Kedi ve Köpeklerde Acil ve Yoğun Bakım Hastalarında Anestezi ve Ağrı Yönetimi
Özet
Kedi ve köpeklerde acil ve yoğun bakım hastasının anestezisi, rutin cerrahi hastasına göre daha değişken ve yüksek riskli bir süreçtir. Bu hastalarda temel amaç yalnızca bilinç kaybı ve immobilizasyon sağlamak değil; oksijen sunumunu, doku perfüzyonunu, ventilasyonu ve vücut ısısını mümkün olduğunca koruyarak gerekli girişimi tamamlamaktır. Anestezi planı, hastanın aciliyet derecesi, hipovolemi veya şok varlığı, solunum rezervi, elektrolit-asit-baz dengesi, ağrı düzeyi ve eşlik eden organ disfonksiyonlarına göre bireyselleştirilmelidir. Bu bölümde kritik hastada preanestezik değerlendirme, stabilizasyon, premedikasyon, indüksiyon, idame, monitörizasyon ve derlenme dönemine ilişkin temel ilkeler özetlenmiştir. Ayrıca travma, solunum sistemi acilleri, akut abdomen, üretral obstrüksiyon, nörolojik aciller ve sepsis/SIRS gibi sık karşılaşılan tablolar için hastalık-spesifik anestezi ve ağrı yönetimi yaklaşımı sunulmuştur. Multimodal analjezi, ilaçların düşük dozda titrasyonu, lokal/bölgesel tekniklerin uygun hastalarda kullanılması ve derlenme döneminin aktif izlenmesi güvenli acil anestezinin temel bileşenleridir.
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