- Gay te tiem ngam: la tiern thuoc gay te VaG dudi da d~ thuoc tham VaG than kinh Phuong phap nay thuong dung khi nh6 rang, trich mun nhot,
ensph6m va lieu dung
- Che' pham:
+Dung ngoai: khi dung 10%, gel 5%; thuoc rna 2,5%, kern 2%, dung dich 2% va 4%.
+Dung dich tiem 1 va 2% ong 2mL, 1<;>10 va 20mL. - Lieu dung:
+Gay te be mat, dung dich 1- 5% dung dl1p len da va niem mac.
+ Gay te d~n truyen va tiem tham: 40- 200mg. Lieu dieu tri 400mg lOl;\i co adrenalin, 500mg lOl;\ikhong co adrenalin.
+ Phong va dieu tri lOl;\nnhip tim: xem bai "Lol;\n nhip tim" - chudng 1, Duqc ly h<;>c,t~p 2.
3.2. Cae thuoe khae
3.2.1. Bupivacain (Marcain, Sensorcain)
Tac d\mg gay te tudng tt,tlidocain, nhung ml;\nh hdn, thdi gian xuat hi~n tac d\mg ch~m va duy tri lau hdn, co th~ keo dai Wi 12 gid ne'u duqc ke't hqp vai chat co ml;\ch adrenalin ho~c noradrenalin. Viv~y, bupivacain thich hqp cho cac ph~u thu~t keo dai. Lieu cao thuoc gay gian cd va lic che' v~n dQng.
Chi dinh chu ye'u la gay te d~n truyen, gay te tuy song. Dung dich 0,25%, 0,5% va 0,75%.
3.2.2. Mepivacain (Carbocain)
Tac d\mg gay te tudng tt,tlidocain nhung khong gay te be m~t va ye'u hdn lidocain khoang 2 111n.Tac d\mg xuat hi~n nhanh hdn va keo dai hdn. Thuoc it
gay gian mach nen khi gay te co th~ khong c~n dung chat co mach. Thu5c chu yeu dung gay te tiem tham va gay te dftn truyen.
Che pham: 5ng 2mL dung dich 1- 4% kern glucose d~ gay te tuy song.
Lieu dung: 20- 80 mg tuy loai phau thuat va tuy vi tri gay teo
3.2.3. Etidocain (Duranest)
Co thoi gian UtCdung keo dai hon lidocain 2- 3 lan, hoat tinh gay te manh hon, Thuong dung gay te tiem tham va gay te dftn truyen (khong dung gay te tuy song). Thu5c gay kich thich than kinh trung uong, lieu cao co th~ gay co giat, nen khong dung cho benh nhan d9ng kinh.
3.2.4. Prilocain (Citanest)
Tuong tu lidocain, nhu tac dung cham va keo dai hon. Thu5c duoc dung nhieu trong nha khoa. Thu5c co th~ gay methemoglobin.
3.2.5. Ropivacain
Hoat luc tuong tu bupivacain nhung it gay d9Ctren tim hon,
4.THUnC GAY TE co CAU TRUC KHAc
Fomocain: la phenylether, co tac dung gay te bg mat keo dai, hay duoc dung d~ lam thuoc giam dau trong khoa bong, loet do chieu tia ...
Ethyl clorid (Kelen):·nguyen la thuoc gay me nhling lic che ho hap va tu~n hoan mlilnhnen khong dung d~ gay me. Thu5c b5c hdi d nhi~t d9 thap nen co tac d\mg lam llilnh vung da bi phun thuoc xuong -52°C, co tac d\lng te m~nh va ngiln. Chu yeu dung gay te bg m~t d~ chich m\ln nh9t, ap xe, giam dau do chan thlidng.
Pramoxin (Anusol, tronothan): la thu5c gay te cau truc ether. Co tac d\lng gay te bg m~t. Thlidng dung dlilngnho milt, mfti.
Dibucain (Nupercaina): la dftn chat quinolin, do d9c tinh cao nen khong dung dlidng tiem, chu yeu dung gay te bg m~t.
Dyclonin (Dyclone):thdi gian xuat hi~n tac d\lng va duy tri tac d\lng tlidng dlidng procain. Hap thu t5t qua da va niem mlilcnen thlidng dung gay te bg m~t.