Ukuqonda jikelele iAnesthesia
I-Anesthesia yonyango enikwe isigulane ukukhusela intlungu. Kukho iintlobo ezininzi ze-anesthesia kunye nezinye zivumela isigulane ukuba siqaphele kwaye sijoliswe ngethuba lenkqubo yezokwelapha, ngelixa ezinye iilesi-anesthesia zinokunikezelwa ukunqanda ukuqaphela ngokwenza isigulane singabi nalwazi ngexesha lonyango.
Uhlobo lwe-anesthesia olusetyenzisiweyo luxhomekeke kwimeko yenkqubo eyenziwa ngayo, ubudala kunye nempilo yesigulane, kunye neenketho zogqirha kunye nomhlinzeki we-anesthesia.
Ngezinye iinkqubo isigulane sinako ukukhetha phakathi kweentlobo ezahlukeneyo ze-aneshesia ngelixa abanye bangadinga uhlobo oluthile.
Jikelele iAnesthesia ichazwe
Kukho iintlobo ezininzi ze-anesthesia. Olunye uhlobo luyi-anesthesia jikelele, i-anesthesia enamandla kakhulu, kunye nohlobo oluqhelekileyo olusetyenziswa rhoqo ngexesha lotyando. Olu hlobo lwe-aneshesia lwenza isigulane singaphenduli kwizinto eziphambili ezixhaswa ngumzimba.
I-anesthesia jikelele idibanisa yamachiza anenjongo yokuba isigulane singazi ukuba kwenzekani kuzo, ukuthintela intlungu, nokukhubaza umzimba ngexesha le nkqubo. Ngokuqhelekileyo kusetyenziswa ngexesha lokuhlinzwa, i-anesthesia jikelele ivumela ugqirha ukuba anikezele unyango oluya kuba buhlungu kakhulu ukuba isiguli sivukile kwaye sikwazi ukuziva.
Ngokubanzi i-aneshesia ayifuni nje ukuba umntu angazi, iphinda ikhubaze imizimba yomzimba kubandakanywa imisipha eyenza ikwazi ukuphefumula.
Ngenxa yesi sizathu, izigulane ezifumana i-anesthesia jikelele zifuna i-ventilator ukwenza umsebenzi we-diaphragm kunye nezinye izihlunu ezenza kube lula ukukhupha nokukhupha.
Kutheni i-General Anesthesia iyimfuneko?
Ngokubanzi i-anesthesia isetyenziselwa utyando olunzulu, iinkqubo ezide, kunye neenkqubo eziza kuba zibuhlungu kakhulu.
Olu hlobo lwe-anesthesia aluvumeli kuphela isigulane ukuba singene kwinkqubo ngaphandle kwentlungu, kodwa ivumela isigulane ukuba singabi nalwazi kule nkqubo.
Kwezinye uphando, kuya kuba buhlungu kakhulu ukuba uphapheme ngenxa yenkqubo, nokuba ngaba awukwazi ukuva intlungu. Khawucinge ukuba unesithuba somzimba esususwe, njengexesha lokusebenzisa i-appendectomy ukususa isihlomelo, kwaye uvuke. Ngelixa ungeke uve naluphi na intlungu, kuya kuba nzima kakhulu ukuba ufumane unyango xa uvuka kwaye uqaphele.
Izingozi ze-General Anesthesia
Ubungozi obuhambisana ne-aneshesia buhluka ngokubanzi ukusuka kwinkqubo ukuya kwinkqubo, kunye phakathi kwezigulane ezahlukeneyo. Njengoko unokucinga, isigulane ngasinye sinomngcipheko ngamnye, kuba kungekho bantu ababini bafana. Ngokomzekelo, isigulane esineminyaka engama-90 siya kuba negalelo elihluke ngokupheleleyo xa kunesiqhelo sokuhlinzwa ngaphezu kwesigulane esineminyaka engama-12 ubudala. Nazi ezinye zeengozi ezinokwenzeka:
- Isihlunu / ukuhlanza : Le yimiba yesiganeko eqhelekileyo ibhekene ne-anesthesia jikelele, kwaye kulula kakhulu ukukhusela kunokuba uphathwe. Ngenxa yeso sizathu kubalulekile ukukhankanya imbali yesiphithiphithi esibangelwa i-anesthesia ngaphambi kokuhlinzwa.
