Mitundu ya anesthesia: nthawi yogwiritsira ntchito ndi zoopsa zanji

Zamkati

• 1. Mankhwala oletsa ululu
• Ziwopsezo zake ndi ziti
• 2. Mankhwala oletsa ululu m'deralo
• Ziwopsezo zake ndi ziti
• 3. Anesthesia yachigawo
• Anesthesia yamtsempha
• Epidural anesthesia
• Mitsempha yotumphukira
• Anesthesia yolowa m'chigawo
• Ziwopsezo zake ndi ziti
• 4. Sedation ochititsa dzanzi
• Ziwopsezo zake ndi ziti

Anesthesia ndi njira yomwe imagwiritsidwa ntchito ndi cholinga choletsa kupweteka kapena kumva kuwawa panthawi yochita opareshoni kapena njira zopweteka kudzera pakupereka mankhwala kudzera mumitsempha kapena kupuma. Anesthesia nthawi zambiri amachitidwa m'njira zowononga kwambiri kapena zomwe zimatha kupweteketsa mtima kapena kupweteka kwa wodwalayo, monga opaleshoni ya mtima, kubereka kapena njira zamano, mwachitsanzo.

Pali mitundu ingapo ya dzanzi, yomwe imakhudza dongosolo lamanjenje m'njira zosiyanasiyana poletsa zikhumbo zamitsempha, kusankha komwe kudzadalira mtundu wa njira zamankhwala komanso thanzi la munthu. Ndikofunika kuti dokotala adziwitsidwe za matenda amtundu uliwonse kapena zovuta zina kuti mtundu wabwino wa oveketsa ziwonetsedwe popanda chiopsezo chilichonse. Onani chisamaliro chisanachitike opaleshoni.

1. Mankhwala oletsa ululu

Pakati pa oesthesia, mankhwala opatsirana amaperekedwa omwe amamukhazika mtima pansi munthu, kotero kuti opaleshoni yomwe idachitidwa, monga opaleshoni pamtima, m'mapapo kapena m'mimba, siyimva kupweteka kapena kusasangalala.

Mankhwala omwe amagwiritsidwa ntchito amachititsa kuti munthu asakomeke ndikupangitsa kuti asamve kupweteka, kulimbikitsa kupumula kwa minofu ndikupangitsa amnesia, kuti zonse zomwe zimachitika pakuchita opaleshoni ziiwale wodwalayo.

Mankhwala opatsirana amatha kulowetsedwa mumtsempha, kukhala ndi mphamvu yomweyo, kapena kupumira kudzera mumagetsi, kufikira magazi m'mapapu. Kutalika kwa zotsatira zake ndikosiyanasiyana, kutsimikiziridwa ndi wochita zodzitetezera, yemwe amasankha kuchuluka kwa mankhwala osokoneza bongo omwe angaperekedwe. Phunzirani zambiri za anesthesia wamba.

Mankhwala omwe amagwiritsidwa ntchito kwambiri pochita dzanzi ndi awa: benzodiazepines, mankhwala ozunguza bongo, mankhwala opatsirana pogwiritsira ntchito mankhwala osokoneza bongo, kutsitsimutsa, kutulutsa minofu ndi mpweya wa halogenated.

Ziwopsezo zake ndi ziti

Ngakhale anesthesia ndi njira yotetezeka kwambiri, itha kukhala ndi zoopsa zina kutengera zinthu zina, monga mtundu wa opareshoni ndi matenda ake. Zotsatira zoyipa kwambiri ndi nseru, kusanza, kupweteka mutu ndi chifuwa cha mankhwala oletsa ululu.

Pazovuta zazikulu, zovuta monga kupuma, kumangidwa kwamtima kapena sequelae yaminyewa imatha kuchitika kwa anthu omwe ali ndi thanzi lofooka chifukwa cha kuperewera kwa zakudya m'thupi, mtima, mapapo kapena impso.

Ngakhale ndizosowa kwambiri, mankhwala oletsa ululu atha kukhala ndi gawo pang'ono, monga kuchotsa chikumbumtima koma kuloleza munthu kuti asunthe kapena munthuyo sangathe kusuntha koma akumva zochitika zowazungulira.

2. Mankhwala oletsa ululu m'deralo

Anesthesia yapafupi imakhudza gawo linalake la thupi, silimakhudza chidziwitso ndipo limagwiritsidwa ntchito pochita maopaleshoni ang'onoang'ono monga njira zamano, diso, mphuno kapena khosi, kapena molumikizana ndi anesthesia ena, monga dera kapena sedation anesthesia.

