Imithi Yokushintshwa Kamadolo

-Delile

• Ukubulawa izinzwa ngesikhathi sokuhlinzwa
• Ukuphatha ubuhlungu
• Imithi yezinhlungu zomlomo
• Amaphampu we-analgesia (PCA) alawulwa yiziguli
• Amabhulokhi emizwa
• I-Liposomal bupivacaine
• Ukuvimbela amahlule egazi
• Ukuvimbela ukutheleleka
• Eminye imithi
• Ukudla okudlela endlini

Ngesikhathi sokushintshwa kwedolo ngokuphelele, udokotela ohlinzayo uzosusa izicubu ezilimele futhi afake idolo lokufakelwa.

Ukuhlinzwa kunganciphisa ubuhlungu futhi kwandise ukuhamba esikhathini eside, kepha ubuhlungu buzobakhona ngokushesha ngemuva kwenqubo nangesikhathi sokululama.

Abantu bavame ukuzizwa bekhululeke ngokuphelele futhi ngemuva kwezinyanga eziyisithupha kuya onyakeni. Okwamanje, imithi ingabasiza ukuphatha izinhlungu.

Ukubulawa izinzwa ngesikhathi sokuhlinzwa

Iningi labantu lihlinzelwa amadolo ngaphansi kwe-anesthetic jikelele.

Kodwa-ke, kusukela esikhathini abavuka ngaso, bazodinga ukukhululeka kobuhlungu nezinye izinhlobo zemithi ukubasiza ukuphatha ukungaphatheki kahle nokunciphisa ubungozi bezinkinga.

Imithi ngemuva kokuhlinzwa esikhundleni samadolo ingakusiza:

• ukunciphisa ubuhlungu
• phatha isicanucanu
• vimbela amahlule egazi
• yehlisa ubungozi bokutheleleka

Ngokuthola ukwelashwa okufanele nokwelashwa ngokomzimba, abantu abaningi bayalulama ekushintsheni idolo futhi bayakwazi ukubuyela emisebenzini yabo yansuku zonke kungakapheli amasonto.

Ukuphatha ubuhlungu

Ngaphandle kokuphathwa kobuhlungu okwanele, ungaba nobunzima bokuqala ukuvuselelwa nokuhambahamba ngemuva kokuhlinzwa.

Ukuvuselelwa nokunyakaza kubalulekile ngoba kuthuthukisa amathuba emphumela omuhle.

Udokotela wakho ohlinzayo angakhetha kokukhethwa kukho okuhlukahlukene, kufaka phakathi:

• ama-opioid
• izigaxa zezinzwa zomngcele
• acetaminophen
• gabapentin / pregabalin
• ama-anti-inflammatories ama-non-steroidal (ama-NSAID)
• I-COX-2 inhibitors
• ketamine

Thola okuningi ngemithi yezinhlungu ukuze ushintshe amadolo ngokuphelele.

Imithi yezinhlungu zomlomo

Ama-opioid angadambisa ubuhlungu obulinganiselayo nobunzima. Udokotela uvame ukubanikeza kanye nezinye izinketho.

Izibonelo zifaka:

• morphine
• i-hydromorphone (Dilaudid)
• i-hydrocodone, ekhona eNorco naseVicodin
• i-oxycodone, ekhona ePercocet
• i-meperidine (Demerol)

Kodwa-ke, ukuthatha imishanguzo eminingi ye-opioid kungadala:

• ukuqunjelwa
• ukozela
• isicanucanu
• ukuphefumula kancane
• ukudideka
• ukulahlekelwa ibhalansi
• indlela engazinzile

Bangabuye babe umlutha. Ngalesi sizathu, udokotela ngeke anikeze imishanguzo ye-opioid isikhathi eside kunalokho okudingayo.

Amaphampu we-analgesia (PCA) alawulwa yiziguli

Amapompo alawulwa yiziguli (PCA) ngokuvamile aqukethe imishanguzo yezinhlungu ze-opioid. Lo mshini uzokuvumela ukuthi ulawule umthamo wemithi yakho.

Uma ucindezela inkinobho, umshini ukhipha imithi eminingi.

Noma kunjalo, ipompo ilawula umthamo ngokuhamba kwesikhathi. Ihlelwe ukuze ingakwazi ukuletha okuningi kakhulu. Lokhu kusho ukuthi awukwazi ukuthola ngaphezu kwesilinganiso esithile semithi ngehora.

Amabhulokhi emizwa

I-nerve block ilawulwa ngokufaka i-intravenous (IV) catheter ezindaweni zomzimba eziseduze nezinzwa ezizodlulisela imiyalezo yobuhlungu ebuchosheni.

Lokhu kwaziwa nangokuthi i-anesthesia yesifunda.

Amabhulokhi ezinzwa ahlukile kwamanye amaphampu we-PCA. Ngemuva kosuku olulodwa kuya kwezimbili, udokotela wakho uzosusa i-catheter, futhi ungaqala ukuthatha imithi yezinhlungu ngomlomo uma uyidinga.

Abantu abathole ukuvinjelwa kwemizwa banokwaneliseka okuphezulu kanye nezenzakalo ezimbi ezimbalwa kunalabo abasebenzise ipompo le-PCA.

Kodwa-ke, ukuvimbela imizwa kusengafaka izingozi ezithile.

Kubandakanya:

• ukutheleleka
• ukusabela okweqile
• ukopha

I-nerve block nayo ingathinta imisipha emlenzeni ongezansi. Lokhu kunganciphisa ukwelashwa kwakho ngokomzimba kanye namandla okuhamba.

I-Liposomal bupivacaine

Lo ngumuthi omusha wokuqedwa kobuhlungu udokotela awufaka endaweni yokuhlinzwa.

