Kunzwisisa General Anesthesia Dambudziko uye Mibayiro
Pane zvakawanda zvingava nemigumisiro inobatanidza nekushandiswa kweanesthesia kwekuvhiya uye nzira. Nyaya idzi dzinosiyana zvakasiyana kubva pamatambudziko maduku kusvika kune zvinetso zvakakosha uye zvoupenyu. Nenguva isipi, nyaya dzakaoma mushure mokunge anesthesia zvisingawanzoitiki uye vashandi vashoma havazovi nemibvunzo kana zviduku mumaawa nemazuva mushure mekuita kwavo.
Mhando yemigumisiro iyo munhu anokwanisa kuwanikwa nekuda kweanesthesia ichave yakasiyana zvakasiyana siyana maererano neshoko reesesthesia ravanowana, kureba kwenguva iyo vari pasi peanesthesia, uye zvakaita dambudziko rakagadzira aneshesia. Semuenzaniso, mwana anodiwa kuti ave nechikwata chake asi asina humwe hutano uye ari pasi peanesthesia kweawa angangodaro ane hutano hushoma kudarika munhu ane makore makumi masere nemasere anotsvaga chirwere cheshuga uyo ane maawa akawanda anesthesia munguva yavo yakazarurwa kuvhiyiwa.
General Anesthesia Anotsanangurwa
Urwu rudzi rweaneshesia runoshandiswa panguva yekuvhiya, uye rinoshandiswa muchipatara kana chirwere chekugadzira nzvimbo. Mishonga inopiwa semhepo inoputika uye kuburikidza ne IV pakuvhiya. Munguva iyi iyi yekudengenyeka, murwere haazive zvachose zvakapoteredza uye haanzwi kurwadziwa sezvavari muhurumende zvakadzama kupfuura kurara.
Jenesi anesthesia inoda murwere kuti ave nechifema chinopfurikidza chakaiswa kuitira kuti vagova muvharidzi panguva yekuvhiyiwa. Izvi zvinoreva kuti mishonga yakawanda yeanesthesia haisi kungoita kuti murwere arege kuziva uye asingakwanisi kunzwa kurwadziwa kwekuvhiyiwa, anokonzerawo mitezo yemuviri kusanganisira mishonga inoita mapapu kushanda.
Kunyange zvazvo mishonga yakawanda yeanesthesia inokonzera kuora mwoyo inoita kuti murwere arege kufamba-izvo zvinonyanya kukosha panguva yekuvhiyiwa kunobata-izvi zvinogonawo kutungamirira kumatambudziko anokonzerwa nekusafamba kwenguva yakareba. Anesthesia, kufanana nekuvhiya kwakanyanya, inowanzoongorora nekunyatsoona njodzi dzinokonzerwa nemigumisiro inogona-uye nekufungidzira kwakadzidziswa neanesthesia provider pamusoro pezvimwe zvingaitika, zvakanaka kana zvakaipa. Zviito zvinotorwawo kuti kuderedze mikana yematambudziko uye kuwedzera mukana wezvibereko zvakanaka.
Zvakakosha kuyeuka kuti njodzi dzese anesthesia haisi yega njodzi murwere anofanira kunge akazviziva zvisati zvaitika, njodzi dzekuvhiya iyo pachayo inofanira kufungwa. Nzira imwe neimwe inofana nayo inogona kunge inogona kunge inogona kuisa njodzi, isina kufanana neanesthesia. Semuenzaniso, murwere ane chirwere chokubvisa zvigadziro angave ane njodzi dzinokonzerwa nehutachiona huri muhuwandu hwekuwedzera hunogona kupararira mudumbu panguva yekuvhiyiwa, pamwe chete nehutachiwana hwehutachiwana hwekudzivirira, husingaenderani njodzi dzese anesthesia.
Matambudziko Anowanzoitika Mushure meGedheni Anesthesia
- Nausea / Kuputika : Kuoma kunowanzoitika mushure mokunge anesthesia yakawanda inononoka uye kurutsa. Kushanda kunoshungurudza uye kusuruvara (PONV) zviri nyore kudzivirira kudarika kurapa, uye mishonga yakawanda inowanika kuvarwere vanoona nyaya iyi.
- Kunyatsoziva kuti kana murwere angasava nemashure ekuvhima uye kushambidzika ane nhoroondo yekushungurudza uye kusuruvara mushure mekuvhiyiwa kwekare. Vaya vakambozviwana munguva yakapfuura vane mikana yekuwanazve zvakare, uye vanowanzofungidzirwa kuti vadzivise kuti irege kuitika zvakare.
