20.500.12556/DKUM-47295 UVOD V SPLOŠNO ANESTEZIJO NA SIMULATORJU METI HPS INDUCTION OF GENERAL ANAESTHESIA ON METI HPS HUMAN PATIENT SIMULATOR Teoretična izhodišča: Simulatorji bolnika omogočajo visoko kakovost izobraževanja na področju anestezije, saj omogočajo osebju ponovljivost scenarijev, analizo in predvsem učenje na napakah. V raziskavi smo simulirali indukcijo v splošno anestezijo z namenom, da bi raziskali, kako se METI HPS simulator odziva na indukcijo v anestezijo v primerjavi z bolniki v realnem kliničnem okolju. Raziskovalna metodologija: V raziskovalnem delu smo na METI HPS izvedli štiri scenarije. Najprej smo aplicirali samo propofol (200 mg) in opazovali učinke. Sledila je aplikacija posameznih zdravil fentanila (150 mcg in 5000 mcg) ter rokuronija (200 mg). V zadnjem scenariju smo izvedli celoten potek indukcije v anestezijo s pravilnim zaporedjem vseh treh zdravil. Ocenjevali smo spremembe v nasičenosti hemoglobina s kisikom v periferni arterijski krvi (v nadaljevanju SpO2) in krvnem tlaku. Dobljene rezultate smo analizirali in jih primerjali s podatki iz strokovne literature. Rezultati: Po aplikaciji fentanila 150 mcg ni bilo sprememb v učinkih na respiratorni in kardiovaskularni sistem. Po aplikaciji 5000 mcg fentanila je nastopila depresija dihanja (padec SpO2) in sekundarni srčni zastoj zaradi asfiksije. Propofol 200 mg je deloval na respiratorni sistem depresivno (padec SpO2), na kardiovaskularni sistem pa vazodilativno, kar smo opazili kot padec krvnega tlaka, vendar so učinki zdravila kmalu izveneli. Po aplikaciji rokuronija 200 mg smo opazili padec SpO2, ki ni bil posledica depresije dihalnega centra, temveč blokade v prevajanju živčnih impulzov do dihalnih mišic. To je privedlo do nezmožnosti dihanja in posledično do sekundarnega zastoja srca. V zadnjem scenariju smo aplicirali fentanil 400 mcg, nato propofol 200 mg in nazadnje rokuronij 80 mg. Takoj po aplikaciji fentanila in propofola sta se SpO2 in krvni tlak znižala, kar je posledica depresivnega delovanja na respiratorni sistem in vazomotoričnega delovanja zdravil. Rokuronij je povzročil asfiksijo, ki se je kazala v hipoksiji in hiperkapniji, kar je prav tako vodilo v sekundarni zastoj srca. Sklep: Primerjava rezultatov v diplomskem delu s strokovno literaturo je pokazala, da je simulirana indukcija splošne anestezije podobna indukciji splošne anestezije v realnem kliničnem okolju, ter da so odzivi METI HPS primerljivi z odzivi bolnikov. Theoretical background: Patient Simulators provide a high quality education in the field of anesthesia, as they enable repeatability of scenarios, analysis, and especially learning from mistakes. In this study, we simulated the induction of general anesthesia, in order to investigate how the METI HPS simulator responses to the induction of anesthesia as compared to patients in real clinical environment. Research Methodology: The research work at METI HPS was done in four scenarios. First, we applied only propofol (200 mg), and observed the effects. This was followed by application of fentanyl (150 mcg and 5000 mcg) and rocuronium (200 mg). In the last scenario, we carried out a full course of induction of anesthesia with the correct sequence of all three drugs. We assessed changes in the saturation of hemoglobin with oxygen in the peripheral arterial blood (in further SpO2), and blood pressure. We analyzed the results and compared them with data from the literature. Results: After applying the fentanyl 150 mcg there were not any changes in the effects on the respiratory and cardiovascular system. After applying 5000 mcg of fentanyl respiratory depression occured (a decrease in SpO2) and secondary cardiac arrest due to asphyxia. Propofol 200 mg affected depression on the respiratory system (a decrease in SpO2), vasomotorically on the cardiovascular system, what resulted decrease in blood pressure, but the effects of the medicine had quickly disappeard. After applying the 200 mg of rocuronium, we observeded decrease of SpO2, which did not happen due to depression of the respiratory center, but due to blocked conduction of nerve impulses to the respiratory muscles. That led to inability of breathing and that resulted to secondary cardiac arrest. In the latest scenario, we applyed 400 mcg fentanyl, then propofol 200 mg, and finally rocuronium 80 mg. Immediately after the applying of fentanyl and propofol the SpO2 and blood pressure decreased, as a result of depressive operation of the respiratory system and the vasomotorical effect of the drug. Rocuronium caused asphyxiation, which was reflected as hypoxia and hypercapnia, and that also led to secondary cardiac arrest. Conclusion: Comparison of the results of the thesis and literature showed that the simulated induction of general anesthesia is similar to induction of general anesthesia in a real clinical environment, and that the responses of METI HPS are comparable to responses of real patients. simulacije bolnika indukcija splošne anestezije METI HPS analgetiki hipnotiki mišični relaksanti. Simulation of the patient the induction of general anesthesia METI HPS analgetics hypnotics muscle relaxants. true false false [M. Prislan] Slovenski jezik Angleški jezik Diplomsko delo/naloga 2015-01-29 13:52:11 2015-03-23 10:18:51 2022-05-20 03:07:36 2021-05-06 03:23:10 2015 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 004.358:612.887(043.2) 2075556 URN:SI:UM:DK:EN3P2VPF VS_Prislan_Maja_2015.pdf VS_Prislan_Maja_2015.pdf 1 9E1A0E0346FCF5CEEC39B9AAC615B3C3 7503a9d0d21bbb25755e3860fb4e269b05c94153013beb4b8e09b167f9b1c078 8846580e-7c0b-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=69910 Fakulteta za zdravstvene vede 0 0 0