Ukuhlaliswa kwe-IV (Ukunyamekelwa kwe-Anesthesia Care okanye iMAC) yoBucholo
Sedation, eyaziwa ngokuba yi-anesthesia ukunakekelwa (MAC) okanye "ubuthongo bokulala," luhlobo lwe-anesthesia olubuyisela isigulane kwisigulane (IV) esifakwe kwisithambiso. Ngokuxhomekeke kwinkqubo yokugonywa, inani le-anesthesia elisetyenzisiweyo linokuvela kwixabiso elincinci-nje ngokwaneleyo ukwenza isigulane sidibene-kwisixa esinzulu kangangokuba isiguli asikwazi ukukhumbula inkqubo.
I-anesthesia ejulile isetyenziselwa ukusetyenziswa kweenkqubo ezincinci ezinjengekolonoscopy.
I-sedation ye-IV inokudibaniswa ne-anesthesia yesithili okanye yengingqi.
Iintlobo zeAnesthesia
Kukho iintlobo ezine eziphambili ze-aneshesia ezisetyenziswa ngexesha lotyando. Iintlobo ziquka:
- Anesthesia yaseNgingqi
I-anesthesia yendawo ijojo lweyeza elithatha indawo encinci. Oku kudla ukusetyenziswa ukususa umlenze wesikhumba okanye umdlavuza wesikhumba okanye ukuthatha i-biopsy. - Anesthesia yeSithili
I-anesthesia yesithili isetyenziselwa ukuphazamisa icandelo elikhulu lomzimba, ngokuqhelekileyo ngaphantsi kwelinqeni. I-anesthesia inokulawulwa ngejoyiki okanye i-catheter. Izigulane ziza kuphaphama kodwa zikwazi ukuvakalelwa kwindawo edibeneyo. Oku kudla ngokusetyenziswa ngexesha lokubeleka kunye nokuhlinzwa kwesisu, umlenze, okanye ingalo. - I-Anesthesia (IV Sedation)
I-aneshesia, okanye i-IV sedation, ilawulwa nge-vein. Izigulane ziyakwazi ukuthetha, kuxhomekeke kwinqanaba le-anesthesia elisetyenzisiweyo, okanye endaweni yokulala. Izigulane ziyakwazi ukuphefumula ngokwabo ukwenzela ukuba intubation (ukubeka ityhubhu ibe yimpompo) ayifuni. I-sedation ye-IV isetyenziselwa i-colonoscopy, ezinye iinkqubo zokuhlinzwa zeplastiki, kwaye iqhutyelwa ukusetyenziswa kwezinye iinkqubo ezenziwe ngaphambili nge-anesthetic jikelele, efana nokulungiswa kwe-hernia.
- Jikelele weAnesthesia
Jikelele i-anesthesia ilawulwa ngumbuso kumbindi okanye ngokugqithiseleyo de ukuba isigulane silahleke ingqalelo. Ukuphefumula kulawulwa ngethubhu lokugqibela eliye lafakwa kwi-windpipe. I-anesthesia jikelele isetyenziselwa izigulane ezineentsholongwane ezinkulu, ezifana nokuguqulwa kwamadolo okanye ukunyakaza okanye ukuhlinzwa kwentliziyo evulekile.
Sedation ekhuselekile ikhuselekile kwaye isebenze kulawo ma gulane afuna ukuhlinzwa okuncinci okanye inkqubo efumanisa imeko yonyango (i-biopsy).
Iinzuzo ze-Intravenous Sedation
Iintlobo zokusebenzisa i-sedation intravenous ngexesha lomsebenzi wokuhlinzwa ngoplastiki ziquka ezi zilandelayo:
- Kukho inani elichanekileyo le-anesthesia elawulwayo
- Inqanaba eliphezulu lekhuseleko
- Isibambiso esincinane sesisindo sokusasaza, ukuhlanza, ukugcinwa kwamanzi, ukunyanzelwa kwemigodi kunye ne-hyperthermia engalunganga
- Izigulana ziphuma kwi-aneshesia ngokukhawuleza
- Umngcipheko omncinci wee- clots zegazi kwaye ngenxa yoko i- pulmonary emboli (iingubo zegazi ezityhutyha emilenzeni uze uhambe emiphakeni)
- Ukuphepha umqala wengqondo emva kokuhlinzwa (i-anesthesia jikelele idinga ukufakwa kwebhubhu endotracheal engabangela ukucasuka komqala)
Ngenxa yokuba isiguli sinako ukuphefumula ngokwabo kunye ne-IV sedation, bobabini ugqirha kunye nodokotela we-anesthesiologist bayazi kakuhle ukugula kakubi phambi kwesigulane kwaye bangaphendula ngokunyuka kwi-anesthetic yendawo okanye inqanaba lokudalwa.
