Ukulawula Ubuhlungu Emva Kokuhlinza Kubalulekile
Izidakamizwa ezivame ukusetshenziswa ngaphambili, ngesikhathi, nangemva kwezinqubo zokuhlinzwa zihlukahluka kakhulu kusuka kwesineke kuya kwesineke. Lokhu kungenxa yokuthi imithi ethize oyitholayo isekelwe uhlobo lokuhlinzwa onalo, i-anesthesia uzobe uhamba nayo, nanoma yiziphi izinkinga zempilo ongaphansi kwakho.
Pre-Operative noma Ngaphambi Kokudokotela Imithi
Ngaphambi kokuhlinzwa, uzohlangana ne-anesthesiologist yakho.
Kulokuhambela, uzobukeza zonke izinkinga zakho zokwelapha nezamazinyo kanye nemithi, kanye nanoma yimiphi imithi oyithathayo, kuhlanganise nezithako zamakhemikhali, amavithamini, kanye nanoma yiziphi izidakamizwa ezingaphezu kwemithi njenge-aspirin.
Ngaphezu kwalokho, qiniseka ukuthi utshela i-anesthesiologist yakho ukuthi uthatha izidakamizwa ezingekho emthethweni, ubhema noma uphuze utshwala, ngoba zonke lezi zinto zingathinta indlela ophulukisa ngayo ngokuhlinzwa kwakho nokuthi izidakamizwa ze-anesthesia zisebenza kanjani.
Ngombhalo ohlangothini, kubalulekile ukuqaphela ukuthi ukuyeka ukubhema kulungile ngaphambi kokuhlinzwa njengoba kuzokwehlisa ingozi yezinkinga zamaphaphu ngemuva kokuhlinzwa, ikakhulukazi i- pneumonia . I-anesthesiologist yakho izophinde ibuze ukuthi ngabe wena noma ilunga lomndeni liye labhekana nokusabela okubi ngaphambi kokuthola i-anesthesia.
Ngokuphathelene nemithi, ngaphambi kokuhlinzwa, i-antibiotic inganikezwa ukuvimbela izifo endaweni yokuhlinzwa. Ama-antibiotics ayingxenye yezidakamizwa ezisetshenziselwa ukulwa nama-bacteria, futhi ngokuvamile avunyelwa ngomlomo (ifomu lesipilisi), noma nge-intravenously (ngokusebenzisa i-IV).
Ukukhethwa kwe-antibiotic kuncike kuhlobo lokuhlinzeka umuntu, futhi inhloso yalo ukuvimbela ukutheleleka endaweni yokuhlinzwa. Isibonelo, umuntu ophethe umshini we-coronary artery overpery angathola i-antibiotic ebizwa ngokuthi i-Ancef (cefazolin) engakapheli ihora elilodwa ngaphambi kokukhipha (ukusika ukuhlinzwa) okwenziwa.
I-ancef inikezwa nge-vein (IV), futhi i- cephalosporin yesizukulwane sokuqala isakhiwo esifanayo ne-penicillin.
Imithi Enikezwa Ngesikhathi Sokuhlinzwa
Kunezinhlobo ezintathu ezahlukene ze-anesthesia:
- I-Anesthesia yasendaweni: Uvukile, futhi imithi ijojowe esikhumbeni ukuze igweme noma ivimbe ubuhlungu endaweni ethize yomzimba (isibonelo, ukususa imvukuzane ngemuva komuntu).
- I-Anesthesia yesiFunda: Wena uphapheme, futhi imithi ijojelwe endaweni yezinzwa ukuze inqunywe ingxenye yomzimba owenziwa ngokuhlinzwa (isibonelo, i-epidural ngesikhathi sokubeletha nokubeletha).
- I-General Anesthesia: Ulele, futhi umuthi unikezwa ukuyeka ubuhlungu ukuba buzwe noma kuphi emzimbeni (isibonelo, ukuhlinzeka ukususa ingubo yomuntu noma isithasiselo).
