Ingabe Ama-Opioid Ayadingeka Ngempela Ngemva Kwesigaba C?

-Delile

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Izwe labasebenzi nokulethwa liyashintsha, ngokushesha. Akubona nje ososayensi abathola indlela yokusheshisa ukuzala, kodwa abesifazane baphinde bakhethe izindlela ezithambile ze-C-section. Ngenkathi izingxenye ze-C zingakanconywa yi-World Health Organisation ngaphandle kokuthi kubonakale kunesidingo kwezokwelapha, kwesinye isikhathi zona kukhona kudingekile. Futhi impumelelo yakamuva yesayensi ingase yenze inqubo yokululama isheshe, ingabi buhlungu, futhi ingalutha kangako.

Vele, izingxenye ze-C ngokwabo awuyona imilutha, kepha izidakamizwa ezivame ukusetshenziselwa inqubo yokutakula ama-opioid afana nePercocet noma iVicodin-are. Futhi umbiko omusha ovela ku-QuintilesIMS Institute uthole ukuthi iziguli ezihlinzayo ezingu-9 kwezingu-10 zithola i-opioid RX ukuze zilawule ubuhlungu bangemva kokuhlinzwa. Banikezwa isilinganiso samaphilisi angama-85 lilinye-inombolo engase ibe phezulu kakhulu, njengoba umbiko uphinde wathola ukuthi ukweqisa ama-opioid ngemva kokuhlinzwa kubangele amaphilisi angasetshenziswanga ayizigidi eziyizinkulungwane ezingu-3.3 ngo-2016 kuphela.

Ucwaningo olusha olushicilelwe ku- I-Obstetrics & Gynecology isekela lokho kwabesifazane abalulama ezigabeni C. Ngemva kokuhlaziya iziguli ezingu-179, bathole ukuthi nakuba amaphesenti angu-83 asebenzisa ama-opioid isilinganiso sezinsuku eziyisishiyagalombili ngemva kokukhishwa, amaphesenti angu-75 ayesenawo amaphilisi angasetshenzisiwe. Lokho kuyingozi ikakhulukazi kwabesifazane, njengoba umbiko weQuintilesIMS uthole ukuthi abesifazane banamathuba angamaphesenti angama-40 okuba ngabasebenzisi be-opioid abaphikelelayo ngemuva kokuvezwa.

Ngakho-ke, uma abesifazane bengase babe imilutha ye-opioid, umbuzo owodwa uphakama: Ingabe ikhona indlela yokuyeka ukuthembela kubo lapho belulama esigabeni C? Omunye udokotela-Richard Chudacoff, M.D., i-ob-gyn eDumas, TX-ucabanga ukuthi impendulo inamandla yebo.

UDkt. Chudacoff uthi ubesebenzisa ezinye izindlela zokuphatha izinhlungu emashumini ambalwa edlule, njengoba ebonile ukuthi iziguli eziya phansi zingazithola lapho zithatha ama-opioid. “Kuyamangaza umphumela we-snowball abangaba nawo,” uyachaza. "Ama-opioid awabususi ubuhlungu, avele akwenze ungakhathali ukuthi ubuhlungu bukhona, okusho ukuthi awunendaba nakho konke okunye." Kepha uma ususa ama-opioid ku-equation, uDkt Chudacoff uthi iziguli zizizwa zicace ngokwengeziwe kwengqondo ngemuva kokubeletha.

Ngaphezu kwalokho, uDkt Chudacoff ulinganisela ukuthi iningi lalabo abane-opioid noma i-heroin umlutha baqala ngokuphuza amaphilisi ezinhlungu, mhlawumbe ngemuva kokuhlinzwa njenge-C-section, ngoba imvamisa ukutholakala kothile okokuqala kubo. "Uya ekhaya naleli bhodlela lamaphilisi futhi kulula ukuwasebenzisa ukuze akusize ulale, unyakaze, futhi uzizwe ungcono uma ucindezelekile kancane." (Ukucindezeleka kwangemva kokubeletha kuvame kakhulu kunokuba ucabanga.)

Noma kunjalo, izingxenye ze-C ziyi- kakhulu ukuhlinzwa okukhulu futhi uzofuna ukukhululeka kobuhlungu uma uyidinga. (Funda kabanzi ku-Parents.com: Ochwepheshe Bakala Izinzuzo Nezingozi Zokuthatha Ama-Opioid Ngemva Kwesigaba Se-C) Futhi ukuze sibe nobulungiswa, iningi labesifazane lithatha amaphilisi ezinhlungu ukuze kukhululeke isikhashana ngaphandle kwenkinga. Ukusetshenziswa okungapheli yilapho uqala khona ukungena ezinkingeni-kodwa lezi zinkinga zinkulu. I-Centers for Disease Control and Prevention (CDC) ithole ukuthi ukweqisa okubulalayo okuvela kuma-opioid kadokotela kuye kwaphindaphindeka kane kusukela ngo-1999, okubalelwa ukufa okulinganiselwa ku-15,000 ngo-2015.

