детей всех возрастных групп: круп . эпиглоттит.
В 1 мл., эмульсии: пропофол 10 мг. Вспомогательные вещества: соевых бобов масло - 100 мг, фосфолипиды яичного желтка - 12 мг, глицерол - 22.5 мг, динатриевая соль этилендиаминтетрауксусной кислоты - 55 мкг, натрия гидроксид (для поддержания уровня рН 7.5-8.5), вода д/и - до 1 мл.
Фармакологические свойства
Пропофол (2,6- диизопропилфенол) является короткодействующим средством для общей анестезии с быстрым началом действия в течение примерно 30 сек. Обычно выход из общей анестезии происходит быстро. Механизм действия Дипривана, как и всех средств для обшей анестезии, недостаточно ясен. Как правило, при применении Дипривана для индукции анестезии и для ее поддержания наблюдается снижение среднего АД и небольшие изменения ЧСС. Тем не менее, гемодинамические параметры обычно остаются относительно устойчивыми во время поддержания анестезии, и частота неблагоприятных гемодинамических изменений низкая. Хотя после введения Дипривана может возникать угнетение дыхания, любые из этих эффектов качественно подобны тем, что возникают при применении других внутривенных анестезирующих средств, и легко поддаются контролю в клинических условиях. Диприван уменьшает церебральный кровоток, внутричерепное давление и снижает церебральный метаболизм. Уменьшение внутричерепного давления более выражено у больных с изначально повышенным внутричерепным давлением. Выход из наркоза обычно происходит быстро, с ясным сознанием и сопровождается низким процентом случаев головной боли, послеоперационной тошноты и рвоты. Как правило, после анестезии Диприваном случаи послеоперационной тошноты и рвоты встречаются реже, чем после ингаляционной анестезии. Возможно, это связано с противорвотным эффектом пропофола. Диприван при обычно достигаемых в клинических условиях концентрациях не подавляет синтез гормонов коры надпочечников.
Показания к применению
Для индукции и поддержания общей анестезии . для обеспечения седативного эффекта у взрослых больных, которые получают интенсивную терапию и которым проводится искусственная вентиляция легких (ИВЛ) . в целях обеспечения седативного эффекта у больных, находящихся в сознании, для проведения хирургических и диагностических процедур.
Противопоказания
Аллергическая реакция на Диприван в анамнезе . детский возраст до 3-х лет. Для обеспечения седативного эффекта во время интенсивной терапии противопоказан при следующих заболеваниях для детей всех возрастных групп: круп . эпиглоттит.
Применение при беременности и в период грудного вскармливания
Диприван не следует применять в период беременности. Однако Диприван применяют во время прерывания беременности в первом триместре. Акушерство Диприван проникает через плацентарный барьер и его применение может быть связано с неонатальной депрессией. Его не следует применять в акушерстве в качестве анестезирующего средства. Период лактации Для новорожденных, находящихся на грудном вскармливании, не была установлена безопасность применения Дипривана у кормящих матерей.
