Ukulawula Ubunzima Emva Kokugqithwa Kubalulekile
Amachiza avame ukusetyenziswa ngaphambili, ngexesha, kwaye emva kokunyangwa kwezicwangciso ziyahlukahluka ukusuka kwisigulane ukuya kwisigulane. Oku kungenxa yokuba izidakamizwa ezithile ozifumanayo zisekelwe kuhlobo lotyando olunezo, u-anesthesia uza kuba, kunye nayiphi na ingxaki yezempilo enayo.
UkuSebenza kwangaphambili okanye Ngaphambi kokuPiliswa kweMithi
Ngaphambi kokuhlinzwa, uya kudibana ne-anesthesiologist yakho.
Kulo tyelelo, uya kuhlolisisa zonke iingxaki zakho zezokwelapha kunye namazinyo kunye nokunyamezela, kunye nawaphi na amayeza owathathayo, kuquka ukuxhaswa kwemfuyo, iivithamini kunye naliphi na izidakamizwa ezingaphezu kwe-aspirin.
Ukongezelela, qiniseka ukuba utshele i-anesthesiologist yakho ukuba uthatha iziyobisi ezingekho mthethweni, umsi, okanye uphuze utshwala, njengoko zonke ezi zinto zingathintela indlela ophilisa ngayo ekusebenzeni kwakho kunye nendlela osebenzisa ngayo iziyobisi ze-anesthesia.
Kwinqaku elincinane, kubalulekile ukuba uqaphele ukuba ukuyeka ukutshaya kulungile phambi kokuhlinzwa njengoko kuya kunciphisa umngcipheko weengxaki zemiphunga emva kokuhlinzwa, ngokugqithiseleyo imiphunga ye-pneumonia . I-anesthesiologist yakho iya kubuza nokuba ngaba ilungu lentsapho liye layiphatha kakubi ngaphambi kokuba i-anesthesia.
Ngokwamachiza, phambi kokuhlinzwa, i-antibiotic inokunikezelwa ekukhuseleni izifo kwindawo yokucoca. I-antibiotics yintlobo yezilwanyana ezisetyenziselwa ukulwa neebhaktheriya, kwaye zinikezwa ngomlomo (kwifom yefilda), okanye nge-intravenously (nge-IV).
Ukukhethwa kwe-antibiotic kuxhomekeke kuhlobo lotyando umntu ayenayo, kwaye nenjongo yalo kukuthintela isifo kwisayithi yokuqapha. Ngokomzekelo, umntu ophantsi kwe-coronary artery optic surgery angafumana i-antibiotic ebizwa ngokuthi i-Ancef (cefazolin) kwisithuba seyure enye ngaphambi kokuchithwa (ukucoca ukucoca).
I-Ancef inikezwa nge-vein (IV), kwaye i- cephalosporin yesizukulwana sokuqala isakhiwo esifanayo kwi-penicillin.
Amachiza anikwa ngexesha loPhengululo
Kukho iintlobo ezahlukeneyo ze-aneshesia:
- I-Anesthesia yaseNgingqi: Uvukile, kwaye unamayeza ajojowe esikhumbeni ukuze anqande okanye avimbe ubuhlungu kwindawo ethile ethile yomzimba (umzekelo, ukususwa kwemoyi kumbuyiselo womntu).
- I-Anesthesia yesiNgingqi: Uvukile, kwaye unamachiza ujojowe kwindawo yentsholongwane ukuba unxweme kwinxalenye yomzimba oqhutywe ngophando (umzekelo, i-epidural ngexesha lokubeleka nokubeletha).
- I-Anesthesia jikelele: Ulele, kwaye unyango lunikezelwa ukuyeka intlungu ekuvelelwe kuyo nawuphi na emzimbeni (umzekelo, utyando olusususweni lomntu okanye isongezelo).