- Ukuqwashiswa kwe-Anesthesia: Le yimeko eyenzekayo xa isigulane singenakuqonda ngokupheleleyo ngexesha le-anesthesia jikelele.
- Umqala / umsindo: Okubangelwa yiphubhu yokuphefumula, le nto isicatshulwa kakhulu.
- Umlomo owomileyo: Umcimbi omncinci ohambayo xa isiguli sinako ukusela amanzi.
- Ukukhupha / ukukhupha: Oku kudla ixesha elifutshane emva kokuhlinzwa kwaye uhamba xa isigulane siphaphekile kwaye sihamba.
- Ukulala: Oku kuqhelekileyo emva kokuhlinzwa kwaye ixazulula xa umzimba uphelile uninzi lwamachiza asetyenziswa kwi-anesthesia.
- Izilonda zamasipha: Ngenxa yonyango okanye ngokulala ngethuba ngexesha le nkqubo, le meko ihlala yesikhashana kwaye ihamba emva kweeyure okanye iintsuku zokuhlinzwa.
- Ukutshiza: Iyeza zonyango zihlala zibeka ityala lokubamba, kwaye le nto ihamba xa iyeza zonyango zingasadingeki.
- Ukudideka: Izigulane ezinokuthi zidideke emva kokuhlinzwa zikhulile, zine-Alzheimer's disease, i-dementia, okanye enye imeko eyenza ukudideka rhoqo.
- Ukukhupha nzima / ukungakwazi ukuvuthwa: Oku kuqhelekileyo kwizigulane ezine-catheter ngexesha lokuhlinzwa kwaye kungathatha iiyure okanye iintsuku ukuba ibuyele kwiindawo eziqhelekileyo.
- Ileus: Le imeko apho amathumbu awavuki ngokukhawuleza njengoko kulindelwe emva kokuhlinzwa kunye nokunyakaza kuncipha kakhulu okanye kungabikho.
- Ubunzima ukuphuma kwisipilisi: Ukucola kwi-ventilator kunzima kakhulu kwizigulane ezigula kakhulu okanye izigulane ezinenkinga yokuphefumula.
- Ukuphefumula / imiphunga yepneumonia: Ukugonywa ngokukhawuleza ukutya okanye ukusetyenziswa kwamanzi ngexesha lotyando kuyingozi yokuba utyando kwaye isizathu sokuba ukutya ngokukhawuleza ngaphambi kokuhlinzwa kungavunyelwe .
- Amacwecwe egazi: Lo mbandela uqhelekileyo emva kokuhlinzwa ngenxa yokuba isiguli sisesexesha elide, eliyingozi eyaziwayo yegazi.
- I-Malignant hyperthermia: Le yimeko ebangela ukuba ubomi bungozi obubangela ukuba i-anesthesia iphendule. Ngokuqhelekileyo isebenza kwiintsapho.
Ezinye iintlobo zeAnesthesia
Ngaphambi kokuba unqume ukuba ufuna i-anesthesia jikelele kwinkqubo yakho, kubalulekile ukwazi iintlobo ezahlukeneyo ze-anesthesia ezikhoyo. Iintlobo eziqhelekileyo ze-aneshesia, ngaphandle kwe-anesthesia jikelele, zilandelayo:
I-anesthesia yesithili : Eyaziwayo njengebloko yesithili, lolu hlobo lwe-anesthesia luvimbela isigulane ukuba singava nommandla womzimba, njengengalo yonke okanye ngaphantsi kwelinqeni.
- I-aneshesia yendawo : Olu hlobo lwe-anesthesia luvimbela ukuva kwiindawo ezincinci zomzimba, njengokuba umnwe uphawulwa ukwenzela ukuba iziqu zingasetyenziselwa ukuthunga ukuvalwa.
- Ukunyamekelwa kwe-anesthesia (MAC) : Olu hlobo lwe-anesthesia, olubizwa ngokuba yi-twilight sleep, luhlobo lwe-anesthesia oluvimbela intlungu xa isigulane siyazi okanye sisilula. Isigulana sinokukhumbula yonke inkqubo okanye ayikwazi ukukhumbula iziganeko.
