Kwenzekani lapho ukwelashwa kwakho okuvamile kungabandeli ubuhlungu?
Iyini Ubuhlungu Bokuhamba?
Ubuhlungu bokuhlukumezeka, okubizwa nangokuthi ubuhlungu be-episodic, igama elibhekiswe ebuhlungu (kokubili umdlavuza kanye non-umdlavuza, nakuba kuningi kakhulu owaziwa ngomdlavuza ophuthumayo) ofika ngokushesha kakhulu futhi enzima, uma usuvele uphathwa imithi yokuhlunguphaza isikhathi eside. (Ubuhlungu "buqeda imithi evamile.) Elinye igama lobuhlungu bokuphumelela" livuleka. "
Ukuphuza okubuhlungu kanye / noma ukuhlukunyezwa kungase kube nzima ngokwanele ukukhubaza noma kukuvimbela. Zenzeka ezimweni zobuhlungu emuva, ubuhlungu bomdlavuza, ubuhlungu be-neuropathic, nokuningi. Ngokuvamile kuhlotshaniswa nobuhlungu bomdlavuza. Ukuze ubuhlungu buvezwe njengobuhlungu obubuhlungu, ubuhlungu obuqhubekayo kufanele buvele kuqala.
Cishe bonke abantu abanezinhlungu ezibuhlungu zokubuhlungu emuva kwesikhathi.
Ukuhlukunyezwa Kwezinhlungu Zobuhlungu
Esifundweni sabo esinesihloko esithi "Impact ye-opioid imithi yokusiza ukuphuza ubuhlungu ekusebenzeni kahle nokubekezelelana kwama-opioid asebenza isikhathi eside ezigulini ezinezinhlungu ezingapheli ezingenabuhlungu," eyanyatheliswa kuyi- British Journal ka-Anaesthia , i-Devulder ne-Okthoba 2009. abahlobo bathi ukuhlukunyezwa ngokuvamile kuthatha imizuzu engaba ngu-10 ukuba iqhubekele ngokugcwele, nokuthi isiqephu singase sigcine (esingama-60) amaminithi.
Uma unezinhlungu zokuhlukunyezwa ezihlobene nesisindo, ungase uthole ama-episodes ambalwa, avamile.
Leli phethini lifaka isandla ekuphenduleni izimpendulo ekuhluphekeni nakwezinye izinkinga kubantu abanezinhlungu zomzimba . Izibonelo zalezi zimpendulo ezishintshiwe zifaka:
Ubuhlungu bokuphulukisa bungabangela odokotela; Isizathu esisodwa salokhu ukuthi izimpawu zivame ukuzithoba. Ngokudabukisayo, lokhu kungaholela ekuxilongweni okungaqondakali futhi ngaphansi kokwelapha.
Ukuphulukisa Imithi Yokuhlunguphaza
Ochwepheshe bezinhlungu zokuhlukumeza ngokuvamile bancoma odokotela ukuthi bahlela ukwelashwa kwesiguli ngasinye. Ubuhlungu bokuphumula buvame ukwelashwa nge-opioid ehamba kancane (izidakamizwa). Imithi ehlinzekwa ubuhlungu bokuhlukumeza ibizwa ngokuthi "imithi yokuhlengwa."
Kunezinhlobo eziningana zobuhlungu obunzima, ngakho-ke ukucacisa ukuthi imiphi imithi ezobhekana neyakho kufanele kwenziwe ngokubambisana nodokotela wakho. Udokotela wakho uzodinga ukwazi ngawe, umlando wakho wezokwelapha, isimo sakho semuva, nobuhlungu bakho bamuva. Ukugcina ishadi lobuhlungu noma idayari cishe kuzokusiza lapha ngoba kuyindlela yokuzibika ukuthi odokotela bavame ukuthembela ekuhlolweni kwabo. Udokotela wakho usebenzisa ulwazi olumnika lona mayelana nephethini, imbangela (uma unolwazi), ukuqina, nokuqala kwesiqephu (s) ukucacisa uhlobo oluthile oluthile futhi ukufanisa nemithi ethile ye-opioid esheshayo.
Ngezinye izikhathi, ubuhlungu bokuphulukisa bungacaciswa. Kulesi simo, udokotela wakho angalindela kusengaphambili futhi akunikeze ama-opioid ama-short acting actively. Uhlobo oluhlukile lokwelapha lunganikezwa lapho ubuhlungu bokuphuza bukwazi ukubikezelwa. Lesi yisinye sezizathu (eziningi) ukuthi kungani kungcono ukuxhumana kahle izimpawu zakho nomlando wezokwelapha kudokotela wakho odokotela.
