Ukuqonda jikelele iingozi zeAnesthesia kunye nemivuzo
Kukho ezininzi iziphumo ezichaphazelekayo ezinxulumene nokusetyenziswa kwe-anesthesia yokuhlinzwa kunye neenkqubo. Le micimbi iyahluka ngokubanzi kwimibandela emancinci ibe neengxaki ezinobungozi kunye nobomi. Ngenhlanhla, imiba enzima emva kokufumana i-anesthesia ayiqhelekanga kwaye isiguli esiphezulu asiyi kuba nemiba okanye iincinci kuphela kwiiyure kunye neentsuku ezilandela inkqubo yazo.
Uhlobo lweempembelelo umntu anokukwazi ukuzenza ngenxa ye-anesthesia iya kuba yinto ehluke kakhulu ngokusekelwe kuhlobo lwe-anesthesia abayifumanayo, ubude bexesha abaphantsi kwe-anesthesia, kunye nesimo sengxaki eyenza i-anesthesia iyimfuneko. Ngokomzekelo, umntwana ofuna ukuba ne-appendix ngaphandle kodwa engenazo ezinye iinkalo zempilo kwaye engaphantsi kwe-anesthesia yeyure aya kuba neengxaki ezincinci kunomntu oneminyaka engama-85 ubudala onesifo sikashukela ophethe iiyure eziliqela ze-anesthesia ngexesha lokuvula intliziyo utyando.
Jikelele iAnesthesia ichazwe
Olu hlobo lwe-aneshesia lusetyenziswa ngexesha lotyando, kwaye lisetyenziswe esibhedlele okanye kwindawo yokupaka indawo. Amachiza anikezwa njengegesi ephazamisayo kunye ne-IV ngexesha lotyando. Ngethuba lolo hlobo lwesilation, isigulane asikwazi ngokupheleleyo iindawo ezikuyo kwaye ayibuhlungu njengokuba basesimweni esinzulu kunokuba balele.
I-anesthesia jikelele idinga ukuba isigulane sibe netyhubhu yokuphefumula ibekwe ukuze ibe yindawo yokuphucula umoya ngexesha lotyando. Oku kungenxa yokuba imishanguzo ye-anesthesia jikelele ayifuni nje ukwenza isigulane singabi nalwazi kwaye ayikwazi ukuva intlungu yokuhlinzwa, iyakhubaza imizimba yomzimba kuquka imisipha eyenza imiphunga isebenze.
Ngoxa iilesi zonyango ze-anesthesia zibangele ukukhubazeka okugcina isigulane singagudluli-nto ibaluleke ngokukhethekileyo ngexesha lotyando olubucayi-oku kuya kubangela iingxaki ezibangelwa ukungathathi ixesha elide. I-Anesthesia, njengamathuba amaninzi okwenziwa ngophando, ngokuqhelekileyo ukuhlalutya ngokucophelela kwingozi echasene nemiphumo emihle-kunye nokuqiqa okufundiswa kakhulu ngumnikezeli we-anesthesia malunga nokuba kungenzeka ukuba kwenzeke, okulungileyo okanye okubi. Izenzo zithathwa kwakhona ukunciphisa amathuba ezintle kunye nokwandisa amathuba okufumana iziphumo ezilungileyo.
Kubalulekile ukukhumbula ukuba ingozi ye-anesthesia jikelele ayiyingozi kuphela isigulane esifanele siyiqonde phambi kwenkqubo yayo, ingozi yokuhlinzwa ngokufanelekileyo kufuneka icatshangelwe. Yonke inqubo ihamba nayo yodwa ingozi yemingcipheko, engahambelani ne-anesthesia. Ngokomzekelo, isiguli esinokuhlinzwa ukususa isihlomelo siya kuba neemeko ezinobungozi ezinxulumene nosulelo olukhoyo kwisihlomelo esinokusasazeka esiswini ngexesha lotyando, kunye nokusuleleka kwintsholongwane kwisicatshulwa, esingahambelani ingozi ye-anesthesia jikelele.
Imiba eqhelekileyo emva kwe-General Anesthesia
- Ukuxubusha / ukuhlambalaza : Inkxalabo eqhelekileyo emva kokuba i-anesthesia jikelele isisongela kunye nokuhlanza. I-post esebenzayo isisulu kunye nokuhlanza (PONV) kulula ukukhusela kunokuba uphathwe, kwaye amayeza amaninzi afumaneka kwizigulana ezifumana le ngxaki.
- Eyona ndlela ihamba phambili yokuba ngaba isiguli siya kuba nesiphene sokususa iisusa kunye nokuhlanza sinomdla wokubamba isantya kunye nokuhlanza emva kokuhlinzwa kwangaphambili. Abo babenayo ngaphambili baye baninzi ukuva kwakhona, kwaye baqhelekile ngaphambili ukuba banqande ukuba kungabikho kwakhona.
