Kumvetsa Kuopsa Kwambiri kwa Anesthesia ndi Mphoto
Pali zotsatira zambiri zokhudzana ndi kugwiritsidwa ntchito kwa anesthesia kwa opaleshoni ndi njira. Nkhani zimenezi zimasiyana kwambiri ndi zovuta zazing'ono komanso zovuta kwambiri. Mwamwayi, vuto lalikulu mutatha kulandira anesthesia ndilosazolowereka ndipo odwala ambiri sangakhale ndi vuto kapena ochepa chabe m'maola ndi masiku akutsatira ndondomeko yawo.
Mtundu wa zotsatira zoyipa zomwe munthu angachite chifukwa cha anesthesia zidzakhala zosiyana kwambiri ndi mtundu wa anesthesia omwe amalandira, kutalika kwa nthawi yomwe ali pansi pa kupweteka kwa thupi, ndi mtundu wa vuto lomwe linapangitsa kuti anesthesia akhale ofunika. Mwachitsanzo, mwana yemwe akuyenera kukhala ndi zowonjezereka koma alibe matenda ena ndipo ali pansi pa anesthesia kwa ora angakhale ndi mavuto oposa omwe ali ndi zaka 85 yemwe akusuta shuga yemwe ali ndi maola ambiri a anesthesia pamtima wawo wouma mtima opaleshoni.
General Anesthesia Akufotokozedwa
Mankhwala oterewa amagwiritsidwa ntchito pa opaleshoni, ndipo amagwiritsidwa ntchito kuchipatala kapena pamalo opangira opaleshoni. Mankhwala amaperekedwa monga gasi lopanda mphamvu komanso kudzera mu IV pamene akuchitidwa opaleshoni. Pa mtundu uwu wa sedation, wodwala sakudziwa kwathunthu malo awo ndipo samamva kupweteka pamene ali mu chikhalidwe chozama kwambiri kuposa kugona.
Mankhwalawa amachititsa kuti wodwala akhale ndi chubu yopuma yomwe imayikidwa kotero kuti akhoza kukhala pa mpweya panthawi yopaleshoni. Izi zili choncho chifukwa mankhwala ambiri a anesthesia samangopangitsa wodwalayo kukhala wosadziŵa ndipo samatha kumva kupweteka kwa opaleshoni, amathanso kufooketsa minofu ya thupi kuphatikizapo minofu yomwe imapangitsa mapapu kugwira ntchito.
Ngakhale kuti mankhwala ambiri a anesthesia amachititsa kuti munthu asatuluke-zomwe ziri zofunika makamaka pa opaleshoni yovuta-izi zingachititsenso mavuto omwe amayamba chifukwa chosasuntha kwa nthawi yaitali. Anesthesia, monga ma opaleshoni ambiri, kawirikawiri amafufuza mosamala za zoopsa zomwe zingakhalepo potsata mphotho zowonjezereka-komanso wophunzira wophunzira kwambiri ndi wothandizira odwala omwe amatha kuchitika, zabwino kapena zoipa. Zitengedwenso kuchepetsa mwayi wa mavuto ndikuwonjezera mwayi wa zotsatira zabwino.
Ndikofunika kukumbukira kuti ngozi za anesthesia sizinthu zokhazo zomwe wodwala ayenera kuzidziŵa asanayambe kuchita, kuopsa kwa opaleshoni yokhayo iyenera kuganiziridwa. Ndondomeko iliyonse ili ndi zifukwa zomwe zingakhale zovuta, zosagwirizana ndi anesthesia. Mwachitsanzo, wodwala amene akuchitidwa opaleshoni kuchotsa zowonjezereka akhoza kukhala ndi zifukwa zowopsa zokhudzana ndi matenda omwe ali mu zowonjezereka zomwe zingathe kufalikira m'mimba pamene akuchitidwa opaleshoni, komanso momwe angathere matendawa, omwe sagwirizana ndi zoopsa za anesthesia.
Nkhani Zowonekera Pambuyo pa General Anesthesia
- Mphuno / Kutupa : Zowopsya kwambiri pambuyo poti anesthesia ndizosautsa ndi kusanza. Zosangalatsa zapatsiku ndi kusanza (PONV) n'zosavuta kupewa kusiyana ndi kuchiza, ndipo mankhwala ambiri amapezeka kwa odwala omwe akukumana ndi vutoli.
- Kuonetsetsa kuti wodwala adzalandira chisawawa ndi kusanza ndikukhala ndi mbiri ya kusambidwa ndi kusanza pambuyo pa opaleshoni yapitayi. Anthu omwe adakhala nawo kale, amatha kukumana nawo kachiwiri, ndipo kawirikawiri amavomerezedwa kuti asadzachitikenso.