Izingozi ze-Intravenous Sedation (IV Sedation)
Ukusetyenzwa okuninzi kunakho ukukhusela umqhubi wokuphefumula kwaye kufuna ukunyamekela ngokucophelela kokuphefumula kokubili kunye namazinga okwenziwa kwe-oxygen.
Ukuba utywala lunzulu kakhulu, intubation endotracheal ingaba yimfuneko.
Ngaphambi kweNkqubo ye-Intravenous Sedation
Ngaphambi kokuba uqhube inkqubo enesilwanyana esilumkileyo, kufuneka ucebise ugqirha wakho malunga nokugula okanye imeko yonyango onokuyenza. Kumele uxelele ugqirha malunga nayiphi na imichiza oyithathayo kunye naluphi na uphando oluphambili, kuquka uhlobo lwe-anesthesia, oye lwayo.
Uya kucebiswa ngesidingo sokulungiselela umntu omdala onoxanduva ukuba akuqhube uye kwi-facility kwenkqubo. Kubalulekile ukuyeka ukutshaya phambi kokuhlinzwa ukunciphisa umngcipheko wokuphulukisa ngokukhawuleza emva kwenkqubo.
Ukulandela utyando lwakho, uya kunikwa uluhlu lwemiyalelo ekufuneka ulandele kunye neempawu ezikufanele zikulumke ukuba ubize ugqirha wakho.
Emva kweNkqubo ye-Intravenous Sedation
Ngokuqhelekileyo uya kuziva u-groggy emva kwenkqubo yakho kwaye unokuba neentloko kunye nesicongconi. Ngexesha lokubuyisela inkqubo, umongikazi wakho uya kujonga iimpawu zakho ezibalulekileyo, kuquka ukuxinzelelwa kwegazi , i-pulse kunye ne-oksijeni. Ngokuqhelekileyo uya kugcinwa emva kweyure ukuya kweyure ezimbini emva kokuba uya kukwazi ukubuyela ekhaya nomqhubi wakho. Kudla ngokucetyiswa ukuba umntu ahlale nawe (kwaye ingcinga efanelekileyo) kwiiyure ezingama-24 zokuqala emva kokuhlinzwa kwakho.
Ngaphantsi kwi-IV Sedation
Sedation sedation (IV sedation) okanye ukunakekelwa kwe-anesthesia (MAC) inikeza enye indawo ekhuselekileyo kwi-anesthesia jikelele kwiinkqubo ezincinci zokuhlinzwa. Ingabangela ukutshatyalaliswa ukusuka kumancinci (ukulala ngokukhawuleza) ukuya kunzulu (ubuthongo obunzulu.) Ngokuqinisekileyo, zonke iintlobo ze-anesthesia zinobungozi , kwaye kubalulekile ukuthetha nodokotela wakho ogqirha kunye ne-anesthesiologist malunga nayiphi na imeko yonyango onokuyenza, kunye nokunyamekela ngokwakho emva kwenkqubo kwaye ulandele imiyalelo oyifumanayo. Ukuba ubhema, shiya. Ukuyeka ukutshaya mhlawumbi yinto enye into umntu otshaya angakwenza kokubili ukwandisa ukhuseleko lwe-anesthesia kunye nokuphilisa kuyo nayiphina inkqubo yokucoca.
Imithombo:
Sohn, Hve-min, kunye noJ. Rvu. Ukunyamekwa kweAnesthesia Ukunyamekela ngaphakathi nangaphandle kweCandelo lokuSebenza. I-Korean Journal ye-Anesthesiology . 2016. 69 (4): 319-326.