Diethyl ether

When ATH:
N01AA01

Characteristic.

Colorless, transparent, very mobile, volatile liquid with a peculiar odor and pungent taste. Ether for narcosis contains 96-98% diethyl ether. Density ether anesthesia 0,713-0,714, Medical ester 0,714 - 0,717, boiling point 34-35 ° C and 34-36 ° C respectively. When evaporation 1 ml of ether for anesthesia formed 230 ml p; vapor density of ether for anesthesia 2,6, relative molecular mass - 74. Decomposed by light, heat, air and moisture to form toxic aldehydes, and ketone peroxides, respiratory irritants. Solubility in water 1:12. It can be mixed with alcohol, benzene, and essential fatty oils in all proportions. Highly flammable, incl. vapor; a certain ratio of oxygen, air and dinitrogen oxide vapors are explosive ether for anesthesia.

Pharmacological action.
Anesthesia.

Application.

Ether for narcosis: for inhalation anesthesia (mixed, combined, potentiated) incl. maintenance of anesthesia (typically in a mixture with oxygen and dinitrogen oxide, against the background of muscle relaxants, induction of anesthesia barbiturates, or dinitrogen oxide).

Ether Medical: for the treatment of cavities and tooth root canals (Preparation for sealing).

Contraindications.

Pulmonary tuberculosis, acute respiratory disease, increased intracranial pressure, cardiovascular disease with a significant increase in blood pressure, incl. hypertonic disease, cardiac decompensation, severe liver and kidney disease, cachectic disorder, thyrotoxicosis, diabetes, state of excitement, pronounced acidosis, operations using electrosurgical instruments, incl. electrocoagulation.

Restrictions apply.

Operations in the maxillofacial region (due explosivity); application anesthesia mask using only ester; childhood, pregnancy, lactation.

Pregnancy and breast-feeding.

Be wary of pregnancy (adequate clinical studies have not been conducted) and during breastfeeding (Data on excretion into human milk are absent).

Side effects.

From the respiratory system: hypersecretion of bronchial glands, cough, laringo- and bronchospasm, disorders of pulmonary ventilation, Fast breathing or respiratory depression, until apnea, pneumonia and bronchopneumonia (postoperatively), diffusion hypoxia (Background to dysfunction of the heart or lungs and long-term use at high concentrations).

Cardio-vascular system and blood (hematopoiesis, hemostasis): tachycardia or bradycardia, up to heart failure; arrhythmia; Hyper- or hypotension; collapse; angiostaxis.

From the digestive tract: hyperptyalism, nausea, vomiting, lowering the tone and motility of the gastrointestinal tract, paralytic ileus (during prolonged anesthesia), transient jaundice, changes in liver function tests.

From the nervous system and sensory organs: excitation, physical activity, rarely - seizures in children, drowsiness, depression (after operation).

Other: metabolic acidosis, hypoalbuminemia, hypogammaglobulinemia, oliguria, albuminuria.

Cooperation.

Potentiates the effect of funds, CNS depressants (mutually), the effect of non-depolarizing muscle relaxants, such as tubocurarine, hypotensive effects of beta-blockers. It decreases the hypoglycemic effect of insulin and sulfonylureas, oxytocin and other hormonal stimulant of the uterus incompatible with analeptikami and psychostimulants. MAO inhibitors inhibit the metabolism (enhance the anesthetic effect); epinephrine and aminophylline increases the risk of arrhythmias, Mr. holinoblokatory and antihistamines negate side effects, muscle relaxants reduce consumption by half ester.

Overdose.

Symptoms: depression of the respiratory and vasomotor center, apnea, asfiksija, gipotenziya, collapse, heart failure, cardiac arrest, coma.

Treatment: termination of anesthesia, airway, IVL hyperventilation, transfuzionnaya therapy, administration of hydrocortisone, dopamine (0,2 g 500 ml of isotonic sodium chloride solution at a rate of 2,5 ug / kg / min), caffeine (1 ml solution 10-20% p /), ʙemegrida (5-10 Ml 0,5% solution / slow);carrying out activities to prevent pneumonia, incl. Patient warming.

Dosing and Administration.

Inhalation: in the open (drop, fractionally, hardware), semi-open, semi-closed system. The concentration depends on the method and sensitivity of the patient narkotizirovaniya; usually - at first getting used to the smell after about 15-20% (if necessary, to use the lull to 25 vol%), then after turning off of consciousness - up 10 vol%, to maintain anesthesia by about 2-12%; in semi system for anesthesia: 2-4% Of analgesia with, 4-8% On a superficial and about 4-12% for deep anesthesia.

Precautions.

For sedation using opioids (trimeperidine), neuroleptics (chlorpromazine), antihistamines (difengidramin, Promethazine), to prevent vomiting reflex reactions and other, including hypersecretion, used m-anticholinergics (atropyn, metotsiniya iodide). Avoid contact with skin and eyes in the open method of application.

Cautions.

Care must be taken into account and explosion, that is operating, at the surface of the floor, may accumulate flammable layer (tk. air is heavier than air). Every 6 month obligatory checks for the presence of impurities.