I-postauseative Nausea neVomiting (PONV) yinkxalabo eqhelekileyo yokuba izigulane zijongene emva kokuhlinzwa. Ukuxubusha nokuhlanza kungabangela ingxaki enkulu, kwaye idla ngokugqithiseleyo ngamachiza asetyenziswa ngexesha lokubhedlelelwa esibhedlele. Imithi ye-Anesthesia, ngokukodwa, iyaziwa ngokuba nemiphumo yecala yokunciphisa i-nausea. Ukuhlanganiswa kwentlungu kunye nokuhlanza kufuneka kugwenywe kuzo zonke iindleko, kuba kungathandeki kwaye kunokubeka uxinzelelo olukhulu kwisiza sakho sokucoca.
Izinto zobungozi
I-anesthesia jikelele yinto ebalulekileyo yengozi yokufudumsa isisu kunye nokuhlanza emva kokuhlinzwa. Ukuba ulungele ukuhlanza emva kokuhlinzwa, ungase ufune ukubuza ukuba kunokwenzeka yini ukuba ube ne-aneshesia ye-IV, kunokuba i-gases eguquguqukayo. Uhlobo oluthile lwamayeza e- anesthesia luyaziwa ukuba lubangele iisambuko ezininzi kunokuba luhlobo olunikezwa yi-IV.
Uhlobo lotyando luyaziwa ngokuba negalelo kunye nokuhlanza. Iinkqubo ezincinci ezingenayo, ukuhlinzwa okubandakanya ubuso kunye nentloko, ukuhlinzwa kwangasese, ukuhlinzwa kwi-urinary tract and surgeries kwizitho zokuzala ziyaziwa ukuba zinamazinga aphezulu e-PONV kunezinye iinkqubo.
Amadoda athambekele ekubeni neentlanzi kunye nokuhlanza emva kokuhlinzwa ngaphantsi kwezigulane zezilwanyana, kwaye izigulane ezincinci zivame ukufumana izigulane ezingaphezu kwezigulane. Abantu abathile banesifo sokunyuswa kwesibhambathiso banamazinga aphezulu amaninzi, njengabangabhemi. Isigulane esineziqholo zangaphambili emva kokuvuthwa kwesisu kunye nokuhlanza kunye nokuhlinzwa okudlulileyo kunokwenzeka ukuba kunokuba kunokwenzeka ukuba kune-patient average.
Isixhobo esibizwa ngokuba yi-Apfel Scale sisoloko sisetyenziselwa ukuchonga ukuba isigulane sinokuba nesicaphulo kunye nokuhlanza emva kokuhlinzwa. Kukho imibuzo emine kwinqanaba:
- Ingaba isiguli sesiguli?
- Ingaba isigulane singabhemi?
- Ingaba isigulane sinezifo zokugula?
- Ngaba iiliti ze-opioid zintlungu ziyinxalenye yesicwangciso sokubuyisela?
Ngempendulo nganye yeewe, isigulane sinikezelwa ngongoma, kunye neyesine inani eliphezulu lamaphupha. Isigulane ngenye indawo ine-10% nethuba lokukhangela isicupunu kunye nokuhlanza, isigulane esinamaqondo amane sinomngcipheko we-78%. Eli nqanaba liya kunceda umnikeli we-anesthesia anqume ukuba ngaba amayeza athintekayo kufuneka anikwe ngexesha okanye emva kokuhlinzwa. Ukuba ubeka amanqaku angaphezu kwe-2 kule nqanaba, ungafuna ukuvumela umnikezeli wakho we-anesthesia ukuba uyasengozini yokuncwina okanye ukuhlanza emva kokuhlinzwa.
Thintelo
Kwezinye izigulane, umboneleli we-anesthesia uza kuqala unyango ukuze aphephe isicupunu kunye nokuhlanza, oku kuthetha ukuba baya kunika imishanguzo yokunciphisa isisulu ngaphambi kokuba isiguli sinempawu. Oku kudla rhoqo xa isigulane sinobuchopho esilungelelaniswayo xa kuhlanza kwenzeka. Ngokomzekelo, izigulane ezinomzimba omkhulu ezinomzimba zineenkcenkqalazo ezibi kakhulu ezibizwa ngokuba yi- dehiscence kunye nokunyanzeliswa xa kuhlanza ixesha elide. Amachiza asetyenziselwa ukunyusa isicupunu isoloko esebenzayo ekuthintekeleni isicongconi sokunciphisa isicupucu emva kokuba kwenzeka.
Ukubuyela kwisidlo esiqhelekileyo kufuneka kwenziwe kwinqanaba. Isinyathelo sokuqala sisondla kwi-chips ze-iceps, ukuba oko kungenziwa ngempumelelo, isigulane siza kuqala ngokutya okucokisekileyo, emva kokutya okutyebileyo okulandelelweyo, okulandelwa kukutya okutyebileyo kwaye ekugqibeleni kukutya okuqhelekileyo.
Abantu ngabanye abaneemfuno ezithile, ezifana nesondlo sokutya ngesifo sikashukela, babeza kutyhila ukutya okunomdla wesifo sikashukela, ngokuhambisana neemfuno zabo zokutya.
Unyango
I-Zofran (Ondansetron): Eli nyanga linokunikwa nge-IV okanye njengepilisi yokukhusela okanye unyango lwezonyameko kunye nokuhlanza.
I-Phenergan (Promethazine): Eli gama linikezelwa ngokusasazeka nokuhlanza, kwaye unokunikezwa IV, ngomlomo njengepilisi okanye isiraphu, njenge-suppository, okanye njengengxube e-muscle. Kuyaziwa ukuba nefuthe elibi le-sedation, okwenza ezininzi izigulane zilele.
Reglan (Metoclopramide): Eli nyanga linikezelwa ukwandisa isenzo samathumbu, njengoko zihlala zilukhuni emva kwe-anesthesia, kwaye oku kunokubangela isicupucu nokuhlanza.
Inikwe njengepilisi okanye nge-IV.
I-Compazine: Le nyeza isetyenziselwa imiba emininzi, kodwa iyaziwa ekunciphiseni isicupunu kunye nokuhlanza kwisigulane sokuhlinzwa. Inokunikezwa njengento yokungena kwi-muscle, nge-IV, njengepilisi okanye i-suppository. Inokunciphisa uxhalaba.
I-Scopolamine: Eli gama lisetyenziselwa ukugula kwesibhambiso kunye nesisindo sokusasazeka nokuhamba . Ingasetyenziselwa njengepatch, enikezwe nge-IV okanye njengejojo.
IV fluids: Kwababantu abathile, ukuxhamla nje kuphela kunokunciphisa isisulu sokuncwina nokuhlanza. Kwabanye, inkqubo yokuhlanza ingakhokelela ngokukhawuleza ekudambiseni amanzi emzimbeni ngokuqhelekileyo asetyenziswa kunye kunye neyeza ukuba unyango lwezonyameko kunye nokuhlanza.
I-Tube ye-Nasogastric: Ukuhlanza okukhulu, ishubhu esiswini sinokufakwa kwisisu. Le bhubhu ifakwe kwimpumlo (okanye umlomo ukuba isigulane sisesiphefumlweni), kwi-esophagus nasezantsi kwisisu. Ityhubhu ifakelwe kwisixhobo sokutshiza esenza ngokunyamekela ukutsala kwi-tube, ukususa iziqulatho zesisu.
> Umthombo:
> Inkcazo yeengxaki kwiCandelo loLondolozo lwe-Post-Anesthesia. Isemgangathweno.