I-Postoperative Nausea nokuvoming (PONV) yinkinga ejwayelekile kunazo zonke iziguli ezibhekana nazo ngemva kokuhlinzwa. Ukudabuka nokuhlanza kungaba inkinga enkulu, futhi kuvame ukuqhutshwa kabi ngemithi esetshenziswa ngesikhathi sokubeletha. Imithi ye-anesthesia, ikakhulukazi, iyaziwa ngemiphumela emibi yokususa izinhlanzi. Inhlanganisela yokuhlunguphazwa kokuhlinzwa nokuhlanza kumele kugwenywe ngazo zonke izindleko, njengoba kungathandeki futhi kungabeka ukucindezeleka okukhulu endaweni yakho yokuhlinzeka.
Izingozi Zezingozi
I-anesthesia jikelele iyingozi ebalulekile yokwehlanya nokuhlanza ngemva kokuhlinzwa. Uma ujwayele ukuhlanza ngemuva kokuhlinzwa, ungase ufune ukubuza ukuthi kungenzeka yini ukuthi ube ne-anesthesia ye-IV, kunokuba kunezigesi ezivuthayo. Uhlobo olunyathelisiwe lwemithi ye-anesthesia lwaziwa ukuthi lubangele izinambuzane ezingaphezu kohlobo oluhlinzekwe ngu-IV.
Uhlobo lokuhlinzwa luyaziwa ukuthi lufaka isandla ekusizeni isisukiso nokuhlanza. Izinqubo ezincane ezingenasidingo, ukuhlinzwa okubandakanya ubuso nekhanda, ukuhlinzwa kwesisu, ukuhlinza ngokuhlinzwa kwamagciwane kanye nokuhlinza ngezigameko zokuzala kuthiwa kunezilinganiso eziphakeme ze-PONV kunezinye izinqubo.
Amadoda athambekele ekubeni nesisulu sokuhlanza nokuhlanza ngemuva kokuhlinzwa ngaphansi kweziguli zesifazane, futhi iziguli ezincane zivame ukuzwa iziguli ezingaphezu kukadala. Abantu abajwayele ukugula okuhambayo banamazinga aphezulu kakhulu okuba nesicashu, njengabangabhemi. Isiguli esiye sabhekana nesifo sokucabangela ngemuva kokusebenza ngemuva kokuhlinzwa futhi ukuhlanza ngokuhlinzwa kwangaphambilini cishe kunakho okungaphezu kokuba nesiguli esiphezulu.
Ithuluzi elibizwa nge-Apfel Scale livame ukusetshenziselwa ukuthola ukuthi isiguli singase sibe nesicanucanu futhi sihlanza ngemuva kokuhlinzwa. Kukhona imibuzo emine esikalini:
- Ingabe owesifazane wesiguli?
- Ingabe isiguli singewokubhema?
- Ingabe isiguli sibhekene nokugula kwesifo?
- Ingabe imithi ye-opioid ubuhlungu yingxenye yecebo lokutakula?
Ngempendulo ngayinye ye-yebo, isiguli sinikezwa iphuzu, kanti ezine kube inani eliphezulu lamaphoyinti. Isiguli esinephuzu elilodwa linethuba elingu-10% lesisulu sokuphuza emva kokuhlinzwa nokuhlanza, isiguli esinamaphuzu amane sinengozi engama-78%. Leli phuzu lizosiza umhlinzeki we-anesthesia anqume ukuthi imithi yokuvimbela kufanele inikezwe ngesikhathi noma ngemuva kokuhlinzwa. Uma uphaqa ngaphezu kwesi-2 ngalesi sizinga, ungase ufune ukunikeza umhlinzeki wakho we-anesthesia ukuthi usengozini yokuzihlambalaza nokuhlanza ngemuva kokuhlinzwa.
