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11.04.2024
2 4 minutes read

Современная медицина немыслима без анестезии. Даже такая, на первый взгляд простая процедура, как удаление зуба, без нее может причинить человеку настоящие муки, и даже чревата болевым шоком, не говоря уже о более сложных операциях. Но наркоз появился сравнительно недавно — лишь в 40-х годах XIX века один дантист продемонстрировал, что эфирный газ можно использовать, чтобы человек “отключился” перед операцией и не чувствовал боль. До этого момента нашим предкам приходилось нелегко, ведь известно, что сложные хирургические вмешательства начали совершать еще тысячи лет назад. В настоящее время различных вариантов анестезий существует множество, причем они действуют по-разному. Однако эффекты многих из них ученые по сей день не до конца понимают.

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Современную медицину невозможно представить без анестезии, однако ее действие на человека до конца не известно

Содержание

  • 1 Что такое местный наркоз
  • 2 Что такое общий наркоз
    • 2.1 Как действует общий наркоз
    • 2.2 Последствия общего наркоза
  • 3 Что такое спинальный наркоз

Что такое местный наркоз

Как известно, анестезия бывает двух типов — местная и общая. Правда, существует еще один тип наркоза, который можно отнести к отдельному виду — спинальный, но о нем поговорим отдельно. При небольших операциях применяют чаще всего местный наркоз, или седацию. Например, она особенно распространена в стоматологии.

В отличие от общего наркоза, местная анестезия не погружает человека в сон, а приводит к онемению определенной части тела, при этом человек находится в сознании. Принцип действия местных анестетиков довольно простой — они не позволяют нервным клеткам посылать сигналы в мозг. Для этого препараты останавливают поток ионов натрия через каналы в нервных клетках.

Этот поток ионов, когда он достаточно интенсивный, побуждает нейрон посылать сигнал соседним нейронам. В результате цепь нейронов посылает сигналы в мозг. Надо сказать, что блокировка ионов происходит постепенно. Вначале блокируются самые мелкие нервные волокна, а затем более крупные. По этой причине вначале человек перестает ощущать боль, а затем ощущения давления.

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Местная анестезия приводит к потере чувствительности в отдельных частях тела, куда она введена

Местный анестетик считается самым безопасным, однако в случае введения слишком большого его количества, могут возникнуть судороги, остановка дыхания и даже кома. Кроме того, у отдельных людей может возникнуть аллергическая реакция.

Что такое общий наркоз

Общие анестетики применяются при выполнении сложных операций. Они обычно вводятся либо внутривенно в виде жидких препаратов, либо подаются в органы дыхания в виде газа. Вариант анестезии врач выбирает сам с учетом различных факторов. Например, ингаляционные анестетики чаще больше подходят для детей. На взрослых газ действует гораздо медленнее, поэтому применяют препараты.

Часто, когда взрослый человек теряет сознание после ввода препаратов, используют ингаляционный анестетик, чтобы поддерживать необходимое состояние анестезии. Однако иногда обходятся вообще без газа.

Как действует общий наркоз

Общий наркоз приводит к потере сознания, обездвиженности, блокированию боли, а также амнезии относительно деталей процедуры. Несмотря на то, что общий наркоз широко распространен и используется уже давно, точные механизмы его действия плохо изучены, поэтому исследования проводятся по сей день.

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Общий наркоз приводит к потере сознания

Скорее всего блокирование боли и дискомфортных ощущений связано с молекулярными механизмами. В зависимости от типа препарата, принцип их действия может различаться, но все они воздействуют на ключевые рецепторы головного мозга, которые оказывают анестезирующее и седативное действие.

Один из самых широко распространенных анестетиков — пропофол. Он действует за счет повышения активности химического медиатора, известного, как гамма-аминомасляная кислота (ГАМК). ГАМК подавляет нейроны, к которым она подключается. Усиливая действие ГАМК в различных частях мозга, препарат приводит к потере сознания.

Хлороформ и изофлуран действуют иначе. Исследование, проведенное на плодовых мухах, показало, что эти препараты вызывают гибель насекомых, разрушая жировые отложения в мембранах клеток их мозга. Вместе с тем высвобождаются белки, которые запускают различные цепных реакции внутри клеток. Один из этих белков подавляет электрическую и химическую активность клеток, переводя мозг в бессознательное состояние. Предположительно, эти препараты аналогичным образом действуют и на людей.

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Ученые работают над созданием препаратов, которые быстро выводят человека из наркоза

При этом по сей день до конца неизвестно, как общий наркоз заставляет человека уснуть, а также как нервные цепи возобновляют свою работу после наркоза. Однако известно, что наркоз действует не только на людей, но и на растения.

