Kumvetsa General Anesthesia
Anesthesia ndi mankhwala opatsidwa kwa wodwalayo kuti asamapweteke. Pali mitundu yambiri ya anesthesia ndipo ena amalola wodwalayo kukhala wochenjera komanso wotsogola panthawi yachipatala, pamene mankhwala ena am'thupi amatha kupatsidwa kuti asamadziwitse mwakumuthandiza wodwalayo kuti asadziwe nthawi yachipatala.
Mtundu wa anesthesia wogwiritsidwa ntchito umadalira mtundu wa ndondomeko yomwe ikuchitidwa, msinkhu komanso thanzi la wodwalayo, ndi zofuna za dokotala wa opaleshoni ndi wothandizira anesthesia.
Ndi njira zina zomwe wodwalayo angathe kusankha pakati pa mitundu yosiyanasiyana ya anesthesia pamene ena amafunikira mtundu wina.
General Anesthesia Akufotokozedwa
Pali mitundu yambiri ya anesthesia. Mtundu umodzi ndi anesthesia, anesthesia wamphamvu kwambiri, ndi mtundu umene umagwiritsidwa ntchito nthawi zambiri pa opaleshoni. Mankhwalawa amachititsa kuti wodwalayo asamvetsere zomwe zimakhala zovuta kwambiri.
Mankhwalawa amachititsa kuti wodwala asazindikire zomwe zikuchitika kuzungulira iwo, kuti asamve kupweteka, komanso kuti awononge thupi panthawiyi. Kawirikawiri amagwiritsidwa ntchito pa opaleshoni, anesthesia ambiri amalola dokotala kupereka mankhwala omwe angakhale opweteka kwambiri ngati wodwalayo ali wokonzeka kumva.
Mankhwalawa amachititsa kuti munthuyo asadziwe, komanso amachititsa kuti thupi likhale ndi minofu yomwe imapangitsa kupuma.
Pachifukwa ichi, odwala omwe amalandira anesthesia amafunikira mpweya woti azigwira ntchito ya chithunzithunzi ndi minofu zina zomwe zimathandiza kuti zikhale zotheka kuzilemba ndi kutulutsa.
N'chifukwa Chiyani Kufunikira Kwambiri kwa Anesthesia N'kofunika?
Anesthesia wambiri amagwiritsidwa ntchito pa opaleshoni yowonjezereka, njira zambiri, ndi njira zomwe zingakhale zopweteka kwambiri.
Mankhwala oterewa amalola kuti wodwalayo achite zinthu popanda kupweteka, komanso amalola wodwalayo kuti asadziwe kanthu.
Kwa opaleshoni zina, zingakhale zomvetsa chisoni kwambiri kukhala maso chifukwa cha ndondomekoyi, kaya simunathe kumva ululu kapena ayi. Tangoganizani kukhala ndi gawo limodzi la thupi, monga pulogalamu ya appendectomy kuchotsa zowonjezereka, komanso kukhala maso. Ngakhale kuti simungamve ululu uliwonse, zikanakhala zovuta kwambiri kuti muchitire opaleshoni mukadzuka komanso mutcheru.
Ngozi za General Anesthesia
Zowopsa zogonana ndi anesthesia zimasiyana kwambiri kuchokera ku ndondomeko ndi njira, komanso pakati pa odwala osiyanasiyana. Monga momwe mungaganizire, wodwala aliyense ali ndi chiopsezo chayekha, popeza palibe anthu awiri omwe ali ofanana. Mwachitsanzo, wodwala wa zaka 90 adzakhala ndi chiopsezo chosiyana kwambiri pamene ali opaleshoni yowonjezera kuposa wodwala wa zaka 12. Nazi zina mwazoopsa zowopsa:
- Nsowa / kusanza : Awa ndi omwe amavutitsidwa kwambiri odwala pambuyo pa anesthesia, ndipo ndi ovuta kwambiri kuteteza kusiyana ndi kuchiza. Pachifukwa ichi ndikofunikira kutchula mbiri ya mseru chifukwa cha anesthesia musanachite opaleshoni.