Ngexesha eliPhezulu le-Anesthesia
Inkqubo ye-anesthesia ngokuqhelekileyo iqala ngokudityaniswa, ukwenza kube lula ukufaka ityhubhu yokuphefumula. Uhlobo lwe-sedation lushiywe kumnikezeli we-anesthesia ukukhetha, kwaye luyahlukahluka ngokuxhomekeke kwisigulane kunye nohlobo lotyando.
Xa isigulane sisegumbini lokuqhuba, siqhotyoshelweyo kwiinkqubo zokubeka iliso, kwaye iinkqubo zokhuseleko zigqityiwe, i-anesthesia ingaqalisa. Kuqhelekileyo ukuba ngaphambi kokuba utywala imithi, "ixesha lokuphuma" lenzelwe ukuchonga isigulane kunye nenkqubo abayenayo. Oku kwenziwa ukwenzela ukuthintela ukuhlinzwa okungalunganga kwesayithi / ukungalunganga.
Xa ixesha eligqityiweyo ligqityiweyo isigulane singanikwa imishanguzo yokubakholisa kwaye umnikezeli we-anesthesia uqala inkqubo yokulungiselela isigulane sokuhlinzwa.
Intubation kunye noVentiment Ngexesha eliqhelekileyo leAnesthesia
Iimfumba zomzimba zikhubazekile ngexesha le-anesthesia jikelele, kubandakanywa izihlunu ezisiza imiphunga ukuba ithinte umoya, oko kuthetha ukuba imiphunga ayinakukwazi ukusebenza ngokwabo. Ngenxa yoko, kubalulekile ukuba i- ventilator isetyenziselwe ukuphefumula kwimiphunga. Ukuze kucace, imiphunga isebenza ngexesha le-aneshesia, ababanakho ukukwazi ukuphefumula ngenxa yokuba izihlunu ezenzayo zisebenzisayo okwethutyana.
Ukufakwa kwi-ventilator kufuna ukuba ityhubhu, ebizwa ngokuba yi-tube endotracheal, ifakwe kwi-airway. Le tube ithotshelwe kwi-tubing enkulu eya kwi-ventilator, evumela ukuba umoya-moya uhambise i-oksijini kwisigulane. Inkqubo yokufaka ityhubhu ibizwa ngokuba yi- intubation .
Ukubekwa iliso Ngethuba le-General Anesthesia
Ngexesha lotyando isigulane sijongwa ngokugqithiseleyo ngokusetyenziswa kweekhompyutheni zogqirha ezithatha izinga lentliziyo, inani le-oksijini egazini, inani lokuphefumula isigulane esithathayo, kunye ne-EKG yesigulane. Ukongezelela ekubekeni iliso ngekhompyutha, isigulane sinokuqwalaselwa ngabasebenzi be-OR kunye nomnikezeli we-anesthesia.
I-anesthesia jikelele ihlinzekwa ngokuqhelekileyo ngunyango ongu-anesthetist, obizwa ngokuba ngu-anesthesiologist, okanye i- CRNA , umhlengikazi obhalisiweyo obhalisiweyo. Bobabini banika i-anesthesia ekhuselekileyo kwaye isebenzayo, kwaye banamava amaninzi ekunikezeni i-anesthesia jikelele.
Ngethuba le nkqubo, injongo kukuba isigulane singabi nakwazi oko kwenzekayo malunga nabo, kubandakanywa kungekho ntlungu.
Ukuvuka Kuvela ku-General Anesthesia
Indlela umntu avuka ngayo kwi-aneshesia kuxhomekeke kuhlobo lotyando ababenalo kunye nendlela abaphefumula ngayo. Injongo emva kokuba i-anesthesia jikelele ikhuphe isigulane-susa ithubhu yokuphefumula-ngokukhawuleza njengoko kwenzeka emva kokuhlinzwa.
Iinkqubo eziqhelekileyo nezingenakunzima ziphela ngokugqitywa ngamachiza anqumla i-anesthesia, evuselela isigulane kwaye iphele ukukhubazeka kwezihlunu. Ezi zi gulane zinefuthe lokuphefumula zisuswe ngokukhawuleza ekupheleni kokuhlinzwa kwaye ziphefumla zodwa ngaphakathi kwemizuzu yokuhlinzwa. Ezi zi gulane zivame ukuvuka kwi-unit-post ye-anesthesia yokunakekela i-anesthesia-kwaye uhambe ekamelweni lesibhedlele okanye ubuyele ekhaya xa bevukile.