- Hora / Hoarseness : Mushure mokunge bhudhi yekufema iripo, chirwere chinorwadza kana inzwi rinoputika rinogona kutarisirwa, zvikurukuru kana chirwere chacho chakanga chakareba. Nepo izvi zvisingagoni kudzivirirwa, maronda maperembudzi, lozenges nemimwe mishonga inoshandiswa kuderedza marwadzo emutsipa yakakodzera mumazuva achangobva kuvhiyiwa. Kutya kusingavandudzi mushure memazuva mashanu kusvika kune manomwe mushure mekuvhiyiwa kunofanira kutaurirwa nemupi wehutano wehutano.
- Dry muromo : Nyaya iyi inogadzirisa apo murwere anokwanisa kudya nokunwa mushure mekuvhiyiwa. Muromo unenge wakazaruka panguva yekuvhiyiwa nekuda kwefemu yekufema, uye inowanzooma kana murwere achimuka.
- Kutyisa / Chills : Izvi zvinowanzoitika kumishonga inopiwa panguva yekuvhiyiwa uye inogadziriswa apo mishonga inopera. Inogonawo kukonzerwa nedonho duku muhutano hwemuviri panguva yekuvhiyiwa, iyo nyaya inogadziriswa nyore nekuvhara nehombodo dzimwe shomanana kusvikira mahwindo echando apfuura. Kuvapo kwefivhiri kunogona kukonzera kupisa uye kunetseka, asi ndicho chikonzero chisingawanzwisisiki nguva pfupi mushure mekuvhiyiwa kunze kwekuti utachiona hwaivepo musati maitiro.
- Kurara: Mishonga inoshandiswa kureva anesthesia inogona kukonzera kurara uye vanhu vakawanda vanozovhara uye vanovhara mumaawa anotevera kuvhiyiwa. Kazhinji, mushure mokurara kwakanaka kwehope, varwere vanoratidza kuti vanonzwa vachizvifarira.
- Tsvina Inobhururuka : Imwe yemishonga inoshandiswa kazhinji neaneshehesia inozivikanwa inokonzera muscle aches. Kunyengera zvachose mune imwe nzvimbo panguva yokuvhiya kunogona kukonzera muscle aches. Varwere vanowanzonyunyutira kurwadziwa kwemuviri mushure mekuita, zvinowanzokonzera kurwadziwa, zvichikonzerwa nokusakwanisa kuchinja nzvimbo panguva yekuvhiyiwa.
- Itching: Mishonga inopiwa panguva uye mushure mekuvhiyiwa inogona, uye inowanzoita, inoguma nekuita. Mishonga yemarwadzo yepiritsi inonyanya kuzivikanwa nekukonesa, iyo inowanzotadza kupfuura mishonga yeanesthesia.
Mamwe Matambudziko Akawanda Mushure meGedheni Anesthesia
Kuvhiringidzika : Kuchinja kwehutano hwepfungwa, zvikurukuru kune avo vanovhiringidzwa nyore nyore mushure mekuvhiyiwa, dzimwe nguva vanoonekwa mushure mekuvhiyiwa. Izvi zvinonyanya kuonekwa kune vamwe vanhu vakwegura, vane dambudziko rekushaya mungozi, chirwere cheAlzheimer kana zvimwe zviitiko izvo zvinokanganisa. Kusanganiswa kwemishonga uye chiito chekuvhiringidzika kazhinji kazhinji chinotungamirira kukuwedzera kwezviratidzo kusvikira muviri uchinatsa zvachose anesthesia.
Kuchinja kubva mumamiriro ezvinhu epamba kumunhu asingazivikanwe (kuchipatara, nzvimbo yekuvhiya) kunogona kukuvadza kudengenyeka. Kana kutarisirwa kuri kupiwa muCUU, iyi inonzi inozviisa pangozi yezviviri zvose uye kuwedzera kwekuvhiringidzika, sezvo murwere ari kugara achikurudzirwa nemwenje mumaawa ose ezuva neusiku, mheremhere yekumhanyisa nekugadzirisa, uye nguva dzose (zvinodiwa) kupindira mune zvehutano nevashandi.
Kuoma kurinating : General anesthesia inokonzera maronda emuviri, uye chirwere chiri musimba. Haisi kungoita chete mishonga inogona kukanganisa chikwata, asi kuvhiyiwa kwakawanda kunoda kuiswa kwecatheter ye urinary. Kubviswa kwegate catheter, inowanzonzi se foley catheter , inogona kukanganisa kukwanisa kurinha mumazuva anotevera.
Kutsamwa kwakajairika mushure mekunge uine foley yakaiswa, iyo inogona kutungamirira pakupisa kana uchikwira, izvo zvisingatauri kuti kune urinary tract infection (UTI) iripo. Kunyange zvazvo chirwere chinokonzera urinary chinowanikwa mushure mekuve ne foley yakaiswa kuvhiyiwa, varwere vazhinji havatombovi nemigumisiro yakaipa kubva kune catheter. Muzviitiko zvisingawanzoitiki, murwere haagoni kukwira mushure mekuvhiyiwa , uye izvi zvinoda nguva yekurapa.
