Izizathu, Ukuxilongwa, kunye neNyango
Abantu abahlala bebuhlungu obungapheliyo ngamanye amaxesha baxhomekeke kwizigulane zephilisi zisebenza. Nangona kunjalo, enye yezona ntlobo eziqhelekileyo ze-painkillers, unokusebenzisa ixesha elide, uqale ukwenza intlungu yakho ibe yimbi.
Xa kwenzeka oko, kuthiwa yi- hyperalgesia (OIH) okanye i- allodynia eyenzelwe i-opioid (OIA). Nantsingiselo yale ntetho:
- I-opioid, ngamanye amaxesha ebizwa ngokuthi i-opiate okanye i-narcotic, luhlobo lwe-painkiller olwenziwa kwindlela eyenziwe ngumntu opium.
- I-hyperalgesia yandisa intlungu; iinkqubo kwinkqubo yeentlanzi zisebenzela ukwandisa ubukhulu beentlungu ozivelayo.
- I-Allodynia intlungu ebangelwa yinto engafanele ibangele intlungu, njengento ethintelayo okanye intsimbi ehamba kuyo.
Xa i-opioids iqala ukubangela okanye ibuhlungu ngakumbi intlungu yakho, kuya kufuneka ukuba ugule kuyo kwaye ufune ezinye iindlela zokulawula amanqanaba akho entlungu.
Intlungu eyenziwa yi-opioid (OIP) ingaba nzima ukuxilonga, ingakumbi kumntu onentlungu ekhoyo sele iquka hyperalgesia kunye / okanye i-allodynia.
I-opioids itholakala kuphela ngomyalelo. Ezinye iziyobisi ziqukethe kuphela i-opioid ngelixa ezinye zidibanisa i-opioid kunye nesinye isilwanyana ezifana ne-acetaminophen. IiOpioids eziqhelekileyo ziquka:
- Hydrocodone
- IOxycodone
- ICodeine
- Morphine
- IMethadone
- Fentanyl
- IMeperidine
- Hydromorphone
Yintoni Edala Ubunzima Opioid-Acuced Pain?
Iingcali zenzululwazi ayikaqinisekanga oko kubangela i-OIH. I-OIA yaqatshelwa kakhulu kungekudala kwaye sazi ngaphantsi kwayo ngaphandle kwe-OIH.
Nangona kunjalo, abaphandi bahlola amathuba amaninzi.
Ngokutsho kokuhlaziywa kwe-OIH epapashwe kwiphepha le- Pain Physician, ezinye iindlela ezinokuthi ziquka:
- Ukungaqhelekanga kwindlela yakho ingqondo ihamba ngayo imiqondiso yeentlungu
- Iimpendulo ezikhethekileyo kwingqondo yakho engasebenzi
- Inani elongezelelweyo le- glutamate ye-neurotransmitter, evuselela amangqamuzana akho ebuchopho, ngamanye amaxesha ngokugqithiseleyo-abavuselele ekufeni
- Umsebenzi ogqithiseleyo wee-receptors kwintambo yomgogodla ekhuthaza imisipha ekhethekileyo, ebizwa ngokuthi i- nociceptors , kwinkqubo yakho ye-nervous system
- Ukunciphisa i- reuptake ye-neurotransmitters ethile, egcina amazinga aphakamileyo kwingqondo
- Ukuvalelwa kobukhulu bemigudu ye-spinal neurons kwi-neurotransmitters substance P (leyo idlulisela iimpawu zentlungu ezenzelwe i-nociceptive) kunye ne-glutamate
Ezinye zeendlela ezinokusebenza zingabamba kunye nokugcina i-OIP. Nangona uphando oluninzi lubhekiselele kwinkqubo yesantya ephakathi, inkqubo ye-nervous system ingabandakanyeka kwezinye iimeko.
Ukuhlaziywa kobugqirha bePain kubonisa ubungqina bokuba i-OIP ingahlakulela ngokuhlukileyo xa kuthethwa iintlobo ezahlukeneyo zentlungu, ngokunjalo.
Ngubani Osemngciphekweni we-Opioid-Pain Pain?
Akunjalo wonke umntu othabatha i-opioids uya kuphuhlisa i-OIP. Uphando lubonisa ukuba i-genetics ingadlala indima. Ukuthatha ii-opioids rhoqo ixesha elide kwandisa umngcipheko wakho, njengoko kuthatha amanani aphezulu. Ukwandisa ngokukhawuleza umyinge wakho kukubeka kwiingozi eziphakamileyo.
Ngenxa yokuba abantu abaninzi bahlakulela ukunyamezela kwezi zi yobisi, kuyaqhelekile ukuba isiqhelo esithathayo ngenxa yentlungu engapheliyo kwandisa ngaphezu kwexesha, oku kuthetha ukuba ube ngakumbi kwaye ulungele ukuphuhlisa i-OIP.