- Umqala womlomo / Ukuhlambalaza : Emva kokuba kufakwe ibhubhu yokuphefumula, umlomo oyingozi okanye izwi elivakalayo lingalindelwa, ingakumbi ukuba ukuhlinzwa kwakude. Nangona oku kungenakukukhusela, ukubola komlomo, i-lozenges kunye neminye imithi esetyenziselwa ukunciphisa intlungu yomlomo iyafaneleka kwiintsuku ezilandelayo emva kokuhlinzwa. Ukuphazamiseka okungaphuculanga emva kweentsuku ezi-5 ukuya kwi-7 emva kokuhlinzwa kufuneka kulungiswe kunye nomboneleli wezempilo.
- Umlomo owomileyo : Lo mbandela uxazulula xa isigulane sikwazi ukutya nokusela emva kokuhlinzwa. Umlomo uvulekile ngokukhawuleza ngexesha lotyando ngenxa yombhobho yokuphefumula, kwaye ihlala isomile xa isigulane siphakamisa.
- Ukuphazamisa / ukukhupha : Oku kusebenza ngokuqhelekileyo kumachiza anikwe ngexesha lotyando kwaye ngokusisigqibo xa isigulana sigqithisa. Inokubangela ukuba uhla oluphantsi kweqondo lokushisa lomzimba ngexesha lotyando, umba osombulula ngokulula ngokubambisa ngeembotyi ezimbalwa ezongezelelweyo ukugqithisa. Ubukho bentsholongwane bungabangela ukuphazamiseka kunye nokududuza, kodwa kuyona nto ibangelwa ngokukhawuleza emva kokuhlinzwa ngaphandle kokuba usulelo lukhona ngaphambi kokuba inkqubo.
- Ukulala: Iyeza elisebenzisa i-anesthesia jikelele lingabangela ubuthongo kunye nabantu abaninzi baqhube kwaye bavale kwiiyure emva kokuhlinzwa. Ngokuqhelekileyo, emva kobusuku obuhle bokulala, izigulane zibonisa ukuba ziziva zifana nazo.
- I-Muscle Aches : Enye yamayeza asetyenziswayo ngokuqhelekileyo nge-anesthesia jikelele iyaziwa ukuba ibangele ama-muscle aches. Ukukhohlisa ngokupheleleyo kwisithuba esinye ngexesha lotyando lunokubangela ukuba ama-accle aches. Izigulane zihlala zikhalaza ngenxa yentlungu emva kwenkqubo, ngokuphindaphindiweyo iintlungu ezibangelwa ukungakwazi ukutshintsha isikhundla ngexesha lotyando.
- Ukutshiza: Amayeza anikwe ngexesha kunye nangemva kokuhlinzwa, kwaye, ngokuphindaphindiweyo, anokubangela ukutshiza. Imishanguzo yeentlungu zepilisi idume ngokubangela ukubetha, oku kudla ngokuba yicala kunamayeza e-anesthesia.
Iingxaki ezininzi ngakumbi emva kwe-General Anesthesia
Ukudideka : Ukuguqulwa kwimeko yengqondo, ngokukodwa kulabo abadideka lula ngaphambi kokuhlinzwa, maxa wambi babonwa emva kokuhlinzwa. Oku kuqhelekileyo kubantu abadala, abanesifo sengqondo somzimba, isifo se-Alzheimer okanye ezinye iimeko ezididekayo. Ukuhlanganiswa kwamachiza kunye nokutyekela ukudideka ngokuqhelekileyo kukhokelela ekunyuseni kweempawu ukuya kuthi umzimba upheliswe ngokupheleleyo i-anesthesia.
Utshintsho oluvela kwimeko yendawo ukuya kwinto engaqhelekanga (isibhedlele, isikhungo sokukhupha) singadala ukudideka. Ukuba unonophelo olunikezelwa kwi-ICU, le yinto ebalulekileyo yengozi yokutya kunye nokudakalisa ukudideka, njengoko isigulane sihlala sishukunyiswa ngezibane kuzo zonke iiyure zomini nobusuku, izandi zoomatshini kunye nokuphazamiseka, kwaye rhoqo (eziyimfuneko) ngoncedo lwezonyango ngabasebenzi.
Ukuvuthwa okunzima : I-anesthesia jikelele ikhubaza izidumbu zomzimba, kwaye isilonda sisisundu. Akunakwenzeka kuphela ukuba imithi ithinte i-bladder, kodwa uphando oluninzi lufuna ukufakwa kwekhothaji yamanzi. Ukususwa kwecatheter ye-urinary, eyaziwayo njenge- catheter ye-foley , kunokuphazamisa ukukwazi ukuchukumisa kwiintsuku ezilandelayo.
