Mankhwala Othandizira Knee

Zamkati

• Anesthesia pa opaleshoni
• Kusamalira ululu
• Mankhwala opweteka pakamwa
• Mapampu olamulidwa ndi odwala (PCA)
• Mitsempha yamitsempha
• Liposomal bupivacaine
• Kuteteza kuundana kwamagazi
• Kupewa matenda
• Mankhwala ena
• Tengera kwina

Pakachotsa bondo lonse, dokotalayo amachotsa minofu yowonongeka ndikupangira bondo lochita kupanga.

Kuchita opaleshoni kumatha kuchepetsa kupweteka komanso kukulitsa kuyenda kwa nthawi yayitali, koma kuwawa kumakhalako atangotsata kumene ndikuchira.

Anthu nthawi zambiri amakhala omasuka kachiwiri pakatha miyezi 6 mpaka chaka.Pakadali pano, mankhwala amatha kuwathandiza kuthana ndi ululu.

Anesthesia pa opaleshoni

Anthu ambiri amachitidwa maondo m'malo mwa mankhwala osokoneza bongo.

Komabe, kuyambira pomwe adzuke, adzafunika kupumula kupweteka ndi mitundu ina ya mankhwala kuti awathandize kuthana ndi mavuto komanso kuchepetsa mavuto azovuta.

Mankhwala atachitidwa opaleshoni yamondo angakuthandizeni:

• kuchepetsa ululu
• sungani nseru
• pewani magazi kuundana
• amachepetsa chiopsezo cha matenda

Ndi chithandizo choyenera komanso chithandizo chamankhwala, anthu ambiri amachira pakadutsa bondo ndipo amatha kubwerera kuzinthu zawo za tsiku ndi tsiku mkati mwa milungu ingapo.

Kusamalira ululu

Popanda kupweteka kokwanira, mungakhale ndi vuto loyambitsa kukonzanso ndikuyendayenda pambuyo pa opaleshoni.

Kukonzanso ndi kuyenda ndizofunikira chifukwa zimapangitsa kuti pakhale zotsatira zabwino.

Dokotala wanu angasankhe pazinthu zingapo, kuphatikiza:

• mankhwala opioids
• zotumphukira mitsempha
• acetaminophen
• gabapentin / pregabalin
• anti-steroidal anti-inflammatories (NSAIDs)
• COX-2 zoletsa
• ketamine

Pezani zambiri zamankhwala opweteka kuti musinthe mawondo anu onse.

Mankhwala opweteka pakamwa

Opioids amatha kuchepetsa kupweteka pang'ono. Dokotala nthawi zambiri amawalemba limodzi ndi njira zina.

Zitsanzo ndi izi:

• morphine
• hydromorphone (Dilaudid)
• hydrocodone, yomwe ilipo ku Norco ndi Vicodin
• oxycodone, yomwe ilipo ku Percocet
• meperidine (Demerol)

Komabe, kumwa mankhwala ochulukirapo opioid kumatha kuyambitsa:

• kudzimbidwa
• Kusinza
• nseru
• kupuma pang'ono
• chisokonezo
• kutaya malire
• mayendedwe osakhazikika

Angakhalenso osokoneza. Pachifukwa ichi, dokotala sangakupatseni mankhwala opioid kwa nthawi yayitali kuposa momwe mukufunira.

Mapampu olamulidwa ndi odwala (PCA)

Mapampu olamulidwa ndi odwala (PCA) nthawi zambiri amakhala ndi mankhwala opioid opweteka. Makinawa amakulolani kuwongolera kuchuluka kwa mankhwala anu.

Mukasindikiza batani, makinawo amatulutsa mankhwala ambiri.

Komabe, mpope umayang'anira kuchuluka kwakanthawi. Adapangidwa kuti sangapereke zochuluka kwambiri. Izi zikutanthauza kuti simungalandire mankhwala ochuluka kuposa ola limodzi.

Mitsempha yamitsempha

Mitsempha yamitsempha imayendetsedwa mwa kuyika katemera wamitsempha (IV) m'malo amthupi pafupi ndi mitsempha yomwe imatha kutumiza mauthenga opweteka kuubongo.

Izi zimadziwikanso kuti anesthesia yachigawo.

Mitsempha yamitsempha ndi njira ina yamapampu a PCA. Pambuyo pa tsiku limodzi kapena awiri, dokotala wanu akuchotsa catheter, ndipo mutha kuyamba kumwa mankhwala opweteka pakamwa ngati mukufuna.

Anthu omwe alandila mitsempha amakhala ndi kukhutira kwakukulu komanso zochitika zochepa zochepa kuposa omwe adagwiritsa ntchito PCA pump.

Komabe, mitsempha ya mitsempha imatha kukhala ndi zoopsa zina.

Zikuphatikizapo:

• matenda
• zosavomerezeka
• magazi

Mitsempha yamtunduwu imathanso kukhudza minofu yakumunsi. Izi zitha kuchepetsa thanzi lanu komanso kuyenda.

Liposomal bupivacaine

Imeneyi ndi mankhwala atsopano opumitsa ululu omwe dokotala amalowetsa m'malo opangira opaleshoni.

Amadziwikanso kuti Exparel, amatulutsa analgesic mosalekeza kuti muchepetse ululu kwa maola 72 mutatha kuchita.