Ukufumanisa ubuhlungu be-Opioid-Inceded
I-OIP kunzima ukuyixilonga.
Akukho mvavanyo okanye uyayiphenya, ngoko ugqirha wakho kufuneka aqwalasele iimpawu zakho kwaye akhangele ezinye izizathu ezibangele ukwanda okanye intlungu entsha. Oku kuthiwa ukuxilongwa kokungabikho, kuba kungenziwa kuphela xa amanye amathuba angabandakanywa.
Isibambiso esibalulekileyo ekuxilongweni kwe-OIP iintlungu zentlungu ebonisa into ebizwa ngokuba "intlungu yesantya" okanye " ukukhulisa phakathi ." Le miqathango ibandakanya i- fibromyalgia , i- rheumatoid arthritis , i- migraine , i- syndrome , i- ME / chronic fatigue syndrome , kunye nesifo sengqondo esisemva kwesifo. Abantu abanezi meko bahlala benesifo se-hyperalgesia kunye / okanye i-allodynia, engasenza i-OIP ifake.
Kungakhathaliseki ukuba yintoni imbandezelo yakho, into ebalulekileyo yokuyilinda kukuba utshintsho okanye ubunzima beentlungu zakho. Khangela ezi ntlobo zenguqu:
- Intlungu exhaphakileyo okanye eyahlukileyo xa isisiseko sizinzile okanye siphucula
- Ukwanda kobuhlungu ubunzima naphezu kwesizathu esibangeleyo esinqabileyo okanye esiphuculayo
- Intlungu ephezulu emva kokuba i-opioid dosage ikhuphuka
- Intlungu ephantsi xa uthatha iipilisi zincinci
Xa unako ukwazi ukuxelela ugqirha wakho malunga nendlela intlungu yakho ishintshile ngayo nokuthi ingahambelana njani nokusetyenziswa kwe-opioid, kuya kuba lula ukufumana umfanekiso ocacileyo wokubangela intlungu.
I-OIP nxamnye nokunyamezela kweMithi
Ukunyanzela inkqubo yokuxilonga kwandisa ukunyamezela kwezidakamizwa. Ukusetyenziswa kwexesha elide kwezi zi yobisi ziyaziwa ngokukhokelela ekunyamezelweni okunyukayo, oku kungakhokelela ukunyuka kwamayeza.
Ngoko ngamanye amaxesha, amanqanaba eentlungu aphakanywanga kungekhona ngenxa yokuba i-opioid iyayibangela, kodwa ngenxa yokuba uye wavelisa ukunyamezela kumayeza, oku kuthetha ukuba akusebenzi nje kunye nokusetyenziswa kwayo. Uxelela njani umahluko?
Kulula. Qiniseka ukuba uthethe ugqirha wakho malunga nento eyenzekayo kunye nendlela yokufumanisa oko kubangela intlungu yakho. Ukuzama ukulinganisa ngokwakho kungabungozi kakhulu, kwaye kungenakukunika ulwazi oluncedo.
Ukunyanga Ubunzima be-opioid
Ukuba isizathu sokuba intlungu iphelile, ngoko ke unyango olunengqiqo luya kuphuma kwi-opioids. Ngokuxhomekeke kumyinge kunye nokuba kuthathe ixesha elingakanani, oko kungadinga inkqubo yokuqhawula ngokuthe ngcembe ukuphepha iimpawu zokuyeka.
Ukuba, nangona kunjalo, imbangela yentlungu iqhubeka, ugqirha wakho unokuncoma ukunciphisa umyinge ukuze ubone ukuba oko kuphelisa i-OIP. Xa usuka kwi-opioids, kunokwenzeka ukuba ubuhlungu bakho be-OIP bube bubi kangangoko ngaphambi kokuhamba.
Unokufumana kwakhona uncedo ngokutshintsha uhlobo lwe-opioid oyisebenzisayo. Umzekelo, i-hydrocodone, i-fentanyl, kunye ne- tramadol zivela kwiiklasi ezahlukeneyo.
Ngamanye amaxesha, oogqirha baya kuzama ukongeza uhlobo oluthile lwe-painkiller-nokuba yi-COX-2 inhibitor okanye engekho-steroidal anti-inflammatory (NSAID) -ngeniso neqondo eliphantsi le-opioids. Ezi ziyobisi zingancedisa izenzo ezingavumelekanga ze-glutamate kunye ne-P ezikholelwa ukuba zinegalelo kwezinye iimeko ze-OIP.
Ezinye iziyobisi ezinokuba luncedo ekuphatheni i-OIP ziquka:
- Dextromethorphan
- I-Methadone (ukuba i-OIP ayikho i-methadone)
- Buprenorphine
- Ketamine
- I-Dexmedetomidine idibene ne flurbiprofen
I-curcumin yokuncedisa (into ekhoyo kwi-spice turmeric) inokuthi iguqule i-OIH, ngokutsho kwesifundo se-2016 kwi- PLoS One .