Eyaziwa nangokuthi i-Exparel, ikhipha i-analgesic eqhubekayo yokudambisa izinhlungu kuze kube ngamahora angama-72 ngemuva kwenqubo yakho.

Udokotela angahle anikeze lo muthi kanye neminye imithi yezinhlungu.

Ukuvimbela amahlule egazi

Ngemuva kokuhlinzwa ngamadolo, kunengozi yokuba negazi. Ihlule emithanjeni yegazi ejulile ibizwa ngokuthi i-deep vein thrombosis (DVT). Ngokuvamile zenzeka emlenzeni.

Kodwa-ke, kwesinye isikhathi iqabaka lingasuka lihambe lizungeze umzimba. Uma ifinyelela emaphashini, kungaholela embolism yamaphaphu. Uma ifinyelela ebuchosheni, ingaholela kohlangothi. Lezi yizimo eziphuthumayo ezisongela impilo.

Kukhona ingozi ephezulu ye-DVT ngemuva kokuhlinzwa ngoba:

• Amathambo akho nezicubu ezithambile zikhulula amaprotheni asiza ekunqandeni ngesikhathi sokuhlinzwa.
• Ukunganyakazi ngesikhathi sokuhlinzwa kunganciphisa ukujikeleza kwegazi, kwandise amathuba okuthi iqhwa likhule.
• Ngeke ukwazi ukuhamba kakhulu isikhathi esithile ngemuva kokuhlinzwa.

Udokotela wakho uzokunika imithi namasu okunciphisa ubungozi bamahlule egazi ngemuva kokuhlinzwa.

Lokhu kungafaka:

• amasokisi okucindezela, ukugqoka kumathole noma emathangeni akho
• amadivayisi wokucindezela alandelanayo, acindezela ngobumnene imilenze yakho ukukhuthaza ukubuya kwegazi
• i-aspirin, i-reliever ye-counter-the-counter epholisa igazi lakho
• i-heparin enesisindo esiphansi, ongayithola ngomjovo noma ngokumnika okuqhubekayo kwe-IV
• eminye imithi yokujova yokujova, efana ne-fondaparinux (Arixtra) noma i-enoxaparin (i-Lovenox)
• eminye imithi yomlomo efana ne-warfarin (Coumadin) ne-rivaroxaban powder (i-Xarelto)

Izinketho zizoya ngomlando wakho wezokwelapha, kufaka phakathi noma yikuphi ukungezwani komzimba, nokuthi unengozi yokuphuma kwegazi yini.

Ukwenza izivivinyo embhedeni nokuhambahamba ngokushesha ngangokunokwenzeka ngemuva kokuhlinzwa kwedolo kungasiza ekuvikeleni amahlule egazi futhi kuthuthukise ukululama kwakho.

Amahlule egazi ngesinye sezizathu zokuthi kube nezinkinga ngemuva kokuhlinzwa esikhundleni sedolo. Thola okuningi mayelana nezinye izinkinga ezingaba khona.

Ukuvimbela ukutheleleka

Ukutheleleka kungenye inkinga ebucayi engavela ngesikhathi sokuhlinzwa esikhundleni sedolo.

Esikhathini esedlule, abantu abazungezile bahlakulela ukutheleleka, kodwa izinga lamanje lizungeze amaphesenti angu-1.1. Lokhu kungenxa yokuthi odokotela abahlinzayo manje banikeza ama-antibiotic ngaphambi kokuhlinzwa, futhi bangaqhubeka nokubanika amahora angama-24 ngemuva kwalokho.

Abantu abanesifo sikashukela, ukukhuluphala ngokweqile, izinkinga zokujikeleza kwegazi, nezimo ezithinta amasosha omzimba, njenge-HIV, basengozini enkulu yokuthola ukutheleleka.

Uma kuba nokutheleleka, udokotela uzonquma enye inkambo yama-antibiotic.

Uma lokhu kwenzeka, kubalulekile ukuthatha yonke inkambo yokwelashwa, noma ngabe uzizwa ungcono. Uma umisa inkambo yama-antibiotic phakathi, ukutheleleka kungabuya.

Eminye imithi

Ngaphezu kwemithi yokwehlisa ubuhlungu nezingozi zamahlule egazi ngemuva kokushintshwa kwedolo, udokotela wakho angakunikeza ezinye izindlela zokwelapha ukunciphisa imiphumela emibi ye-anesthesia nemithi yezinhlungu.

Kokunye ukuhlola, cishe amaphesenti angama-55 wabantu adinga ukwelashwa kwesicanucanu, ukuhlanza, noma ukuqunjelwa ngemuva kokuhlinzwa.

Imithi ye-Antinausea ifaka:

• i-ondansetron (iZofran)
• i-promethazine (Phenergan)

Udokotela wakho angaphinde anikeze imishanguzo yokuqunjelwa noma izithambisi zendle, njenge:

• i-docusate sodium (Colace)
• i-bisacodyl (Dulcolax)
• i-polyethylene glycol (MiraLAX)

Ungathola nemithi eyengeziwe uma uyidinga. Lokhu kungafaka isichibi se-nicotine uma ubhema.

Ukudla okudlela endlini

Ukuhlinzwa okufakwa esikhundleni samadolo kungakhuphula ubuhlungu isikhashana, kepha inqubo ingathuthukisa amazinga okuhamba nobuhlungu esikhathini eside.

Imithi ingasiza ekunciphiseni ubuhlungu, futhi lokhu kungathuthukisa ukuhamba kwakho ngemuva kokuhlinzwa.

Uma uhlangabezana nanoma yiziphi izimpawu noma imiphumela emibi ngemuva kokushintshwa kwedolo, kungcono ukukhuluma nodokotela. Ngokuvamile bangakwazi ukulungisa umthamo noma bashintshe imithi.