Побочное действие
Общее Как правило, индукция анестезии протекает гладко, с минимальными признаками возбуждения. Наиболее часто встречающиеся побочные реакции являются предсказуемыми, с точки зрения фармакологии, побочными эффектами любого средства для обшей анестезии, например, гипотензия. Случаи, о которых докладывалось в связи с анестезией и интенсивной терапией, могут быть также связаны с получаемыми процедурами или с состоянием пациента. Очень часто (> 1/10) Общие реакции и реакции в месте введения Боль в месте введения при индукции(1) Часто (> 1/100, < 1/10) Общие Синдром отмены у детей(4) Со стороны сердечно- сосудистой системы: Гипотензия(2), брадикардия (3), прилив крови у детей(4) Со стороны ЖКТ: Рвота и тошнота во время пробуждения Со стороны ЦНС: Головная боль во время пробуждения Со стороны дыхательной системы: Временное апноэ во время индукции Нечасто (>1/1000, < 1/100) Со стороны сердечно- сосудистой системы: Тромбозы и флебиты Редко (>1/10000, < 1/1000) Со стороны ЦНС: Эпилептиформные движения, включая конвульсии и опистотонус во время индукции, поддержания анестезии и пробуждения Очень редко (< 1/10 000) Скелетно-мышечные эффекты, соединительная ткань: Рабдомиолиз (5) Процедурные осложнения: Послеоперационная лихорадка Со стороны ЖКТ: Панкреатит Со стороны почек и мочевыводящей системы: Обесцвечивание мочи после продолжительного применения Со стороны иммунной системы: Анафилаксия может проявляться в виде: ангионевротического отека, бронхоспазма, эритемы и гипотензии Со стороны репродуктивной системы: Сексуальное растормаживание Со стороны сердечно- сосудистой системы: Отек легких Со стороны ЦНС: Послеоперационное бессознательное состояние (1) Боль в месте введения можно уменьшить посредством введения препарата в большие по размеру вены предплечья и локтевого сгиба. Болевые ощущения также могут быть уменьшены при совместном введении Дипривана 1% с лигнокаином. (2) Гипотензия может вызвать необходимость в/в введения жидкости и уменьшения скорости введения Дипривана. (3) Серьезные случаи брадикардии встречаются редко. Имеются изолированные сообщения о прогрессировании брадикардии вплоть до асистолии. (4) Возникает во время резкого прекращения применения Дипривана во время интенсивной терапии. (5) Докладывалось об очень редких случаях рабдомиолиза при применении Дипривана в дозах более чем 4 мг/кг/ч для седации при интенсивной терапии.
Особые указания
Общее Как правило, индукция анестезии протекает гладко, с минимальными признаками возбуждения. Наиболее часто встречающиеся побочные реакции являются предсказуемыми, с точки зрения фармакологии, побочными эффектами любого средства для обшей анестезии, например, гипотензия. Случаи, о которых докладывалось в связи с анестезией и интенсивной терапией, могут быть также связаны с получаемыми процедурами или с состоянием пациента. Очень часто (> 1/10) Общие реакции и реакции в месте введения Боль в месте введения при индукции(1) Часто (> 1/100, < 1/10) Общие Синдром отмены у детей(4) Со стороны сердечно- сосудистой системы: Гипотензия(2), брадикардия (3), прилив крови у детей(4) Со стороны ЖКТ: Рвота и тошнота во время пробуждения Со стороны ЦНС: Головная боль во время пробуждения Со стороны дыхательной системы: Временное апноэ во время индукции Нечасто (>1/1000, < 1/100) Со стороны сердечно- сосудистой системы: Тромбозы и флебиты Редко (>1/10000, < 1/1000) Со стороны ЦНС: Эпилептиформные движения, включая конвульсии и опистотонус во время индукции, поддержания анестезии и пробуждения Очень редко (< 1/10 000) Скелетно-мышечные эффекты, соединительная ткань: Рабдомиолиз (5) Процедурные осложнения: Послеоперационная лихорадка Со стороны ЖКТ: Панкреатит Со стороны почек и мочевыводящей системы: Обесцвечивание мочи после продолжительного применения Со стороны иммунной системы: Анафилаксия может проявляться в виде: ангионевротического отека, бронхоспазма, эритемы и гипотензии Со стороны репродуктивной системы: Сексуальное растормаживание Со стороны сердечно- сосудистой системы: Отек легких Со стороны ЦНС: Послеоперационное бессознательное состояние (1) Боль в месте введения можно уменьшить посредством введения препарата в большие по размеру вены предплечья и локтевого сгиба. Болевые ощущения также могут быть уменьшены при совместном введении Дипривана 1% с лигнокаином. (2) Гипотензия может вызвать необходимость в/в введения жидкости и уменьшения скорости введения Дипривана. (3) Серьезные случаи брадикардии встречаются редко. Имеются изолированные сообщения о прогрессировании брадикардии вплоть до асистолии. (4) Возникает во время резкого прекращения применения Дипривана во время интенсивной терапии. (5) Докладывалось об очень редких случаях рабдомиолиза при применении Дипривана в дозах более чем 4 мг/кг/ч для седации при интенсивной терапии.
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