Ngokusho kukaManchikanti, et. Al, ekubuyekezweni okushicilelwe encwadini ye- Pain Physician ngo-2011, akukhona nje kuphela ukuthi akukho bufakazi besayense bokuthi ubuhlungu bubuhlungu, kodwa ukusetshenziswa kwama-opioid ukuphatha lona umsolwa.
Abalobi babika ukuthi ukwelashwa (ubuhlungu obungapheli komdlavuza) obunama-opioid narcotics kuye kwanda eminyakeni eyishumi eyedlule noma kunjalo, futhi bathi ukunyuka kokumiswa kuye kwaholela ekusetshenzisweni okudliwayo odokotela, kanye nokusebenzisa kabi izidakamizwa, futhi abaningi izinkinga (ezibizwa ngokuthi imicimbi yezidakamizwa ezimbi.)
Ukubukeza akutholanga ubufakazi obubalulekile kunoma yiluphi uhlobo lwezinhlungu ezibuhlungu ezincwadini zezokwelapha ezingezona zomdlavuza ezingapheli.
Abalobi bathi ukunyuka kwama-opioid okungeyona umdlavuza ongapheli komdlavuza kungabhekwa emuva ngasekupheleni kwawo-1990 lapho amabhodi wezokwelapha ezwe eqala ukukhulula imithetho ephathelene nokusetshenziswa kwalesi sici. Kusukela ngaleso sikhathi, ukugqugquzela ukuhlinzekwa kwama-opioid kuye kwanda kakhulu, kanye nodokotela ngabanye kanye nezinhlangano ezinamandla neziguli ezingelapheki ezimile ngemuva kwalolu hlelo.
Ukwelashwa Okungekho Kwezidakamizwa Nasekhaya Ukuhlukunyezwa Kwezinkinga
Izifo ezingezona izidakamizwa zingahle zihlanganiswe nama-opioids ngenxa yezinhlungu. Udokotela wakho angakeluleka ukuba unciphise umsebenzi wakho, ukusebenzisa i-ice noma ukushisa, noma ezinye zokwelapha ekhaya. Angase akubhekise ekwelapheni ngokomzimba noma ngokusikhipha, noma kumchwepheshe we-block block.
Ukuze uhlanganise indlela yokuphila kanye nemithi yokwelashwa ehlukile emisebenzini yakho yokuphatha ubuhlungu, kubalulekile ukukhuluma nodokotela wakho ngokuqondile.
Imithombo:
UBennett D, uBurton AW, Fishman S, et al. Izincomo zezincomo ze-Consensus zokuhlola nokuphathwa kobuhlungu obukhulu. Ingxenye 1: Ukuhlola. I-Pharm Ther. 2005.
UBennett D, uBurton AW, Fishman S, et al. Izincomo zezincomo ze-Consensus zokuhlola nokuphathwa kobuhlungu obukhulu. Ingxenye 2: Ukuphathwa. Kufinyelelwe: Dec 2010. PT Community
I-Devulder J, et. al. Umthelela wemithi yokusiza i-opioid yokuphuza ubuhlungu ekusebenzeni nokubekezelelana kwama-opioid asebenza isikhathi eside ezigulini ezinezinhlungu ezingelapheki ezingapheli. Br J Anaesth. 2009 Okthoba; 103 (4): 576-85. I-Epub 2009 Sep 6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742451/?tool=pubmed
Ubuhlungu be-Manchikanti L. Ukuhlukumezeka ebuhlungu obungapheli bomdlavuza: iqiniso, inganekwane noma ukuhlukunyezwa. Udokotela Wezinhlungu. Mashi-Ephreli 2011. Kufinyelelwe: June 2016. http://www.ncbi.nlm.nih.gov/pubmed/21412376
McCarberg BH., Ukwelapha ubuhlungu obukhulu. I-Med Med. 2007 Jan-Feb; 8 I-Suppl 1: S8-13. http://www.ncbi.nlm.nih.gov/pubmed/17280601
Payne, R., MD, i-Colliflower, E., Ukuqashelwa Nokuthola Ukuhlushwa Kwezinhlungu. Imithi Yezinhlungu. I-Vol. 8. Inombolo S1. I-American Academy of Medicine Pain. I-Blackwell Publishing Inc. 2007. Ifinyelelwe ngo-Dec 2010.