Uninzi lweenkqubo eziphambili zonyango zifuna i-anesthesia jikelele. Ngo-anesthesia jikelele, imithi ebizwa ngokuba yi-anesthetic isetyenziselwa ukunyusa ukungazi kakuhle kwaye uqinisekise ukuba awunayo intlungu. Inokunikwa ngethuba (nge-intravenously) okanye ngokusebenzisa imaski yokuphefumula okanye ityhubhu. Umzekelo we-anesthetic esetyenziswa rhoqo ukudala i-anesthesia yipropofol .
Ngamanye amaxesha, ityhubhu yokuphefumula ifakwe kwisipopu somntu ngomntu onesi-anesthesiologist ukuqinisekisa ukuba umntu uphefumle ngokufanelekileyo ngexesha lotyando.
Ukongezelela, imithi ebizwa ngokuthi i- paralytic ingasetyenziselwa kunye ne-anesthetic ukuze ikhulule imisipha yomzimba womntu ngexesha lotyando.
Iibharbiturates kunye ne- benzodiazepines , eyaziwa ngokuba yi-"downers" okanye i-sedatives, ziinkalo ezimbini ezinxulumene nemithi yokugonywa esetyenziselwa ukuphazamisa inkqubo ye-nervous central. Ngamanye amaxesha kusetyenziswa i-anesthesia ukuzolalisa isigulane phantsi nje ngaphambi kokuhlinzwa ngexesha lokubuyisa.
Imizekelo emithathu ye-benzodiazepines ngamanye amaxesha asetyenziselwa ukudibanisa iquka:
- Ativan (lorazepam)
- Valium (diazepam)
- Versed (midazolam)
Imithi Emva kokuPiliswa koPhulo lweSithuba
Emva kokuba umntu agqiba ukuhlinzwa kwigumbi lokusebenza, uya kufumana kwigumbi lokuphucula apho oongikazi baya kujonga ngokukhawuleza iivili (umzekelo, izinga lentliziyo, izinga lokuphefumla, kunye negazi), kwaye uqinisekise ukulawulwa kwentlungu efanelekileyo njengoko umntu eqala ngokugcwele vuka kwi-anesthesia.
Ukuba uhlala ubusuku bonke, ekugqibeleni umntu uya kufudukela kwigumbi lesibhedlele ukuze aphumle, abuye abuye abuye asebenze. Xa sele esesibhedlele, oongikazi noogqirha baya kuqhubeka bevavanya iintshukumo kunye nokuvelisa umchamo kunye nesantya segazi.
Abagqirha banokuthi babe nemiyalelo ethile yendawo yokuchonga, njengendlela yokubonelela ngononophelo olwenziwe ulonda, kunye nokuhlelwa kweemvavanyo zegazi ukujonga iimpawu zokuphapha okanye ukusuleleka.
Ukongezelela kule miyalelo yokunyamekela, unyango olufana neentlungu zokuxilwa luya kunikwa ukuze kugcinwe intlungu xa iphilisa umzimba.
Uhlalutyo
Iingxaki zokuhlaziya, okanye iintlungu, zisebenzise ukulawula intlungu emva kokuhlinzwa. Zifumaneka kwiindidi ezahlukeneyo kwaye zinokunikezwa ngeendlela ezininzi ezinjenge-IV, ifomu lepilisi, i-lozenge, i-suppository, i-liquid, kunye ne-patch, apho iyeza lithathwa ngesikhumba.
Amandla enyango yemilenze nganye iyahluka ngokubanzi, njengoko umlinganiselo ochazwe ngugqirha unokuhluka kwiigulane esinye. Ngenxa yesi sizathu, imithi echanekileyo iya kuxhomekeka kakhulu kwiimeko apho imiselweyo.
Uninzi lwama-analgesics olusemva kokusebenza luqukethe i-opioids, mhlawumbi okanye luhlanganiswe ne-acetaminophen okanye i-NSAID.