Ukuvimbela
Kwezinye iziguli, umhlinzeki we-anesthesia uzokhipha imithi ngaphambi kokuncelisa isisu nokuhlanza, okusho ukuthi bayonikeza imithi yokulwa nesicanshu ngaphambi kokuba isiguli sibe nezimpawu. Lokhu kuvame ukwenziwa lapho isiguli sitholakale ukuhlinzwa okuhambisana nezinkinga lapho kuhlanza kwenzeka. Isibonelo, iziguli ezinezikhukhula ezincane zomzimba zingaba nokucindezeleka okunzima kakhulu okubizwa ngokuthi i- dehiscence nokuzivocavoca uma kwenzeka ukuhlanza isikhathi eside. Imithi esetshenziselwa ukwelapha isicucu sevame ukuphumelela kakhulu ekuvikeleni isicanucanu kunokunciphisa izinambuzane emva kokuba kwenzeke.
Ukubuyela ekudleni okuvamile kufanele kwenziwe ngezinyathelo. Isinyathelo sokuqala ngokuncelisa nge-ice chips, uma lokhu kungenziwa ngempumelelo, isiguli sizoqala ngeziphuzo ezicacile, bese kudla okugcwele okuketshezi, okulandelwa ukudla okunomsoco futhi ekugcineni ukudla okuvamile.
Abantu abanezidingo ezithile, ezifana nokudla kwesifo sikashukela, bazobe besondla ukudla okunomsoco wesifo sikashukela, ngokuhambisana nezidingo zabo zokudla.
Ukwelapha
I-Zofran (Ondansetron): Le mithi inganikezwa nge-IV noma njengepilisi ekuvimbeleni noma ekwelapheni inhlanzi nokuhlanza.
I-Phenergan (Promethazine): Lo muthi uvame ukuhlinzekwa nge-nausea nokuhlanza, futhi unganikwa i-IV, ngomlomo njengepilisi noma isiraphu, njenge-suppository, noma njengomjovo ube yisisipha. Kuyaziwa ukuthi kunomthelela ohlangothini we-sedation, okwenza iziguli eziningi zilele.
I-Reglan (i-Metoclopramide): Le mithi inikezwa ukwandisa isenzo samathumbu, ngoba ngokuvamile ivila ngemva kokubulawa kwe-anesthesia, futhi lokhu kungaholela ekusikeni isisulu nokuhlanza.
Inikezwa njengephilisi noma nge-IV.
I-Compazine: Le mithi isetshenziselwa izixazululo eziningi, kodwa iyaziwa ukunciphisa izinambuzane nokuhlanza esigulini sokuhlinzwa. Inganikezwa njengemjovo ibe yisisipha, nge-IV, njengepilisi noma i-suppository. Kunganciphisa nokukhathazeka.
I-scopolamine: Le mithi isetshenziselwa ukugula okuhambayo kanye nesisindo sokuphuza ngemuva nokuhlanza. Ingasetshenziswa njenge-patch, inikezwa nge-IV noma njengomjovo.
IV uketshezi: Kwabanye abantu, ukuhlanza kahle nje kunganciphisa ukucabangela nokuhlanza. Kwabanye, inqubo yokuhlanza ingasheshe iholele ekudambiseni amanzi emzimbeni emzimbeni ngokuvamile asetshenziselwa kanye nemithi yokwelapha isicanucanu nokuhlanza.
I-Tube esenzakalelayo: Ukuhlanza okukhulu, ithubhu le-nasogastric lingase lifakwe esiswini. Le tube itholakala emakhaleni (noma umlomo uma isiguli sisesithombeni), singena emgodleni futhi singene esiswini. I-tube ihlanganiswe nedivaysi yokuluthwa okusebenzisa ngokucophelela ukuncibilika kwiphubhu, isuse okuqukethwe kwesisu.
> Umthombo:
> Sibutsetelo Sezinkinga Emkhakheni Wokunakekela I-Post-Anesthesia. Kusesikhathini.