Dokotala amatha kupereka mankhwalawa pamodzi ndi mankhwala ena opweteka.

Kuteteza kuundana kwamagazi

Pambuyo pa opaleshoni yamaondo m'malo mwake, pamakhala chiopsezo chotenga magazi. Chovala m'mitsempha yozama kwambiri amatchedwa deep vein thrombosis (DVT). Nthawi zambiri zimachitika mwendo.

Komabe, khungu nthawi zina limatha kuyenda ndikuyenda mozungulira thupi. Ikafika pamapapu, imatha kubweretsa kuphatikizika kwamapapu. Ngati ikafika kuubongo, imatha kudwala matenda opha ziwalo. Izi ndi zoopsa zoopsa zoopsa.

Pali chiopsezo chachikulu cha DVT pambuyo pa opaleshoni chifukwa:

• Mafupa anu ndi minofu yanu yofewa imatulutsa mapuloteni omwe amathandiza pakumira panthawi yopaleshoni.
• Kukhala osasunthika panthawi yochita opaleshoni kumatha kuchepetsa kuyendetsa magazi, ndikuwonjezera mwayi woti khungu ligwire ntchito.
• Simungathe kuyendayenda kwambiri kwakanthawi mutachitidwa opaleshoni.

Dokotala wanu adzakupatsani mankhwala ndi njira zochepetsera kuopsa kwa magazi atagwidwa opaleshoni.

Izi zingaphatikizepo:

• masitonkeni, kuvala ana ang'ombe kapena ntchafu zanu
• zida zopanikiza, zomwe zimafinya miyendo yanu molimbikitsira kubwerera kwa magazi
• aspirin, mankhwala ochepetsa ululu omwe amagulitsanso magazi anu
• heparin yolemera kwambiri, yomwe mungalandire kudzera mu jakisoni kapena kudzera mu kulowetsedwa kosalekeza kwa IV
• Mankhwala ena ojambulira jekeseni, monga fondaparinux (Arixtra) kapena enoxaparin (Lovenox)
• mankhwala ena apakamwa monga warfarin (Coumadin) ndi rivaroxaban powder (Xarelto)

Zosankhazo zimadalira mbiri yanu yazachipatala, kuphatikizapo zovuta zilizonse, komanso ngati muli ndi chiopsezo chotaya magazi.

Kuchita masewera olimbitsa thupi pabedi ndikusuntha posachedwa pambuyo pa maondo kungakuthandizeni kupewa kuundana kwamagazi ndikupangitsa kuti mupeze bwino.

Magazi am'magazi ndi chimodzi mwazifukwa zomwe zovuta zimachitika pambuyo pochita maondo m'malo. Dziwani zambiri za zovuta zina zomwe zingachitike.

Kupewa matenda

Kutenga ndi vuto lina lalikulu lomwe lingachitike panthawi yopanga mawondo.

M'mbuyomu, anthu ozungulira adadwala matenda, koma kuchuluka kwawo pakadali pano ndi 1.1%. Izi ndichifukwa choti ochita opaleshoni tsopano amapereka maantibayotiki asanayambe opaleshoni, ndipo amatha kupitiliza kuwapatsa kwa maola 24 pambuyo pake.

Anthu omwe ali ndi matenda ashuga, kunenepa kwambiri, mavuto azungulira, komanso zovuta zomwe zimakhudza chitetezo chamthupi, monga HIV, ali pachiwopsezo chachikulu chotenga matenda.

Ngati matenda ayamba, adokotala adzaperekanso njira ina ya maantibayotiki.

Izi zikachitika, ndikofunikira kumwa mankhwala onse, ngakhale mutakhala bwino. Mukasiya njira yothandizira maantibayotiki, matendawa amatha kubwerera.

Mankhwala ena

Kuphatikiza pa mankhwala ochepetsa kupweteka komanso kuwopsa kwa magazi m'magazi pambuyo pamaondo anu, adotolo amatha kukupatsani mankhwala ena ochepetsa zovuta za mankhwala ochititsa dzanzi komanso mankhwala opweteka.

Pakafukufuku wina, pafupifupi 55% ya anthu amafunikira chithandizo cha nseru, kusanza, kapena kudzimbidwa pambuyo pochitidwa opaleshoni.

Mankhwala a Antinausea ndi awa:

• ondansetron (Zofran)
• mankhwala (Phenergan)

Dokotala wanu amathanso kukupatsani mankhwala othandizira kudzimbidwa kapena zotsekemera, monga:

• docusate sodium (Colace)
• Chizindikiro (Dulcolax)
• polyethylene glycol (MiraLAX)

Muthanso kulandira mankhwala ena owonjezera ngati mukufuna. Izi zitha kuphatikizira chigamba cha chikonga ngati mumasuta.

Tengera kwina

Kuchita maondo m'malo mwake kumatha kukulitsa ululu kwakanthawi, koma njirayi imatha kuchepetsa kupweteka komanso kuyenda kwakanthawi.

Mankhwala angathandize kuchepetsa ululu, ndipo izi zitha kupititsa patsogolo kuyenda kwanu mukatha opaleshoni.

Ngati mukumva zisonyezo kapena zovuta pambuyo poti bondo lisinthe, ndibwino kuti mulankhule ndi dokotala. Nthawi zambiri amatha kusintha mlingo kapena kusintha mankhwala.