Последствия общего наркоза

Наиболее распространенные последствия применения общего наркоза — это угнетение дыхания, нарушения памяти, нарушения сна, головные боли, галлюцинации, нарушения слуха и речи. Многие из них сохраняются только в первые часы после пробуждения. Но существуют и более опасные осложнения. Например, ранее мы также рассказывали о том, что применение наркоза во время родов может спровоцировать психические заболевания.

Наиболее же опасным осложнением от анестезии является остановка сердца во время операции. Правда, до конца нет доказательство того, что именно анестезия становится причиной остановки сердца. Однако одно из исследований показало, что статистически риск остановки сердца не зависит от вида анестезии, но он более высокий при использовании общего наркоза.

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Самое опасное осложнение от анестезии — остановка сердца

Когда пациента вводят в наркоз, артериальное давление снижается, и сохраняется низким в течение всего времени действия анестезии. Передозировка анестетиком провоцирует падение давления до критически низкого уровня. Кроме того, анестезия может вызывать различные, угрожающие жизни изменения в работе сердца. Однако, чтобы снизить риск опасных последствий, врачи при помощи электрокардиографа отслеживают работу органа и, при необходимости, своевременно предпринимают необходимые меры, например, уменьшают дозу вещества.

А вот риск не проснуться после наркоза — это миф, так как этого не может произойти из-за анестезии. Трагические последствия возможны, но они возникают по другим причинам. Как правило, к коме приводит нарушение доставки кислорода в мозг.

Что такое спинальный наркоз

Спинальный наркоз является компромиссом между общей и местной анестезией. Он позволяет выполнять сложные операции, но при этом имеет ряд преимуществ — человек находится в сознании, ему не требуется наблюдение в посленаркозном периоде, кроме того он имеет меньше противопоказаний и негативных последствий.

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Cпинальный наркоз более безопасный, чем общий. Источник фото: 24health.by

Спинальная анестезия осуществляется путем введения определенной дозы местного анестетика в цереброспинальную жидкость. В результате блокирование передачи импульсов происходит на уровне корешков спинномозговых нервов. Человека при этом, фактически, парализует в нижней части туловища и нижних конечностях.

Обязательно подпишитесь на наши каналы в Дзен и Telegram. Так вы всегда будете в курсе новых научных открытий!

По этой причине применение спинального наркоза сильно ограничено. Его используют, когда хирургические вмешательства необходимо выполнить в нижней части туловища, например, при кесаревом сечении. Возможно, дальнейшие исследования в области анестезии сделают наркоз еще менее опасным и вредным. Но для этого ученым необходимо до конца разобраться как действуют существующие препараты.

Источник

11.04.2024
2 4 minutes read
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26.04.2024

12-летний мальчик воссоздал «луч смерти» Архимеда, и он работает — Hi-News.ru»>/**/ article{display:block}body{font-size:14px;line-height:1}ol,ul{list-style:none;padding:0;margin:0}html,body{font:400 -apple-system,BlinkMacSystemFont,sans-serif}html,body,div,span,iframe,h1,p,a,img,ins,strong,b,form,article,time{margin:0;padding:0;border:0;font-size:100%;-webkit-text-size-adjust:100%;font-family:-apple-system,BlinkMacSystemFont,sans-serif;vertical-align:baseline;-webkit-font-smoothing:antialiased}body{font-size:14px;line-height:1;min-width:1124px}ol,ul{list-style:none;padding:0;margin:0}b,strong{font-weight:700}img{overflow:hidden;height:auto;max-width:100%;font:400 10px -apple-system,BlinkMacSystemFont,sans-serif}p{color:#000;margin-bottom:15px;font:400 20px/1.5 -apple-system,BlinkMacSystemFont,sans-serif}h1{color:#000;margin:0 0 28px 0;font:700 54px/1 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13.02.2024

Вулканическая трещина длиной в 4 километра в Исландии — может ли она разрушить город? — Hi-News.ru»>/**/ article{display:block}body{font-size:14px;line-height:1}ol,ul{list-style:none;padding:0;margin:0}html,body{font:400 -apple-system,BlinkMacSystemFont,sans-serif}html,body,div,span,iframe,h1,p,a,img,ins,strong,b,form,article,time{margin:0;padding:0;border:0;font-size:100%;-webkit-text-size-adjust:100%;font-family:-apple-system,BlinkMacSystemFont,sans-serif;vertical-align:baseline;-webkit-font-smoothing:antialiased}body{font-size:14px;line-height:1;min-width:1124px}ol,ul{list-style:none;padding:0;margin:0}b,strong{font-weight:700}img{overflow:hidden;height:auto;max-width:100%;font:400 10px -apple-system,BlinkMacSystemFont,sans-serif}p{color:#000;margin-bottom:15px;font:400 20px/1.5 -apple-system,BlinkMacSystemFont,sans-serif}h1{color:#000;margin:0 0 28px 0;font:700 54px/1 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