Ileus : Sezvo bladder inogona kupera simba nemishonga, ndizvo zvinogona mumatumbo, uye kana matumbo asingamutswi munguva inenge yakatarwa inonzi seyeus. Dambudziko iri rinowanzogadzirisa mumazuva achangobva kuvhiyiwa. Muzuva rimwechete kuvhiyiwa murwere anowanzochengetwa muimba yekudzikinura kusvikira vatanga kudarika gesi , chiratidzo chokuti havana chipara uye vanogona kuenda kumba zvakanaka.
Dambudziko rekubuda muvharidziro : Kune vanorwara vakawanda, kuputira bhuni kunobviswa nokukurumidza kana chirwere ichipera uye vanogona kufema pachavo mumaminitsi ekupera kwekuita kwavo. Vamwe varwere, kazhinji vakura kana vanorwara, vanoda nguva yakawanda kuti vabvise ventilator kubudirira. Varwere vasingakwanisi kubviswa zvakanaka muvharidziro pakarepo mushure mekuvhiyiwa vanogona kuita kudaro mushure maawa mashomanana kuti vamukezve kubva pamishonga. Muchiitiko chisingawanzoiti, murwere achange achida kugara kwenguva yakareba munzvimbo yakanyatsotarisirwa asi boka rehutano rinoshanda kuitira kuti murwere apfuurire oga.
Aspiration / Pneumonia : Ichi ndicho chinetso chakakanganisika chinowanikwa apo zvokudya kana mvura inonaya yakavharidzirwa mumapapu panguva yekuvhiyiwa. Nemhaka yokuti murwere haazive, uye kufema kunenge kuri munzvimbo, zviri nyore kuisa zvinhu zvekunze mumapapu. Muzuva rezuva rega rega hupenyu huno tinoti izvi "kuenda pasi pombi isina kunaka" uye tinosvina chero chii chiri kumusoro. Panguva yekuvhiyiwa, hazvibviri kukwezva, kana kutove uchiziva kuti chimwe chinhu chiri kuwira pasi pombi isina kunaka, iyo inotungamirira kumata kana kunyange kurutsa kupinda mumapapu. Izvi zvinogona kutungamirira kumapurumisi mushure mekuvhiyiwa, iyo inonzi inhare yakakomba inoda mishonga inorwisa mabhakitiriya uye inogona kutora kuverengera kuchipatara pane dzimwe nguva.
Ropa rinoputika : Kuva panzvimbo imwechete kwemaawa akawanda panguva yekuvhiyiwa kunogona kuwedzera njodzi yekuumba ropa rinoputika, rinozivikanwa semvura yakadzika yepine , pashure pokuvhiyiwa. Izvi zvinowanzoitika mumigumo, kunyanya mumakumbo. Kana iwe wakambotanga kuvhiyiwa uye wakashamisika kuti nei vashandi vakakuda iwe uye uchifamba saizvozvo nguva pfupi mushure mekuvhiyiwa kwako kwapera, kwaive kudzivirira ropa rekuvhara kubva pakuumba.
Zvinosuruvarisa hyperthermia: Ichi ndicho chirwere chakakomba zvikuru chinonzi genetic, zvakagadzirirwa nhaka kune mamwe mishonga inoshandiswa panguva yeanesthesia inogona kutyisa upenyu. Izvi zvinokonzera high fever uye muscle zvinokonzera izvo zvinogona kutungamirira kukundikana kwomuviri kana zvisingawaniki uye zvakarapwa nokukurumidza. Murwere ane hama yehupenyu hwehutachiona hutachiona hunogona kuongororwa asati agamuchira anesthetics.
Anesthesia awareness : ichi chinhu chisingawanzoiti chinokonzerwa neanesthesia isinganyatsobudirira mukukonzera kusaziva. Varwere vanorondedzera zviitiko kubva pakurangarira zvikamu zvekukurukurirana zviri kuitwa muimba yekugadzirira panguva yavo yekuita kuti vave nekukwanisa kuona, kunzwa uye kunzwa zvose zvinoitika panguva yekuvhiyiwa. Nenguva isipi, anesthesia awareness haisati yakakurumbira kana zvakakodzera anesthesia inopiwa panguva inoitwa.
> Kwakabva:
> Anesthesia Fact Sheet. National Institute of General Medical Sciences. Yakasvika May, 2017. https://www.nigms.nih.gov/education/pages/factsheet_Anesthesia.aspx