- Phuno / Hoarseness : Pambuyo pokhala ndi mpweya wopuwala, chimfine kapena mawu omveka amatha kuyembekezera, makamaka ngati opaleshoniyo inali yaitali. Ngakhale kuti izi sizingalephereke, kupopera khosi, lozenges ndi mankhwala ena omwe amachepetsa kupweteka kwa mmimba ndi oyenera masiku omwe akuchitika opaleshoni. Kuwopsya komwe sikukuyenda pambuyo pa masiku asanu ndi asanu ndi asanu ndi asanu (7) kuchokera pamene opaleshoni iyenera kuyang'aniridwa ndi wothandizira zaumoyo.
- Mlomo wouma : Nkhaniyi imatsimikiza kuti wodwala angathe kudya ndi kumwa pambuyo pa opaleshoni. Kamwa imatseguka panthawi ya opaleshoni chifukwa cha kapu ya kupuma, ndipo nthawi zambiri imakhala youma pamene wodwala akuwuka.
- Kutupa / Chills : Izi ndizofala kawirikawiri kwa mankhwala operekedwa pamene akuchitidwa opaleshoni ndipo amakhala otsimikiza pamene mankhwala amatha. Ikhoza kuyambanso chifukwa cha dontho laling'ono la kutentha kwa thupi panthawi ya opaleshoni, vuto limene limathetsedwa mosavuta povala mazenera angapo owonjezera mpaka kuzizira kuzizira. Kukhalapo kwa malungo kungayambitsenso kukhumudwa, komanso kusokonezeka, koma ndizochepa chifukwa chotsatira opaleshoni pokhapokha ngati matendawa analipo musanachitike.
- Kugona: Mankhwala omwe amagwiritsidwa ntchito kwa anesthhesia amachititsa kuti munthu agone ndipo anthu ambiri amatha kugwira ntchito maola angapo atatha opaleshoni. Kawirikawiri, atagona bwino, odwala amasonyeza kuti amadzikonda kwambiri.
- Minofu Yambiri : Imodzi mwa mankhwala omwe amagwiritsidwa ntchito ndi anesthesia ambiri amadziwika kuti amayambitsa minofu. Kubodza kwathunthu pa malo amodzi pamene opaleshoni ikhoza kuyambitsa minofu. Odwala amadandaula chifukwa cha kupweteka kwa thupi pambuyo pochitika, makamaka ululu wobwerera, chifukwa cholephera kusinthana malo pamene opaleshoni.
- Kuyamwa: Mankhwala operekedwa pakapita nthawi ndi pambuyo pochita opaleshoni akhoza, ndipo nthawi zambiri amachititsa kuti ayambe kuyabwa. Mankhwala opweteka pa mankhwalawa amadziwika kuti amachititsa kuti ayambe kuyabwa, omwe nthawi zambiri amakhala okhumudwa m'malo mowa mankhwala a anesthesia.
Nkhani Zowonjezereka Pambuyo pa General Anesthesia
Kusokonezeka : Kusintha kwaumphawi, makamaka mwa iwo omwe amasokonezeka mosavuta asanachitike opaleshoni, nthawi zina amawoneka pambuyo pa opaleshoni. Izi zimafala makamaka kwa anthu omwe ali okalamba, odwala matenda a dementia, matenda a Alzheimer kapena zinthu zina zomwe zimasokoneza. Kuphatikiza kwa mankhwala ndi chizoloŵezi chosokonezeka kawirikawiri nthawi zambiri kumapangitsa kuwonjezeka kwa zizindikiro mpaka thupi lichotseratu anesthesia.
Kusintha kuchokera kumalo a nyumba kupita ku malo osadziwika (chipatala, malo opangira opaleshoni) kungawononge chisokonezo. Ngati chisamaliro chikuperekedwa ku ICU, izi ndizidziwikiratu kuti zimakhala zovuta kwambiri kuti zikhale zovuta komanso zowonjezereka, monga momwe wodwalayo akulimbikitsira ndi magetsi nthawi zonse usana ndi usiku, kumveka kosavuta ndi kusokoneza makina, ndipo nthawi zonse (zofunikira) thandizo lachipatala ndi ogwira ntchito.
Kuvuta kukodza : Anesthesia wambiri amawopsya thupi, ndipo chikhodzodzo ndi minofu. Sikuti mankhwala okhawo angakhudze chikhodzodzo, koma opaleshoni zambiri zimafuna kukhazikitsidwa kwa catheter ya mkodzo. Kuchotsedwa kwa catheter yamakodzo, yomwe imadziwika kuti foathe catheter , ikhoza kusokoneza mphamvu yakukoka m'masiku otsatirawa.
