Ester for narcosis stabilized - instructions for use, dose, side effects, contraindications

Active substanceDiethyl etherDiethyl ether

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Ether for narcosis stabilized

solution d / inhal.

MEDHIMPROM ПХФК, ОАО Russia

Ether for narcosis stabilized

solution d / inhal.

Dosage form: & nbspLiquid for inhalation.

Composition:Diethyl ether (medical ether) - 100%

Stabilizer-antioxidant: para-phenylenediamine

Description:Colorless, transparent, mobile, flammable volatile liquid, characteristic odor.

Pharmacotherapeutic group:Means for inhalation of general anesthesia.

ATX: & nbsp

N.01.A.A.01 Diethyl ether

Pharmacodynamics:

Diethyl ether is a means for inhalation of general anesthesia, has analgesic and miorelaksiruyuschim properties.

General anesthesia when using ether is easily controlled, relatively safe. The ether for general anesthesia has a direct depressive effect on the myocardium, which, however, is leveled by an increase in the level of catecholamines in the blood (norepinephrine and epinephrine). It causes a temporary (not more than 24 hours) oppression of the liver and kidneys.

Weakened intestinal peristalsis due to stimulation of the sympathetic-adrenal system, the volume of circulating blood and plasma decreases by approximately 10%.The period of introductory anesthesia is long (12-20 minutes).

Pharmacokinetics:

The relatively low solubility of ether in the blood leads to the fact that the alveolar concentration gradually increases in the initial stage of general anesthesia and gradually decreases when the intake of the inhaled preparation ceases. When inhaled, the ether is absorbed into the bloodstream and enters the brain.

Almost all the ether is excreted from the body in an unchanged form through the respiratory tract, and only a small part of it is excreted by the kidneys. The smell of the exhaled ether can persist for a day or more.

Indications:

For inhalation of general anesthesia (mainly for short-term surgical interventions);
As a means to maintain general anesthesia, with combined anesthesia, with the use of psychotropic drugs, peripheral muscle relaxants and other medicinal products.

Contraindications:

Surgical operations requiring electrocoagulation or an electroknife;
Increased individual sensitivity to the drug;
Acute inflammatory diseases of the upper respiratory tract; Arterial hypertension and heart failure;
Cranial-cerebral hypertension;
Hepatic or renal insufficiency;
Diabetes;
Cachexia;
Acidosis.

Pregnancy and lactation:During pregnancy and lactation, the drug should be used when the benefits for the pregnant woman and the mother exceed the risk for the fetus and newborn.

Dosing and Administration:With a half-open system, 2-4 vol. % of the ether in the inhaled mixture maintain analgesia and turn off consciousness, 5-8 vol. % - superficial anesthesia, 10-12% vol% - deep anesthesia. To put the patient to sleep, concentrations of up to 20-25 vol. %.

Side effects:

Cough, psychomotor agitation, increased blood pressure, tachycardia, excessive secretion of saliva and mucus of bronchial glands, laryngospasm, nausea, vomiting, respiratory depression (up to a stop).

In the postoperative period, vomiting, bronchitis, laryngitis, tracheitis, bronchopneumonia, pulmonary edema, toxic intestinal paresis, decreased bile secretion, a violation of the acid-base state - metabolic acidosis, decreased glomerular filtration, decreased diuresis.

Overdose:

In acute inhalation intoxication, headache, nausea, back pain, agitation, inadequate behavior, then general weakness, drowsiness, loss of consciousness are first noted.Breathing rare, superficial, cyanosis, acrocyanosis, tachycardia, pulse threadlike, pupils maximally enlarged, lowering blood pressure, stopping the heart.

Chronic intoxication with ether indicates: loss of appetite, nausea, rarely vomiting, constipation, apathy, pallor of the skin, headache, dizziness, alcohol intolerance.

Treatment

Immediate cessation of the ether supply during general anesthesia. Removal of the victim from the area of action of the toxic compound to fresh air or in a well-ventilated room.

Inhalations with moistened oxygen, alkaline oil inhalations, with persistent cough - dionine (ethylmorphine hydrochloride), preparations containing codeine.

Intravenously inject 20-30 ml of 40% dextrose solution with 5 ml of 5% solution of ascorbic acid; subcutaneously inject heart means: camphor (20% solution), caffeine sodium benzoate (10% solution), nikethamide (1-2 ml) or other analeptic agents.

If necessary, sedatives.

With respiratory depression: ALV according to the indications, which must be carried out taking into account the possible toxic pulmonary edema. Indirect cardiac massage according to indications.

In case of accidental ingestion of the ester into the gastrointestinal tract, it is necessary to induce vomiting, rinse the stomach (8-10 liters) with water, 2% with sodium bicarbonate solution, and allow to drink finely crushed Activated carbon (2-3 tablespoons), cause a second vomiting, and after 10-15 minutes give a salt laxative. In the future - symptomatic therapy.

Interaction:

Strengthens the action of peripheral muscle relaxants.

The value of the minimum alveolar concentration decreases with simultaneous application of nitrous oxide.

Oppresses the central nervous system when interacting with psychotropic drugs, anxiolytics, sedatives and hypnotics, enhancing their effect.

Special instructions:

The ether for anesthesia should be used only by medical personnel trained for general anesthesia.

Inhalational ethereal general anesthesia should not be conducted deeper (III₁- III2) level of the surgical stage.

When feeding larger ether concentrations (from 10-12 vol.% To 20-25 vol.%) During the introduction of general anesthesia to reduce the time required for the onset of the surgical stage of general anesthesia, irritating effects of high concentrations of ether vapors may cause coughing , salivation, laryngospasm, severe hemodynamic disturbances.

In this regard, an introductory general anesthesia with ether is currently rarely used.

To reduce the induced reflex reactions and restrict secretion to patients before general anesthesia, it is necessary to administer atropine or other anticholinergic agents.

Relaxation of skeletal muscles caused by ether is not eliminated by the use of anticholinesterase agents.

Frequent inhalation of ether vapors causes drug dependence. Aether vapor with air, oxygen and nitrous oxide form explosive mixtures in certain concentrations.

The maximum permissible concentration of ether vapor in the air of the working zone is 300 mg / m³.

When performing an ethereal general anesthesia in a closed system, it is necessary to observe measures to prevent the possibility of an explosion.

The ether for general anesthesia is stored in vials of orange glass with a tightly ground glass stopper, so. as under the influence of air, light and elevated temperature, the ether decomposes with the formation of harmful impurities (peroxides, aldehydes), which cause severe irritation of the respiratory mucosa. The ether for general anesthesia should be chemically pure, containing a stabilizer, which prevents the oxidation of the ester.

In this connection, the vials with ether are uncorked just before the beginning of general anesthesia.

Form release / dosage:

Liquid for inhalation.

Packaging:

Bottles of 140 ml, 150 ml, made of orange glass in corrugated cardboard boxes with cells for each vial. By 18, 48 or 72 bottles (depending on the type of box).

Bottles of 700 g, in boxes of corrugated cardboard with cells for each bottle. For 12 bottles.

"For hospitals."

Storage conditions:

Table III of list IV of the list of precursors.

Keep in a dark place, away from fire, out of the reach of children, at a temperature not exceeding 15 ° C.

Shelf life:3 years.

Do not use after the expiration date printed on the package.

Terms of leave from pharmacies:For hospitals

Registration number:P N002441 / 01

Date of registration:25.12.2008 / 09.01.2013

Information update date: & nbsp06.01.2016

Illustrated instructions

Instructions

Ether for narcosis stabilized (Aether anaesthesia to stabilized)