Ngophando lwango-2016 olupapashwe kwi- Scientific Reports , abaphandi babika ukuba ukuguqulwa kohlobo oluthile lwe-stem cell eguqulwe i-OIH kunye nokunyamezela kwe-morphine.
Ukuthintela ubuhlungu be-Opioid-Impuced Pain
Kakade, kungcono ukuba unokuthintela i-OIP kwindawo yokuqala. Ucwaningo lwe-2017 olupapashwe kwiiNgxelo eziNje kwi-Anaesthesiology licebisa ukujikeleza ngeeklasi ze-opioids, ukuhlala kwinqanaba eliphantsi kakhulu, kunye nokudibanisa i-opioids kunye ne-opioid painkillers. Ukubhalisa ukuya kumazinga aphezulu kakhulu kunokugcina i-OIP ekuphuhliseni.
Ungaphinda ufune ukuphonononga unyango olungenalo unyango lwakho ukuze uncede ukugcina i-opioid yakho isezantsi ngelixa ungahambisani nomgangatho wobomi.
Unyango lweZiyobisi ezingekho phantsi kweziyobisi
Unyango olungenalo unyango oluthile luxhomekeke kwimbangela yentlungu yakho kwaye kufuneka uxoxe nodokotela wakho. Ukungenelela okuqhelekileyo kubandakanya:
- Ukwenza i-Acupuncture
- Ukunyanga kwamayeza
- Ulungiso lwenyama
- Chiropractic
- Biofeedback
- Ulwaphulo lokuziphatha
- Izibonelelo
Abanye abantu abaneentlungu ezingapheliyo bafumana ukukhululeka ekusebenziseni okunyamekileyo njengoku:
ILizwi
Ukuba ubona ukwanda kwentlungu okanye utshintsho kwimeko yentlungu yakho, xela ugqirha wakho malunga nokuba ingaba ngenxa ye-opioids yakho. Ubuhlungu obungapheliyo bunokwaneleyo kwimeko ebomini bakho kuba-awuyidingi imithi yakho ekwenzeni kakubi nakakhulu!
Ukuba wena kunye nogqirha wakho nisenza isigqibo sokuba uyeke ukuyithatha, qiniseka ukuba ufunda indlela yokucima ngayo kakuhle kwaye ulandele imiyalelo.
Ngaloo michiza, umlutha unokwenzeka. Akukho ntloni kulowo-ngumphumo wendalo weyeza. Nangona kunjalo, kunokuthetha ukuba ufuna uncedo olungakumbi. Kwakhona into enokuxoxa ngayo nodokotela wakho.
Oku kunokwenkqisa ukuyeka ukuthatha imithi oyithembele kuyo ukusebenza. Zama ugxininise indlela enokunciphisa intlungu yakho kwaye uphucule ubomi bakho, kwaye khumbula ukuba unayo unyango oluthile lokuhlola.
> Imithombo:
> Lee M, Silverman SM, Hanse H, Patel VB, Manchikanti L. Ukuhlaziywa okubanzi kwe-hyperalgesia eyenziwa ngama-opioid. Ugqirha. Ngo-2011 uMar-Apr; 14 (2): 145-61.
> Li SQ, Xing YL, Chen WN, et al. Ukuqaliswa kwe-NMDA receptor idibene nomgaqo-uphakamiso we-COX-2 ibonakaliso kwiphondo lokugulisa umgogodla ngexesha lokufakelwa kwee-nociceptive in rats. Neurochem Res . 2009: 34: 1451-1463.
> Ramasubbu C, Gupta A. unyango lwe-Pharmacological ye-opioid-induced hyperalgesia: ukuhlaziywa kobungqina. Umbhalo weentlungu kunye nokunyamekela ulondolozo lwe-pharmacotherapy. 2011; 25 (3): 219-30. i-doi: 10.3109 / 15360288.2011.589490.
> I-Silverman S. Opioid yenza ukuba i-hyperalgesia ibe nempembelelo yonyango. Ugqirha wezinhlungu . 2009: 12: 679-684.
> Wasserman RA, Brummett CM, Goesling J, Tsodikov A, Hassett AL. Iziganeko zezigulane ze-chornic zithatha i-opioids kwaye ziqhubeka zixela ubuhlungu obukhulu. I-anesthesia yesithili kunye neziyobisi zentlungu. 2014 uJan-Feb; 39 (1): 13-7. i-doi: 10.1097 / AAP.0000000000000024.
> Yu Z, Wu W, Wu X, et al. Iziphumo ezikhuselekileyo ze-dexmedetomidine zidibanise ne-flurbiprofen i-hyperalgesia ekhutshwe nge-remifentanil. Iyeza lovavanyo kunye neyeza. 2016 Oktobha; 12 (4): 2622-2628.