- Anesthesia awareness: Ichi ndi chikhalidwe chomwe chimapezeka pamene wodwalayo sakudziwa kwathunthu pa nthawi ya anesthesia.
- Phuno / mantha: Chifukwa cha kupopera kupuma, izi zimakhala zochepa.
- Mlomo wouma: Nkhani yaying'ono imene imachoka pamene wodwalayo amatha kumwa madzi.
- Kusokoneza / kutentha: Izi zimakhala kwa nthawi yochepa chitachitika opaleshoni ndipo zimachoka pamene wodwala ali maso komanso akusuntha.
- Kugona: Izi zimawoneka pambuyo pa opaleshoni ndipo zimatsimikiza pamene thupi latha kuchotsa mankhwala ambiri ogwiritsira ntchito anesthesia.
- Zisokonezo za mitsempha: Chifukwa cha mankhwala kapena kubodza panthawi ya ndondomeko, vutoli ndilokhalitsa ndipo limatha masiku angapo kapena masiku opita opaleshoni.
- Kuwomba: Mankhwala opweteka nthawi zambiri amachititsa kuti ayambe kuyabwa, ndipo nkhaniyi imachoka pamene mankhwala opweteka sakuthanso.
- Kusokonezeka: Odwala omwe amatha kusokonezeka atatha opaleshoni ali okalamba, ali ndi matenda a Alzheimer, dementia, kapena matenda ena omwe amachititsa chisokonezo nthawi zonse.
- Kuvuta kukodza / kusatheka kukodza: Izi ndizofala kwambiri kwa odwala omwe ali ndi catheter yamakono pa opaleshoni ndipo zingatenge maola kapena ngakhale kuti chikhodzodzo chibwerenso.
- Ileus: Izi ndizimene matumbo samadzutsa msanga monga momwe amayembekezera opaleshoni itatha ndipo kuyenda kuli pang'onopang'ono kapena kulibe.
- Kuvuta kuchoka pa mpweya wabwino: Kuyeretsa kuchokera ku mpweya wabwino kumakhala kovuta kwambiri kwa odwala kwambiri kapena odwala omwe ali ndi vuto lopuma.
- Kuchepa / chibayo: Kumeza mwachangu chakudya kapena madzi pa opaleshoni ndidzidzidzi woopsa wa opaleshoni ndipo chifukwa chake kudya nthawi yomweyo asanachitike opaleshoni siletsedwa .
- Magazi amagazi: Magaziniyi imakhala yofala pambuyo pa opaleshoni chifukwa wodwala akadali kwa nthawi yochulukirapo, yomwe imadziwika kuti ndi yotheka chifukwa cha magazi.
- Zoopsa za hyperthermia: Ichi ndi chiopsezo chowopsya chomwe chimachititsa kuti munthu asamavutike kwambiri ndi matendawa. Amayendetsa mabanja.
Mitundu Yina ya Anesthesia
Musanayambe kuganiza kuti mukufunikira anesthesia wambiri pazochitika zanu, nkofunika kudziwa mitundu yosiyanasiyana ya anesthesia yomwe ilipo. Mitundu yambiri ya anesthesia, kunja kwa anesthesia, ndi izi:
Chigwa cha m'madera : Chidziwitso chotchedwa anesthesia choterechi chimateteza wodwala kuti asamvere gawo la thupi, ngati mkono wonse kapena pansi pa chiuno.
- Anesthesia wa m'deralo : Mtundu uwu wa anesthesia umalepheretsa kumverera m'dera laling'ono la thupi, monga ngati chala chimagwedezeka kotero kuti zimagwiritsidwa ntchito kuti zisochedwe.
- Kusamalira anesthesia (MAC) : Mtundu uwu wa anesthesia, wotchedwanso twilight sleep, ndi mtundu wa anesthesia umene umaletsa kupweteka pamene wodwalayo akudziŵa kapena osakhala pansi. Wodwala akhoza kukumbukira njira yonseyo kapena sangakhale ndi kukumbukira zochitika.