Kuwopsya kumakhala kofala mutatha kukhala ndi foley, yomwe ingayambitse kuyaka pamene mukukaka, zomwe sizikutanthauza kuti pali matenda a mkodzo (UTI) omwe alipo. Ngakhale kuti matenda opatsirana mitsempha amatha kukhala ovuta kwambiri atatha kuchitidwa opaleshoni, odwala ambiri sakhala ndi vuto lililonse la catheter. Nthawi zambiri, wodwala sangakhoze kukodza pambuyo pa opaleshoni , ndipo izi zimafuna nthawi yomweyo kuchipatala.
Ileus : Monga momwe chikhodzodzo chikhoza kufookera ndi mankhwala, matumbo amatha, komanso pamene matumbo samadzuka mu nthawi yoyenera amatchulidwa ngati leus. Vutoli limathera masiku omwe akutsata opaleshoni. Patsiku lomwelo opaleshoni wodwala amakhala nthawi yosungiramo mpweya mpaka atayamba kudutsa gasi , chizindikiro choti alibe leusi ndipo akhoza kupita kwawo bwinobwino.
Kuvuta kuchoka pa mpweya wabwino : Kwa odwala ambiri, phukusi lopuma limachotsedwa mwamsanga pamene opaleshoni yatha ndipo amatha kupuma payekha mkati mwa mphindi zomwe amatha kukwaniritsa. Odwala ena, omwe amakhala odwala kale kapena odwala, amafunika nthawi yambiri kuti achotse mpweya wabwino. Odwala omwe sangathenso kuchotsedwa pamphepete mwachangu nthawi yomweyo atatha opaleshoni amatha kuchita zimenezi patapita maola ochepa kuti amwetse mankhwala ambiri. Nthawi zambiri, wodwalayo amafunikanso kukhala mu malo osamalidwa bwino pamene gulu lachipatala limayesetsa kupuma wodwala.
Kupuma / Chibayo : Ichi ndi vuto lalikulu lomwe limapezeka pamene chakudya kapena madzi amalowa m'mapapo pakapita opaleshoni. Chifukwa chakuti wodwalayo sakudziwa, ndipo pulogalamu yopuma imakhalapo, n'zosavuta kuyika zinthu zakunja m'mapapo. Pa moyo wamasiku ndi tsiku timayitcha "kutsika chitoliro cholakwika" ndipo timatsokomola chili chonse. Pa opaleshoni, sikutheka kuti chifufuze, kapena ngakhale kudziwa kuti chinachake chikudutsa chitoliro cholakwika, chomwe chimabweretsa m'matumbo kapena ngakhale kusanza kupita m'mapapu. Izi zingayambitse chibayo pambuyo pochita opaleshoni, zomwe zimaonedwa kuti ndizovuta kwambiri zomwe zimafuna mankhwala a antibiotic ndipo zingayambitse kuvomereza kuchipatala nthawi zina.
Magazi amagazi : Kukhala pamalo omwewo kwa maola angapo panthawi ya opaleshoni amatha kuonjezera chiopsezo chopanga magazi, omwe amadziwika ngati mitsempha yambiri ya thrombosis , pambuyo pa opaleshoni. Zipindazi zimakonda kuchitika pamapeto, makamaka miyendo. Ngati munayamba mwachitapo opaleshoni ndikudabwa chifukwa chake antchito akufunani inu ndikuyenda patangotha opaleshoni yanu itatha, kuti muteteze magazi.
Mankhwala osokoneza bongo: Izi ndizoopsa kwambiri zomwe zimayambitsa matenda, zomwe zimatengera mwadala mankhwala ena omwe amagwiritsidwa ntchito panthawi yomwe amatha kupweteka kwambiri. Matendawa amachititsa kutentha kwa thupi ndi mitsempha ya mitsempha yomwe ingayambitse thupi kuti lisagonjetsedwe ngati sichipezeka ndi kuchiritsidwa mofulumira. Wodwala yemwe ali ndi wachibale ndi mbiri ya matenda oopsa a hyperthermia akhoza kuyesedwa asanalandire anesthetics.
Anesthesia kuzindikira : ichi ndi chosowa chomwe chimabwera chifukwa cha kuchepa kwa anesthesia kusapangitse bwino kuchititsa kuti munthu asadziwe. Odwala amalongosola zochitika zomwe zikuchitika kuchokera kukumbukira mbali za zokambirana zomwe zikuchitikira mu chipinda chogwiritsira ntchito panthawi ya ndondomeko yawo kuti athe kuona, kumva ndi kumva zonse zomwe zimachitika panthawi ya opaleshoni. Mwamwayi, chidziwitso cha anesthesia si chachilendo pakakhala koyenera kuti anesthesia aperekedwe.
> Chitsime:
> Chipepala cha Anesthesia. National Institute of General Medical Sciences. Idapezeka May, 2017. https://www.nigms.nih.gov/education/pages/factsheet_Anesthesia.aspx