Kwezinye uphando olunzulu, ezifana nokuvulwa kwentliziyo evulekileyo okanye ukuhlinzwa kwengqondo, isigulane sivunyelwe ukuba siphume ngokukhawuleza kwi-anesthesia kwaye akukho nkonzo yokuguqula inikwe. Oku kuthetha ukuba isigulane sinokuhlala kwisipilisi emva kweeyure ezingama-6 ukuya ku-8 emva kokuhlinzwa kwaye emva kokuba i-tube yokuphefumula isuswe xa ivukile.
Ezinye izigulane ziya kuhlala zixhomekeke kwintsholongwane okanye iintsuku emva kokuhlinzwa, kodwa le nto ayifani. Izigulane ezinezifo zokuphefumula ezenza ukuphefumla kunzima kakhulu ukuba zinzima ukuba zisuswe kwi-ventilator, njengokuba zibhema kunye nezigulane.
Ukutya nokusela Emva kweAnesthesia
Xa isigulane siphaphekile emva kokuhlinzwa, kaninzi banako ukunamathela kwi-chips okanye ukuthabatha amanzi. Ukuba oku kuhamba kakuhle, isinyathelo esilandelayo kukusela i-liquids rhoqo, elandelwa ukutya rhoqo. Le nkqubo ingathatha iiyure, okanye iintsuku ukuba isigulane sineenkcenkceshe, ukuhlanza, okanye nje asizivumi ukufumana ukutya okanye utywala.
Kwiimeko ezininzi, isigulane sinako ukutya ukutya ngokuqhelekileyo ngosuku lokufumana i-anesthesia jikelele.
Ukhuseleko Emva kwe-General Anesthesia
I-American Association of Nurses Anesthetists (AANA) yenza iziphakamiso ezininzi ngokukhusela isigulane emva kokufumana i-anesthesia jikelele. Kungenxa yokuba kunokuthatha usuku olupheleleyo okanye ixesha elide ukuba i-anesthesia igqitheke ngokupheleleyo, kwaye ide ide, isigulane esiphezulu sinokuzifumana siziva silele, sivalelwa okanye sididekile.
Ngosuku lokuqala emva kokuhlinzwa, lindela ukuchitha ixesha elininzi lokuphumla ngokuzithelayo, ngokulahla, okanye ukwenza imisebenzi ephumayo. Cwangcisa ukuthatha umhla emva kwe-anesthesia jikelele emsebenzini kunye neminye imisebenzi enzima.
Iziphakamiso ze-AANA ziquka ukungasebenzi komatshini-kuquka ukuqhuba imoto-okanye ukusayina nawuphi na iphepha lomthetho ubuncinane kwiiyure ezingama-24 emva kokuhlinzwa. Hlela ukuba nomqhubi ukuba akuyise ekhaya ukusuka kwisikhungo sokuhlinzwa, kwaye uphephe ukusela utywala okanye uthabathe imishanguzo engagqithwanga ngumgqithanga wakho ngosuku lokuqala emva kokuhlinzwa.
Baphakamisa ukuba ufumane uncedo lokunakekelwa kwabantwana ukuba unabantwana abancinci ekhaya, njengoko uzakufuna ukuphumla okungaphezulu kunokwenyani okungenani ngosuku emva kokuhlinzwa, mhlawumbi ixesha elide.
ILizwi
Jikelele i-anesthesia inemingcipheko, kodwa umvuzo wokuba utyando olungenasifo lukhulu. Isigqibo sakho sokuba utyando kufuneka silinganise ingozi yenkqubo kunye ne-anesthesia oyifumanayo malunga nembuyekezo enokubakho yenkqubo. Nangona kuyiyo yonke into yokuba utyando luneengozi, kunokukhokelela kakhulu kwiintlobo zokuhlinzwa. Nguwe kuphela onokugqiba isigqibo sokuba uzimisele ukwenza utyando-kunye ne-aneshesia-ukuba iinzuzo zifanele ixesha, inzame, intlungu kunye nobungozi.
> Umthombo:
> Zonke malunga neAnesthesia. AANA. Kufike ngo-Agasti, 2017. http://www.aana.com/forpatients/Pages/All-About-Anesthesia.aspx