Pa General Anesthesia
Mchitidwe wa anesthesia nthawi zambiri amayamba ndi sedation, kuti athe kuyika chubu chopuma. Mtundu wa sedation umasiyidwa ndi wothandizira munthu wodwalayo kuti asankhe, ndipo amasiyana mosiyanasiyana malinga ndi wodwala komanso mtundu wa opaleshoni.
Pomwe wodwalayo ali m'chipinda chogwiritsira ntchito, atagwirizanitsidwa ndi zipangizo zowunika, ndipo zokhudzana ndi chitetezo zatsirizidwa, anesthesia ikhoza kuyamba. Ndizozoloŵera kuti mankhwala asanayambe kusamba, amapatsidwa "nthawi" kuti adziwe wodwalayo komanso momwe amachitira. Izi zatsimikiziridwa kuti tipewe opaleshoni yolakwika ya site / yolakwika.
Nthawi ikadzatha, wodwalayo angaperekedwe mankhwala kuti apange mankhwalawa ndipo wothandizira odwala amayamba njira yokonzekera wodwalayo.
Intubation ndi Window Pa General Anesthesia
Minofu ya thupi ili ndi ziwalo zowopsa m'kati mwa anesthesia, kuphatikizapo minofu yomwe imathandiza mapapu kukhala ndi mpweya, zomwe zikutanthauza mapapu sangathe kugwira ntchito pawokha. Pa chifukwa ichi, nkofunika kuti mpweya uzigwiritsidwa ntchito kupereka mpweya m'mapapo. Kuti zikhale zomveka, mapapu amathabe kugwira ntchito panthawi yopweteka kwambiri, amangolephera kutulutsa mpweya chifukwa minofu yomwe imagwira ntchitoyo imatha kugwira ntchito kwa kanthawi.
Kuikidwa pa mpweya kumafuna kuti chubu, yomwe imatchedwa endotracheal tube, imayikidwa panjira. Pambuyo pake chubuchi chimagwirizanitsidwa ndi zikuluzikulu za tubing zomwe zimapita ku mpweya wotsegula mpweya, kuti mpweya uzipereka oxygen kwa wodwalayo. Ndondomeko yowonjezera chubu imatchedwa kutukuka .
Kuwunika Pa Nthawi Yonse Anesthesia
Pa opaleshoni wodwalayo amayang'anitsitsa kwambiri ndi zipangizo zamagetsi zomwe zimayendera mlingo wa mtima, mpweya wabwino m'magazi, chiwerengero cha mpweya womwe wodwalayo akutenga, komanso EKG wodwalayo. Kuphatikiza pa zamagetsi, wodwalayo akuyang'aniranso ndi OR ogwira ntchito ndi anesthesia.
Anesthesia wambiri amaperekedwa ndi wodwala wodwalayo, wotchedwa antiesthesiologist, kapena CRNA , yemwe amalembetsa odwala amaliseche. Zonsezi zimapereka mankhwala otetezeka komanso ogwira mtima, ndipo zimakhala ndi zochitika zambiri popereka anesthesia.
Panthawiyi, cholinga chake ndi chakuti wodwalayo asadziwe kwathunthu zomwe zikuchitika kuzungulira iwo, kuphatikizapo kukhala wopanda ululu.
Kudzuka Kuchokera ku General Anesthesia
Momwe munthu amachokera ku anesthesia zimadalira mtundu wa opaleshoni yomwe iwo anali nayo komanso momwe iwo akupuma. Cholinga pambuyo poti anesthesia ndikutulutsa wodwalayo-chotsani chubu chopuma-mwamsanga mwamsanga atatha opaleshoni.
Njira zowonongeka komanso zosavuta zimathera ndi mankhwala operekedwa omwe amachititsa kuti munthu asamamveke bwino, akukweza wodwalayo ndikuthera ziwalo za minofu. Odwalawa amakhala ndi mpweya wopuma mofulumira kumapeto kwa opaleshoni ndipo akupuma okha mkati mwa mphindi zochepa za opaleshoniyo. Odwalawa amatha kukhala mu chipinda chachipatala cha PACU-post anesthesia-ndikupita kuchipinda cha chipatala kapena kubwerera kwawo akakhala atadzuka.
