Izimbangela, Ukuxilongwa, Nokunakekelwa
Abantu abahlala nobuhlungu obungapheli ngezinye izikhathi bathembele kumaphilisi wokugulisa okwelashwa ukuthi basebenze. Kodwa-ke, enye yezinhlobo ezivame kakhulu zama-painkillers, ingaba nokusebenzisa isikhathi eside, uqale ukwenza ubuhlungu bakho bubi nakakhulu.
Uma lokho kwenzeka, kubizwa ngokuthi i- hyperalgesia (OIH) noma i- allodynia eyenziwe ngama-opioid (OIA). Nakhu okushiwo lawo misho:
- I-opioid, ngezinye izikhathi ebizwa ngokuthi i-opiate noma i-narcotic, uhlobo lwama-painkiller olwenziwe ngefomu elenziwe nge-opium.
- I-hyperalgesia yandisa ubuhlungu; izinqubo zesimiso sezinzwa zandisa ukwanda kobuhlungu ozizwayo.
- I-Allodynia ubuhlungu obubangelwa into engafanele idale ubuhlungu, njengokuthinta ukukhanya noma indwangu ehamba isikhumba sakho.
Uma ama-opioids eqala ukubangela noma ephuthumayo ubuhlungu bakho, cishe uzodinga ukuwayeka futhi ubheke ezinye izindlela zokuphatha amazinga akho obuhlungu.
Ubuhlungu obusuka opioid (OIP) kungaba nzima ukuyihlolisisa, ikakhulukazi kumuntu onenkinga ebuhlungu kakade ehilela i-hyperalgesia kanye / noma i-allodynia.
I-opioids itholakale kuphela nge-odokotela. Ezinye izidakamizwa ziqukethe i-opioid kuphela kanti ezinye zihlanganisa i-opioid nomunye umuthi njenge-acetaminophen. Ama-opioid avamile ahlanganisa:
- I-Hydrocodone
- I-oxycodone
- I-Codeine
- Morphine
- I-Methadone
- Fentanyl
- I-Meperidine
- I-Hydromorphone
Yini Ebangela Ubunzima Opioid-Inceded?
Ososayensi abakakaqiniseki ukuthi yini ebangela i-OIH. I-OIA yaqashelwa kakhulu kakhulu futhi sazi ngisho nangaphansi kwayo kunokuba senze i-OIH.
Nokho, abacwaningi bahlola amathuba amaningana.
Ngokokubuyekezwa kwe-OIH eyanyatheliswa kuyi-Journal of Pain Physician, ezinye izindlela ezikhona zingabandakanya:
- Ukungahambi kahle ngendlela ubuchopho bakho buhlela ngayo izibonakaliso zobuhlungu
- Ama-receptors akhethekile ebuchosheni bakho abusebenza kahle
- Ukwandisa inani le- glutamate ye-neurotransmitter, evuselela amangqamuzana akho obuchopho, ngezinye izikhathi ngaphezulu-okubavuselela kuze kube sekufeni
- Umsebenzi okwedlulele we-receptors emthonjeni womgogodla ovuselela izinzwa ezikhethekile ezibizwa ngokuthi i- nociceptors , ohlelweni lwakho lwesifo sezinzwa
- Ukwehlisa kabusha i-reuptake yezinzwa ezithile ze-neurotransmitters, ezigcina amazinga aphakeme asebenzayo ebuchosheni
- Ubuzwe obukhulu bezinsipho zomgogodla kumzimba we-neurotransmitters P (okuyinto idlulisela izibonakaliso zobuhlungu obungenayo i-nociceptive) ne-glutamate
Ezinye zalezi zindlela zingasebenza ndawonye ukudala nokugcina i-OIP. Nakuba ucwaningo oluningi luye lwagxila esimisweni sezinzwa zomphakathi, isimiso sezinzwa se-peripheral singase sibandakanyeke kwezinye izimo.
Ukubuyekezwa Kwezinhlungu Zobunzima kubonisa ubufakazi bokuthi i-OIP ingathuthuka ngokuhlukile uma kuziwa ezinhlobonhlobo zobuhlungu, futhi.
Ngubani osemngciphekweni we-opioid-earned?
Akuwona wonke umuntu othatha ama-opioids azokwakha i-OIP. Ucwaningo lubonisa ukuthi izakhi zofuzo zingadlala indima. Ukuthatha ama-opioid isikhathi eside kwandisa ingozi yakho, njengoba kuthatha amanani aphezulu. Ukwandisa umthamo wakho ngokushesha futhi kukubeka engozini ephakeme.
Ngenxa yokuthi abantu abaningi bahlakulela ukubekezelela lezi zidakamizwa, kuvamile ukuthi inani ozithathayo ngenxa yobuhlungu obungapheliyo ukwandisa ngokuhamba kwesikhathi, okusho ukuthi uba amathuba okuthuthukisa i-OIP.
Ukuthola ubuhlungu obuphihliwe opioid
I-OIP inzima ukuyihlolisisa.
