Kusuruvara kunorwadza (BTP) ndiko kurwadziwa kunowanzoitika pakati pezvirongwa zvese zvinorongwa nemishonga inorwadza. Iyo chiratidzo chinotambudza chinoda kurapwa nokukurumidza.
Vakawanda varwere vane marwadzo asingagumi, kusanganisira kurapa kwechiremba uye varwere vanochengetedza varwere , vanopiwa mishonga yekushandisa sezvinodiwa kurapa kurwadziwa. Mishonga yeBTP inowanzokurumidza kuita nekusvika kwenguva pfupi yekuita (kazhinji kunopa zororo kwemaawa maviri kana mana).
Zvinosuruvarisa, zvidzidzo zvakaratidza kuti kunyange kurwadziwa kunowanzoitika kune varwere vane zvirwere zvakanyanya kumba, mishonga yekudzikinura haisi nguva dzose inorayirwa, uye varwere vari kurwadziwa havashandisi mishonga yakawanda yekurapa marwadzo avo sezvaanobvumirwa.
BTP Inobata Rini?
Varwere vane kurwadziwa kusingaperi vanowanzotarisirwa kumativi ose-i-clock (ATC) maitiro emishonga inorwadza maopioid . Kusuruvara kunorwadza pakati pezviyero izvi zvemishonga uye kazhinji zvinokonzera murwere kutambudzika kukuru. Zvakakosha kukwanisa kuona BTP uye kuchengetedza rekodhi yakarurama yaro kuitira kuti mupiro wako wehutano, kana weaidiwa waunotarisira, anogona kuritora zvakanaka.
Kurwadziwa kunorwadza kune zvikamu zvitatu zvakakosha: kurwadziwa kwezviitiko, kurwadziwa kunorwadza, uye kupera kwe-kushaya mishonga kusakundikana. Zvakakosha kuti mutapi wako wehutano aone kuti ndeupi rudzi rweBTP uri kutarisana sezvo kurapa kweumwe neumwe kunogona kusiyana.
Kurapa Chiitiko Chiitiko
Kurwadziwa kwepamweya kunorwadza kunogona kufanotaurwa uye kunoitika nemamwe mabasa. Muenzaniso weiyu ndeye murwere ane marwadzo nguva dzose paanoshanduka kubva kune rumwe rutivi kune rumwe rutivi rwekutarisira kwake.
Kurwadziwa kwezviitiko zvinowanzotarisirwa zvishoma. Nemhaka yokuti kurwadziwa kunofanirwa kuitika, varwere vane marwadzo ezvakaitika vanogona kunge vasati vafungidzirwa nekukurumidza-kuita, mishonga kwenguva pfupi inorwadza mishonga pamberi pemabasa anokonzera kurwadziwa.
Chirwere ichi chinogona kugadziriswa zvichienderana nehuwandu uye nguva yebasa rinotarisirwa kuti riite marwadzo.
Kurapa Utano Hwakadzika
Kunetseka kwakangoerekana kusingatariswi uye kusabatanidzwa nemabasa chero ipi zvayo. Nemhaka yekusagadzikana kwayo, zvinowanzova zvakaoma kurapa.
Kurwadziwa kwepanyama kunowanzotarisirwa nekukurumidza-kuita, maawa mashomanana anorwadza marwadzo anopiwa nokukurumidza apo marwadzo anouya. Mishonga yeAdjuvant inogonawo kuedzwa kuti ipe hutano huri nani hwekutarisa. Mishonga yeAdjuvant inosanganisira anti-depressants, anti-seizure , nemimwe mishonga inosimudzira kurwadziwa kwevamwe varwere.
Kurapa Kupera-kwe-Dose Mishonga Kusakundikana
Izvi ndizvo zvinonzwika sei: marwadzo anowira kumagumo ezuva rinoshandiswa nemushonga wemishonga unoshanda. Semuenzaniso, mumurwere anotora nguva yakasunungurwa morphine maawa gumi nemaviri, kurwadziwa kunoitika pakati peawa yechisere uye yegumi kunofungidzirwa kuguma-kwe-kukundikana kwekurasi.
Kurapa kwekupedzisira kwekupera kweizi kunogona kusanganisira kuderedza nguva iripo pakati pemiti kana kuwedzera mukana wemishonga. Somuenzaniso, murwere ane kurwadziwa mushure memaawa masere paanenge ari mishonga inofanirwa kugovera zororo kwemaawa gumi nemaviri inogona kuva nenguva yepakati inoderera kusvika kumaawa masere ose, kana kuti chirwere chacho chinogona kuwedzerwa ne25 muzana kusvika 50 muzana.
Muzviitiko zvose, mishonga inowanzowanzoshandiswa mukuchengetwa kwekuchengetedza kugadzirisa BTP ndeyemuromo morphine solution (OMS). OMS inenge yakanyanyisa mvura yemafomu e morphine inotanga kushanda nekukurumidza uye inowanzopa zororo kwemaawa maviri kana mana.
Kuchengeta Nyaya Yokuputsa Pain
Nzira yakanakisisa yekuita kuti hurumende inetseke ndeyekutarirwa zvakakwana ndeyekuchengetedza zvakakwana uye zvakakwana mishonga yemishonga. Kuchengetedza rekodhi yakarurama yehutano hwemazinga, mishonga inoshandiswa kurapa iyo, uye kupindura kumishonga kunobatsira mutano wehutano anopa hutano hwakanaka. Mishonga yako yehuni inogona kutarisa yakafanana neyo iri pasi apa.
Muenzaniso Kubudirira Pain Medication Log Log
| Date / Time / Pain Level | Dec. 8, 9: 00a, kurwadzisa 5/10 | Dec. 8, 5: 00p, marwadzo 6/10 | Dec. 11, 11: 00a, kurwadziwa 4/10 | Dec. 12, 2: 00a, marwadzo 6/10 |
| Mishonga / Dose / Mhinduro | morphine 5mg, kurwadziwa kusingagadziriswi, imwe 5mg yakapiwa nerubatsiro | morphine 10mg, kurwadziwa kunonunurwa | morphine 10mg, kurwadziwa kunonunurwa | morphine 10mg, kurwadziwa kunonunurwa |
Sources:
Ferrell, BR naCoyle, N; Bhuku reWorld Palliative Nursing, Oxford University Press, 2006.
Ferrell BR, McGuire DB, uye Yarbro CH; Cancer Pain Management, Jones naBartlett Publishers, 1995.
Mercadante, C, et. al .; Kushungurudzika Pain in Advanced Cancer Varwere Vanoteverwa Pamba: A Longitudinal Study, Journal of Pain and Symptom Management, Volume 38, Nyaya 4, Mapeji 554-560 (October 2009).