Kuchita opaleshoni yoopsa kwambiri, monga opaleshoni yotseguka kapena opaleshoni ya ubongo, wodwala amaloledwa kuti apite pang'onopang'ono kuchokera ku anesthesia ndipo palibe wothandizira wotsatiridwa amapatsidwa. Izi zikutanthauza kuti wodwala akhoza kukhala pa mpweya wabwino kwa maola asanu ndi atatu ndi asanu ndi atatu (6-8) pambuyo pa opaleshoni ndikukhala ndi kachidutswa kabwino kamene kamachotsedwa akadzuka.
Odwala ena adzalandira mpweya wabwino kwa masiku kapena ngakhale atatha opaleshoni, koma izi sizikhala zofala. Odwala omwe ali ndi matenda opuma omwe amapangitsa kupuma kukhala kovuta kwambiri amakhala ovuta ndi kuchotsedwa pa mpweya wotentha, monga osuta ndi odwala kwambiri.
Kudya ndi Kumwa Pambuyo pa Anesthesia
Pomwe wodwalayo ali maso atatha opaleshoni, nthawi zambiri amatha kuyamwa pa zipsu za madzi kapena kumwa madzi. Ngati izi zikuyenda bwino, chinthu chotsatira ndicho kumwa zakumwa zamadzizolowezi, ndikutsatira chakudya chokhazikika. Izi zimatha kutenga maola ambiri, ngakhale masiku ngati wodwalayo akusowa, kusanza, kapena basi samamva ngati akudya chakudya kapena madzi.
Nthaŵi zambiri, wodwalayo amatha kudya chakudya chokhazikika tsiku limodzi lokhala ndi anesthesia.
Chitetezo Pambuyo Padziko Lonse Anesthesia
Bungwe la American Nurse Anesthetists (AANA) limapereka malangizo ochuluka a chitetezo cha odwala pambuyo atalandira mankhwala ambiri a anesthesia. Izi zikhoza kukhala tsiku lonse kapena nthawi yayitali kuti anesthesia ayambe kuvala, ndipo mpaka atatero, wodwalayo angapeze kuti akugona, asokonezeka kapena asokonezeka.
Kwa tsiku loyamba mutatha opaleshoni, muyembekezere kuti nthawi zambiri mupumule mwakachetechete, kupukuta, kapena kuchita zinthu zosangalatsa. Konzani pa tsiku lotsatira anesthesia kuntchito ndi ntchito zina zovuta.
Malangizo a AANA akuphatikizapo kusagwiritsa ntchito makina olemera-kuphatikizapo kuyendetsa galimoto-kapena kulemba mapepala alionse kwa osachepera maola 24 pambuyo pa opaleshoni. Konzani kuti woyendetsa bwenzi akutenge kwanu kuchokera ku malo opaleshoni, ndipo musamamwe mowa kapena kumwa mankhwala osakanizidwa osanenedwa ndi dokotala wanu opaleshoni tsiku loyamba pambuyo pa opaleshoni.
Amalimbikitsanso kuti mupeze chithandizo pothandiza ana ngati muli ndi ana aang'ono pakhomo, popeza mudzafuna kupuma mokwanira kuposa tsiku limodzi pambuyo pa opaleshoni, mwinamwake utali wotalika.
Mawu Ochokera
Mankhwala a antiesthesia amakhala ndi zoopsa, koma mphotho zokhala opaleshoni yopanda malire zingakhale zabwino. Chisankho chanu chochita opaleshoni chiyenera kuyeza kuopsa kwa njirayi ndi anesthesia yomwe mudzalandira potsata mphotho zomwe mungachite. Ngakhale ziri zoona kuti opaleshoni iliyonse ili ndi ngozi, palinso phindu lalikulu kuchokera ku opaleshoni. Ndiwo okha amene mungasankhe ngati mukufuna kuchitidwa opaleshoni-ndi anesthesia-ngati phindu liyenera kukhala nthawi, khama, ululu ndi chiopsezo.
> Chitsime:
> Zonse Za Anesthesia. AANA. Inapezeka mu August, 2017. http://www.aana.com/forpatients/Pages/All-About-Anesthesia.aspx