Iimvumi eziqhelekileyo zokunyanga iintlungu ezinikwe esibhedlele emva kokuhlinzwa ngenxa yesisu somntu ziquka i- Duramorph (morphine) kunye ne- Dilaudidi (i-hydromorphone) e- opioids .
Emva kokukhutshwa kwindlela yokuhlinzwa, amayeza enhlungu ye-opioid anikwa ngendlela yeLortab okanye i-Vicodin (i-acetaminophen / i-hydrocodone) ne- Percocet (i-acetaminophen / oxycodone) .
Olunye unyango olwenziwe ngophulo olutyhutywayo olwenziwe ngugqirha lwakho lubandakanya:
- Ultram (tramadol)
- I-NSAID (umzekelo, ibuprofen)
- ITylenol (i-acetaminophen)
Anticoagulants
Olunye unyango olubaluleke kakhulu olunikezwa emva kokuhlinzwa luyi-anticoagulant, leyo yonyango elinciphisa ukuvalwa kwegazi. Oku kubaluleke njengenye yemingcipheko yokuhlinzwa yinkxalaba yegazi, ingakumbi i- thrombosis enesisindo esichukumisayo , esoloko ivela kwimilenze.
Ukuthintela amaqhekeza egazi ukudala kunye nokubangela iingxaki ezinjenge-stroke okanye i-pulmonary embolus (i-clot emphupheni), ii-anticoagulants zinikezwa nge-IV, injection, okanye kwifom yepilisi.
Imizekelo ye-anticoagulants ifaka:
- Argatroban
- Coumadin (Warfarin)
- Heparin
- Lovenox (Enoxaparin)
Iimpawu zokunciphisa amayeza
Ekugqibeleni, ugqirha wakho unokunika ezinye iimpawu zokunciphisa imishanguzo yokunciphisa naziphi na izinto eziphazamisayo onokuzibandakanya kunye nokuhlinzwa okanye kunye neentlungu ezithathayo (isicupunu kunye nokuziqhenya ziqhelekile ngeopioids). Imizekelo ingaquka:
- I-Acid reducers efana ne-H-2 Blocker Pepcid (i-famotidine)
- I-softol kunye ne-laxative evuselelayo njengePeri-Colace (docusate sodium / sennosides)
- Iimfucu zokusasaza isisu ezifana neZofran (ondansetron)
ILizwi
Xa kuziwa kutyando, kuyinyaniso engenakuphikiswa ukuba amayeza enza inkqubo ibekezeleleke, ukuphucula ngokukhawuleza kunye nentlungu engaphantsi. Oko akuthethi ukuba amayeza anokunyamekela yonke into, kuba iziyobisi zenza okungakumbi ukwenza ukuphucula ngcono.
Isigulane ngokuzimisela ukuvuka nokunyuka emva kokuhlinzwa siya kuba nethuba elingcono lokuphepha umphunga wesifo kunegulane ongayi kuphuma ebhedini. Isigulane esithatha inxaxheba ngokubuyiselwa ekubuyiselweni kwakhona siya kuqina kwaye sibuyele kwimisebenzi eqhelekileyo kunomntu omele adibanise aze aqhube ukwenza umsebenzi wakhe.
> Imithombo:
> Anderson DJ, u-Sexton DJ. (2017). I-Prophylaxis ye-Antimicrobial yokuKhusela ukuThatshazwa kweSayithi kwi-Adults. Ku: U-UpToDate, iHarris A (Ed), UpToDate, i-Waltham, MA
> Johns Hopkins Medicine. Iintlobo zeAnesthesia kunye ne-Anesthesiologist yakho.
> Mohabir PK, uGurney J. (Meyi 2015). I-Merck Manual: I-Professional Version: Intshayelelo kwiNkathazo yokugulisa isigulane.
> Salkind AR. I-Antibiotics Prophylaxis Yokukhusela Izifo Zokungcebeleka Kwezityalo. I-Phys Physician . 2011 uMar 1; 83 (5): 585-90.