Ayikho ivivinyo noma isithwebuli, ngakho udokotela wakho kufanele acabangele izimpawu zakho futhi abheke ezinye izimbangela ezibangelwa ukwanda noma ubuhlungu obusha. Lokhu kubizwa ngokuthi ukuxilongwa kokukhipha, ngoba kungenziwa kuphela lapho amanye amathuba engekho.
Isivimbela esiyinhloko sokuxilongwa kwe-OIP yizimo ezibuhlungu ezifaka okuthiwa "ubuhlungu obuphakathi" noma " ukuzwela okuphakathi ." Lezi zimo zibandakanya i- fibromyalgia , i- rthumicid arthritis , i- migraine , i- syndrome eyathukuthela , i- ME / chronic tiredness syndrome , kanye nesifo sokucindezeleka ngemva kokucindezeleka. Abantu abanezimo ngokuvamile bavele benesifo se-hyperalgesia kanye / noma i-allodynia, esingazifihla i-OIP.
Kungakhathaliseki imbangela yobuhlungu bakho, into ebalulekile okufanele uyibuke ishintsho ebukhulu noma ubunjani bobuhlungu bakho. Bheka lezi zinhlobo zenguquko:
- Ubuhlungu obubanzi noma obusakazekayo uma imbangela eyinhloko izinzile noma ithuthuka
- Ukwanda okukhulu kobuhlungu naphezu kwesizathu esiyisisekelo esisezinzile noma esithuthukisiwe
- Ubuhlungu obuningi ngemva kokuba umthamo we-opioid ukhuphuke
- Ukunciphisa ubuhlungu uma uthatha izinhlungu ezincane
Uma ukwazi ukutshela udokotela wakho mayelana nokuthi ubuhlungu bakho buguquke kanjani nokuthi bungabonakala kanjani nokusetshenziswa kwakho kwe-opioid, kuzoba lula ukuthola isithombe esicacile salokho okubangela ubuhlungu.
I-OIP vs. Ukwandisa Ukubekezelela Imithi
Ukucindezela inqubo yokuxilonga kwandisa ukubekezelelana kwezidakamizwa. Ukusetshenziswa kwesikhathi eside kulezi zidakamizwa kuyaziwa kakhulu ukuholela ekubekezelelaneni okukhudlwana, okungaholela ekutheni umthamo wenyuka njalo.
Ngakho-ke, ngezinye izikhathi, amazinga obuhlungu aphakama hhayi ngoba i-opioids iyayibangela, kodwa ngenxa yokuthi ukhulise ukubekezela emithini, okusho ukuthi akusebenzi nje njengoba kusetshenziswe. Utshela kanjani umehluko?
Akulula. Qinisekisa ukuthi ukhuluma nodokotela wakho ngalokho okwenzekayo nokuthi ungazi kanjani ukuthi yini ebangela ubuhlungu bakho. Ukuzihlola ngomthamo ngokwakho kungaba yingozi kakhulu, futhi kungase kungakunikezi ulwazi oluwusizo.
Ukwelapha Ubuhlungu Ophiwe Opioid
Uma isizathu sokuba ubuhlungu obukhulu buphelile, khona-ke ukuphathwa okunengqondo ukuphuma kwama-opioids. Kuye ngesilinganiso nokuthi kuthathwe isikhathi esingakanani, lokho kungadinga inqubo yokugaya kancane kancane ukugwema izimpawu zokuhoxisa.
Uma, noma kunjalo, imbangela yobuhlungu iqhubeka, udokotela wakho angancoma ukunciphisa umthamo ukuze ubone ukuthi lokho kususa i-OIP. Uma usuka kuma-opioids, kungenzeka ukuthi ubuhlungu bakho be-OIP bube bubi okwesikhashana ngaphambi kokuhamba.
Ungathola futhi ukukhululeka ngokushintsha uhlobo lwe-opioid oyisebenzisayo. Isibonelo, i-hydrocodone, i-fentanyl, ne- tramadol zivela emakilasini ahlukene.
Ngezinye izikhathi, odokotela bazozama ukufaka uhlobo oluhlukile lwe-painkiller-kungaba i-COX-2 inhibitor noma okungezona-steroidal anti-inflammatory (NSAID) -ngena ngesilinganiso esiphansi sama-opioid. Lezi zidakamizwa zingasiza ukubhekana nezinyathelo ezingavamile ze-glutamate ne-substance P ezikholelwa ukuthi zifaka isandla kwezinye izimo ze-OIP.
Ezinye izidakamizwa ezingase ziwusizo ekwelapheni i-OIP zihlanganisa:
- I-Dextromethorphan
- I-Methadone (uma i-OIP ingewona ohlobene ne-methadone)
- Buprenorphine
- I-Ketamine
- I-Dexmedetomidine ihlanganiswe ne-flurbiprofen eseceleni
I-curcumin yokwengeza (into e-spice turmeric) ingase iguqule i-OIH, ngokusho kocwaningo luka-2016 ku- PLoS One .