Ukhiye ubuyekeza izinketho zakho nodokotela wakho kusengaphambili. Ngenye indlela, uDkt Chudacoff ubelokhu esebenzisa i-Exparel, umjovo ongewona opioid owenziwa ngesikhathi sokuhlinzwa futhi uqeda kancane ubuhlungu ngaphezu kwamahora angama-72. Ufunde ngomuthi wokubulala izinzwa lapho umngani wakhe omkhulu, umphathi omkhulu wesikhungo sokuhlinza, emtshela ngaso ukuthi sisetshenziswa odokotela abahlinzayo abebebhekene neziguli ezine-hemorrhoid, kanye nodokotela abahlinza amadolo. Iziguli bezibika ngokungabikho kobuhlungu izinsuku ezingaphezu kwezine, ngakho-ke uDkt Chudacoff wenze ucwaningo olwengeziwe ukubona ukuthi lungasebenza yini ezingxenyeni ze-C nakwizibeletho.

Ekugcineni, wenza isigaba sakhe sokuqala se-C esingenayo i-opioid futhi uthi isiguli asikaze sidinge imishanguzo yokuhlinzwa. Okufanayo kuya komunye nomunye akwenzile kusukela ngaleso sikhathi. "Angibhalanga imiyalo yama-opioid asemva kokuhlinzwa ezinyangeni ezintathu," uyaphawula, echaza ukuthi izinga lakhe lokunakekelwa kunalokho lishintsha phakathi kwe-acetaminophen (Tylenol) noma ibuprofen (Motrin) kuya "ekwelapheni ubuhlungu ngaphambilini ngendlela engeyona i-opioid; ukuqeda ingozi yokuba umlutha. "

Ngaphezu kwalokho, uDkt Chudacoff uthi iziguli zakhe ze-Exparel, ngokwesilinganiso, zivukile embhedeni futhi zihamba phakathi kwamahora amathathu wokuhlinzwa, futhi "amaphesenti angama-99 ahambe, achamile, futhi adle kungakapheli amahora ayisithupha. Izinsuku ezingu-1.2. " I-American Congress of Obstetricians and Gynecologists (ACOG) ithi isilinganiso sokuhlala esibhedlela esigabeni sakwa-C siyizinsuku ezimbili kuya kwezine, ngakho umehluko omkhulu lowo.

Ngenkathi lokhu kuzwakala kuyimpendulo kuwo wonke umkhuleko wabesifazane osebenzayo, umuthi awuzi ngaphandle kwezixwayiso. Okokuqala, kuyabiza. UDkt. Chudacoff uthi isibhedlela asebenza kuso njengamanje sihlanganisa izindleko zomuthi ezigulini, kepha lokho akuyona inqubo ejwayelekile, kanti intengo ye-20-mL vial ye-Exparel icishe ibe ngu- $ 285. "Lokhu kusanda kwenzeka njengomuthi, okungenani owezingxenye ze-C, ukuthi iningi lama-ob-gyns awazi nakwazi ngakho," usho kanje. Futhi ayimboziwe ngumshuwalense, uyanezela, yingakho ancoma ukuthi ubheke esibhedlela sakini mayelana nezindleko ezengeziwe zezokwelapha ozoba nesibopho ngazo ngaphambi kokusayina kulayini onamachashazi.

Intengo akuyona ukuphela kokukhathazeka, noma kunjalo. Ucwaningo olubili luthole ukuthi umuthi wawungasebenzi kahle kakhulu ekudambiseni ubuhlungu bokuhlinzwa kwedolo kune-bupivacaine, isibulala-zinzwa somgogodla esijovwe ebe siyindinganiso yokunakekelwa kokuhlinzwa okuhlukahlukene, okuhlanganisa izigaba ze-C. Kepha lokho akusho ukuthi akusebenzi ekunciphiseni ukusetshenziswa kwe-opioid. Lapho abacwaningi benikeza i-Exparel iziguli ezihlinzwa emadolweni-esikhundleni sokusetshenziswa okujwayelekile kwe-bupivacaine-total opioid kwehle ngamaphesenti angama-78 emahoreni angama-72 okuqala ngemuva kokuhlinzwa, ngamaphesenti ayi-10 asele engenawo opioid, ngokusho kocwaningo olushicilelwe Ijenali ye-Arthroplasty. Lokho kunengqondo uma kucatshangelwa ukuthi i-Exparel ihlala cishe amahora angama-60 ubude.

"Lokhu ngempela kuyisiqalo sentuthuko enkulu engahle ibe khona," usho kanje. "Uma ucabanga ukuthi izingxenye ze-C zingenye yezinqubo ezivame kakhulu e-United States, ezigidini eziyi-1.2 ngonyaka, lokho kusho ukuthi ungalahla inani lemiyalelo ye-opioid ngaphezulu kwesigidi unyaka nonyaka, okungaba kukhulu ekulweni ubhadane esikulo njengamanje. "

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