Ukutshitshiswa kuqhelekile emva kokuba kufakwe i-foley, engakhokelela ekutshiseni xa uchama, oku kungathethi ukuba kukho ukusuleleka kwe- urinary tract (UTI) . Nangona ukusuleleka kwe-urinary tract kuyenzeka emva kokuba ne-foley eya kutyunjwa, ezininzi izigulane azibubi naziphi iziphumo ezimbi kwi-catheter. Kwiimeko ezinqabileyo, isigulane asikwazi ukucima emva kokuhlinzwa , kwaye oku kufuna ukukhawuleza unyango.
Ileus : Kanye njengoko isambatho sinokukhubazeka ngamachiza, ngokunjalo amathumbu, kwaye xa amathumbu avuki ngexesha elifanelekileyo libhekiswa njengeleus. Le ngxaki ihlala isombulula kwiintsuku ezilandelayo emva kokuhlinzwa. Ngethuba lolo suku lonyango isigulane sisoloko sigcinwe kwigumbi lokubuyisela kude liqale ukudlula igesi , uphawu lokuba abanalo i-ileus kwaye banokubuyela ekhaya ngokuphepha.
Ubunzima ukuphuma kwisipilisi : Kwizigulane ezininzi, ityhubhu yokuphefumula isuswe ngokukhawuleza ukuba ugqirha lugqityiwe kwaye bayakwazi ukuphefumula ngokwabo kwimizuzu yokugqiba inkqubo yabo. Ezinye izigulane, isigulane esidala okanye isiguli, sidinga ixesha elide ukuba lisuswe ngomoya. Izigulane ezingenakukhutshwa ngokukhuselekileyo kwi-ventilator ngokukhawuleza emva kokuba utyando lunokukwenza njalo emva kweeyure ezimbalwa ukuvusa ngaphezulu kumayeza. Kwiimeko ezinqabileyo, isigulane sidinga ukuhlala ixesha elide kwindawo yokunyamekela kakhulu ngelixa iqela lezononophelo lisebenzela ukuphefumula isigulane ngokuzimela.
Ukuphefumula / I-Pneumonia : Le ngxaki enokubakho enkulu xa kwenzeka xa ukutya okanye uketshezi kuphazamiseka ngengozi kwimiphunga ngexesha lotyando. Ngenxa yokuba isigulane asiyazi, kwaye ityhubhu yokuphefumula isendaweni, kulula ukuyifaka izinto zangaphandle kwimiphunga. Ngexesha eliqhelekileyo lobomi bemihla sikubiza ngokuthi "wehla ipayipi engafanelekanga" kwaye sinokukhwehlela nayiphi na into ephakamileyo. Ngethuba lokuhlinzwa, akunakwenzeka ukukhwehlela, okanye nokuba uqaphele ukuba into ehlayo ipayipi engafanelekanga, ekhokelela kumathe okanye okanye ehlanza ukuya kwimiphunga. Oku kungakhokelela ekubangeni kwiphunga emva kokuhlinzwa, okubhekwa njengengxaki enzulu efuna unyango lwe-antibiotic kwaye inokukhokelela ekufundeni esibhedlele kwezinye iimeko.
Iingubo zegazi : Ukuba kwindawo efanayo kunye neeyure eziliqela ngexesha lotyando lunokunyusa umngcipheko wokwenza i-blood clot, eyaziwa ngokuba yi- thrombosis yangaphakathi , emva kokuhlinzwa. La macala amaninzi ayenzeka kakhulu kwimida, ngokukodwa kwimilenze. Ukuba unake utyando kwaye wazibuza ukuba kutheni abasebenzi befuna wena kwaye uhamba kungekudala emva kokuba utyando lwakho lugqityiwe, bekukukuthintela ama-clots igazi.
I-Malignant hyperthermia: Le yimeko ebalulekileyo kakhulu yimizimba, i-reaction response kwiimpawu ezithile ezisetyenziswayo ngexesha le-anesthesia elingasongela ubomi. Le meko ibangela ukukhulelwa komkhuhlane kunye nemisipha yomzimba engakhokelela ekuphumeleleni komzimba ukuba ingafumaneki kwaye iphathwe ngokukhawuleza. Isigulane esinesihlobo kunye nomlando we-hyperthermia engafanelekiyo singavanywa ngaphambi kokufumana i-anesthetics.
Ukuqwashiswa kwe-Anesthesia : le yimeko engabonakaliyo ebangela ukuba i-anesthesia ingayisebenzisi ngokupheleleyo ekubangela ukungazi. Izigulane zibika amava avela ekukhunjuleni iinxalenye zeengxoxo eziqhutywe kwigumbi lokusebenza ngexesha lokusebenza kwazo ukukwazi ukubona, ukuva nokuziva yonke into eyenzeka ngexesha lotyando. Ngenhlanhla, ukuqwashisa i-anesthesia akuqhelekanga xa i-anesthesia efanelekileyo inikwa ngexesha le nkqubo.
> Umthombo:
> I-Anesthesia Fact Sheet. Isizwe seSizwe soPhando lwezeNzululwazi. Kufumaneke ngoMeyi, 2017. https://www.nigms.nih.gov/education/pages/factsheet_Anesthesia.aspx