Iningi lezinqubo ezinkulu zokuhlinza zidinga i-anesthesia ejwayelekile. Nge-anesthesia ejwayelekile, imithi ebizwa ngokuthi i-anesthetic isetshenziselwa ukudala ukungazi futhi uqinisekise ukuthi awuzwa ubuhlungu. Kungenziwa kunikezwe nge-vein (intravenously) noma ngokusebenzisa imaski ephefumulayo noma ithubhu. Isibonelo se-anesthetic esivame ukusetshenziselwa ukudala i-anesthesia yi- propofol .
Ngezinye izikhathi, ibhuloho lokuphefumula lifakwa emgodini womphefumulo womuntu yi-anesthesiologist ukuqinisekisa ukuthi umuntu uphefumula kahle ngesikhathi sokuhlinzwa.
Ngaphezu kwalokho, imithi ebizwa ngokuthi i- paralytic ingase isetshenziswe kanye ne-anesthetic ukuze iphumule ngokujulile imisipha yomzimba womuntu ngesikhathi sokuhlinzwa.
I-barbiturates kanye ne- benzodiazepines , eyaziwa ngokuthi "abahlaseli" noma izidakamizwa, ziyizigaba ezimbili ezihlobene zemithi yokwelashwa ezisetshenziselwa ukucindezela isimiso sezinzwa zomphakathi. Ngezinye izikhathi zisetshenziswe nge-anesthesia ukuzolalisa isiguli phansi nje ngaphambi kokuhlinzwa ngesikhathi sokuthola.
Izibonelo ezintathu ze-benzodiazepines ngezinye izikhathi ezisetshenziselwa ukudalwa zihlanganisa:
- I-Ativan (lorazepam)
- I-Valium (diazepam)
- I-Versed (midazolam)
Imithi Emva Kokuhlinzwa Emva kokusebenza
Ngemuva kokuba umuntu eseqedile ukuhlinza ekamelweni lokuhlinzwa, uzongena ekamelweni lokuphumula lapho abahlengikazi bezoqapha ngokucophelela amagciwane (isibonelo, izinga lenhliziyo, izinga lokuphefumula, nokucindezelwa kwegazi), futhi uqinisekise ukulawulwa okwanele okubuhlungu lapho umuntu eqala ngokugcwele vuka kusuka ku-anesthesia.
Uma uhlala ubusuku bonke, umuntu uzogcina eguduka egumbini lesibhedlela ukuze aphumule ngokuqhubekayo, alulame, futhi asebenze ubuhlungu. Ngesinye isikhathi ekamelweni lesibhedlela, abahlengikazi nodokotela bazoqhubeka nokuqapha amavithamini kanye nomkhiqizo wamanzi kanye nesilinganiso se-fluid intravenous.
Odokotela abahlinzayo bangase babe nemiyalelo ethize yendawo yokucwaninga yokuhlinzwa, njengendlela yokunakekela ukunakekelwa okufanele, nokuhlola ukuhlolwa kwegazi ukuhlola izimpawu zokugaya noma ukutheleleka.
Ngaphandle kwalezi ziqondiso zokunakekelwa, imithi efana nobuhlungu bokuphulukisa izonikezwa ukuze kugcinwe ubuhlungu lapho umzimba uphulukisa.
Ama-Analgesics
Ama-analgesics, noma imithi yobuhlungu, isetshenziselwa ukulawula ubuhlungu ngemva kokuhlinzwa. Zitholakala ezinhlobonhlobo ezihlukahlukene futhi zinganikezwa ngezindlela eziningana njenge-IV, ifomu lepilisi, i-lozenge, i-suppository, i-liquid, kanye ne-patch, lapho imithi ithola khona isikhumba.
Amandla womuthi ngamunye wezinhlungu ahluka kakhulu, njengoba nje umthamo onqunywe udokotela ungahluka kwesiguli esinye kwesinye. Ngenxa yalesi sizathu, imithi enqunyiwe iyoxhomeke kakhulu esimweni esinqunyiwe.
Ama-analgesics amaningi ase-post-operative aqukethe ama-opioid, noma ahlanganiswe noma ahlanganiswe ne-acetaminophen noma ama-NSAID.