Esifundweni sika-2016 eshicilelwe kuyi- Scientific Reports , abacwaningi babike ukuthi ukuguquka kwesimo esithile se-stem cell kuguquguquke i-OIH kanye nokubekezelelana kwe-morphine.
Ukuvimbela ubuhlungu obunama-opioid
Yiqiniso, kungcono uma ungakwazi ukuvimbela i-OIP endaweni yokuqala. Ucwaningo olwenziwa ngo-2017 olushicilelwe kwi- Current Opinions ku-Anaesthesiology lukhuthaza ukuncintisana ngezigaba zama-opioid, ukuhlala esilinganisweni esincane kunazo zonke, nokuhlanganisa ama-opioid ngamaphilisi angenayo i-opioid. Ukufaka ama-dose ephakeme kancane kancane kungase kugcine i-OIP ingathuthuki.
Ungase futhi ufuna ukuhlola ukwelashwa okungewona okwelapha ubuhlungu bakho ukusiza ukugcina ukusetshenziswa kwakho kwe-opioid phansi ngenkathi ungangqubudi izinga lokuphila.
Ukwelapha Okungeyona Imithi Yezinhlungu
Ukunakekelwa okulungile okungewona izidakamizwa kuncike ekubambeni ubuhlungu bakho futhi kuyinto okufanele uxoxe nodokotela wakho. Ukwelashwa okuvamile kuhlanganisa:
- I-Acupuncture
- Ukwelashwa kwe-Massage
- Ukwelapha ngokomzimba
- I-Chiropractic
- I-Biofeedback
- Ukwelashwa kokuziphatha kwengqondo
- Izithako
Abanye abantu abanezinhlungu ezingapheli bathola impumuzo ekuzivocavoca ngobumnene njenga:
Izwi elivela
Uma ubona ukukhuphuka kobuhlungu noma ushintsho ngendlela yobunzima bakho, khuluma nodokotela wakho mayelana nokuthi kungenzeka yini ngenxa ye-opioids yakho. Ubuhlungu obungapheli buyathatha umonakalo empilweni yakho njengoba kungukuthi-awudingi imithi yakho okwenza ubuhlungu bubi nakakhulu!
Uma wena nodokotela wakho benquma ukuthi kufanele niyeke ukuyithatha, qiniseka ukuthi ufunda ukuthi ungayinqamula kanjani kahle futhi ulandele imiyalelo.
Ngezidakamizwa, ukulutha umlutha kungenzeka. Akukho amahloni kulokho-kungumphumela wemvelo wemithi. Noma kunjalo, kungasho ukuthi udinga usizo olwengeziwe. Lokhu kuyinto yokuxoxa nodokotela wakho.
Kungaba ukwethusa kakhulu ukuyeka ukuthatha imithi oyithembele kuyo ukusebenza. Zama ukugxila ekunciphiseni ubuhlungu bakho futhi uthuthukise impilo yakho, futhi khumbula ukuthi unezinye izindlela zokwelapha ukuhlola.
> Imithombo:
> Lee M, Silverman SM, Hanse H, Patel VB, Manchikanti L. Ukubuyekezwa okuphelele kwe-hyperalgesia eyenziwe ngama-opioid. Udokotela wezinhlungu. 2011 Mar-Apr; 14 (2): 145-61.
> Li SQ, Xing YL, Chen WN, et al. Ukuvuselelwa kwe-NMDA receptor kuhlotshaniswa nokuphakanyiswa okuphezulu kwe-COX-2 ukuveza uphondo lwe-spinal dorsal ngenkathi kutholakala ama-nociceptive ama-rats. I-Neurochem Res . 2009; 34: 1451-1463.
> I-Ramasubbu C, i-Gupta A. Ukwelapha ngokwemithi ye-hyperalgesia eyenziwe ngama-opioid: ukubuyekezwa kobufakazi. Journal of ubuhlungu & ukunakekelwa palliative pharmacotherapy. 2011; 25 (3): 219-30. doi: 10.3109 / 15360288.2011.589490.
> U-Silverman S. Opioid wakhuthaza i-hyperalgesia: impikiswano yomtholampilo yomsebenzi wezinhlungu. Udokotela Wezinhlungu . 2009; 12: 679-684.
> Wasserman RA, Brummett CM, Goesling J, Tsodikov A, Hassett AL. Izici zeziguli ezizwa ubuhlungu be-chornic ezithatha ama-opioid futhi ziqhubeka zibika ubuhlungu obukhulu. I-anesthesia yesiFunda kanye nemithi yokwelapha. 2014 Jan-Feb; 39 (1): 13-7. i-doi: 10.1097 / AAP.0000000000000024.
> Yu Z, Wu W, Wu X, et al. Imiphumela yokuzivikela ye-dexmedetomidine ihlangene ne-flurbiprofen ngokuxilongwa kwe-hyperalgesia okukhipha i-remifentanil: isilingo esilawulwa ngokungahleliwe. Imithi yokuhlola kanye nokwelapha. 2016 Okthoba; 12 (4): 2622-2628.