Imishanguzo ejwayelekile eyenziwa ubuhlungu obuhlungu ehlinzekwa esibhedlela ngemuva kokuhlinzwa ngenxa yomzimba womuntu ihlanganisa i- Duramorph (morphine) ne- Dilaudid (i-hydromorphone) e- opioids .
Uma kukhishwa ukuhlinzwa, imithi ye-opioid ubuhlungu inikezwa nge-Lortab noma i-Vicodin (i-acetaminophen / i-hydrocodone) ne- Percocet (i-acetaminophen / oxycodone) .
Eminye imithi yokuphulukisa ubuhlungu-emva kokuhlinzwa okungenziwa udokotela wakho ihlanganisa:
- Ultram (tramadol)
- Ama-NSAID (isibonelo, ibuprofen)
- I-Tylenol (i-acetaminophen)
Anticoagulants
Omunye imithi ebaluleke kakhulu ovame ukunikezwa ngemva kokuhlinzwa i-anticoagulant, okuyinto imithi ephuza ukuqeda igazi. Lokhu kubalulekile njengenye yezingozi zokuhlinzeka ngegazi, ikakhulukazi i- vein thrombosis ejulile , evame ukuvela emilenzeni.
Ukuvimbela ama-clots egazi ekwakheni nasekubangela izinkinga ezifana nesifo noma isifo se-pulmonary (i-clot emaphaphu), ama-anticoagulants anikezwa nge-IV, umjovo, noma ifomu lepilisi.
Izibonelo zama-anticoagulants zifaka:
- I-Argatroban
- I-Coumadin (i-Warfarin)
- I-Heparin
- I-Lovenox (i-Enoxaparin)
Imithi Yokunciphisa Impawu
Okokugcina, udokotela wakho angase anikeze ezinye izidakamizwa zokunciphisa imithi yokunciphisa noma yikuphi ukuhlukumeza okungenzeka ukuthi ukuhlobanise nokuhlinzwa noma imishanguzo oyithathayo (isicashu kanye nokuqothulwa kuvamile ngama-opioids). Izibonelo zingafaka:
- Ama-Acid reducers afana ne-H-2 Blocker Pepcid (i-famotidine)
- Abathengisi bezitsha kanye ne-laxative evuselelayo njenge-Peri-Colace (docusate sodium / sennosides)
- Imithi yokuncibilikisa izinkinga zokuhlukunyezwa njengoZofran (ondansetron)
Izwi elivela
Uma kuziwa ekuhlinzekeni, kuyiqiniso elingenakuphikwa ukuthi imithi yenza inqubo ebekezeleleke kakhulu, ukuphumula ngokushesha futhi ubuhlungu bungaphansi. Lokhu akusho ukuthi imithi ingayinakekela yonke into, ngoba izidakamizwa zingenza okuningi ukuze zenze ngcono.
Isiguli esinesifiso sokuvuka nokuhamba ngemva kokuhlinzwa sizoba nethuba elingcono lokugwema i-pneumonia kunesiguli esingeke siphume embhedeni. Isiguli esibambe iqhaza ekuvuselelweni kuzoba namandla futhi sibuyele kangcono emisebenzini evamile kunalowo ozophoqelelwa futhi enze umkhuba wokuzivocavoca.
> Imithombo:
> Anderson DJ, u-Sexton DJ. (2017). I-Antiphytical Prophylaxis Yokuvimbela Ukutholakala Kwesifo Sokungena Esikhungweni Sabantu abadala. Ku: UpToDate, Harris A (Ed), UpToDate, Waltham, MA
> Johns Hopkins Medicine. Izinhlobo ze-Anesthesia ne-Anesthesiologist yakho.
> Mohabir PK, uGurney J. (Meyi 2015). I-Merck Manual: I-Professional Version: Isingeniso Sokunakekelwa Isiguli Esihlinzayo.
> Salkind AR. I-Antibiotic Prophylaxis Yokuvimbela Izifo Ezithathelwanayo Zokudla. Am Fam Physician . 2011 Mar 1; 83 (5): 585-90.