Mtundu uwu wa anesthesia ukhoza kuperekedwa m'njira ziwiri, pogwiritsa ntchito kirimu chodzitetezera kapena kutsitsi kudera laling'ono la khungu kapena mucosa, kapenanso kubayira jakisoni wa mankhwala oletsa kupweteka m'thupi kuti asafe. Lidocaine ndi mankhwala ofala kwambiri wamba.

Ziwopsezo zake ndi ziti

Anesthesia yakomweko, ikagwiritsidwa ntchito moyenera, ndiyotetezeka ndipo siyikhala ndi zotsatirapo zilizonse, komabe, muyezo waukulu imatha kukhala ndi zotsatira zoyipa, zomwe zimakhudza mtima ndi kupuma kapena kusokoneza ubongo, popeza kuchuluka kwambiri kumatha kufikira magazi.

3. Anesthesia yachigawo

Anesthesia yachigawo imagwiritsidwa ntchito pakafunika kutonthoza gawo limodzi la thupi, monga mkono kapena mwendo, mwachitsanzo ndipo pali mitundu ingapo ya dzanzi:

• Anesthesia yamtsempha

Mu kupweteka kwa msana, mankhwala oletsa ululu am'deralo amaperekedwa ndi singano yabwino, mumadzimadzi omwe amasamba msana, wotchedwa cerebrospinal fluid. Mu mtundu uwu wa dzanzi, dzanzi limasakanikirana ndimadzimadzi a msana ndipo limalumikizana ndi mitsempha, zomwe zimapangitsa kuti munthu asamve bwino m'miyendo ndi m'mimba.

• Epidural anesthesia

Amadziwikanso kuti epidural anesthesia, njirayi imaletsa kupweteka ndi kumva kuchokera kudera limodzi lokha la thupi, nthawi zambiri kuyambira mchiuno mpaka pansi.

Mu mtundu uwu wa anesthesia, mankhwala oletsa ululu am'deralo amaperekedwa kudzera mu catheter yomwe imayikidwa m'malo ozungulira mozungulira ngalande ya msana, zomwe zimapangitsa kuti munthu asamve bwino m'miyendo ndi m'mimba. Onani zambiri za epidural anesthesia ndi zomwe zimapangidwira.

• Mitsempha yotumphukira

Mu mtundu uwu wa mankhwala ochititsa dzanzi am'deralo, mankhwala oletsa ululu am'deralo amaperekedwa mozungulira mitsempha yomwe imapangitsa kuti thupi liziyenda bwino komanso kuti liziyenda bwino pomwe opareshoniyo ichitidwe, ndipo njira zingapo zamitsempha zitha kuperekedwa.

Magulu amitsempha, otchedwa plexus kapena ganglion, omwe amapweteka ku chiwalo china kapena dera lakuthupi, amatsekedwa omwe amatsogolera ku dzanzi la madera amthupi monga nkhope, mphuno, m'kamwa, khosi, phewa, mkono, pakati pa ena .

• Anesthesia yolowa m'chigawo

Anesthesia yolowa mkati ndi njira yomwe catheter imayikidwa mu mtsempha wa mwendo, kotero kuti mankhwala oletsa ululu am'deralo amuthandizidwa, poyika malo oyendera malo pamwamba pake kuti anesthesia ikhale m'malo. Kumvetsetsa kumabwezeretsedwanso pamene maulendowa achotsedwa.

Regional anesthesia nthawi zambiri imagwiritsidwa ntchito pochita opaleshoni yosavuta monga nthawi yobereka bwino, maopareshoni ang'onoang'ono monga ma gynecological kapena maesthetic opaleshoni kapena ma orthopedics, mwachitsanzo.

Pezani momwe anesthesia amathetsa zowawa za kubereka.

Ziwopsezo zake ndi ziti

Ngakhale ndizovuta, zoyipa monga thukuta kwambiri, matenda opezeka jekeseni, kawopsedwe, mavuto amtima ndi mapapo, kuzizira, malungo, kuwonongeka kwa mitsempha, kuwonongeka kwa nembanemba yomwe imateteza msana, yotchedwa dura mater, imatha kuchitika. chimfine.

Kuwonongeka kwa nthawi yayitali kumayambitsanso kupweteka kwa msana kwa msana m'maola 24 oyamba kapena mpaka masiku 5 pambuyo pake. Zikatero, munthuyo amamva kupweteka mutu atakhala pansi kapena atayimirira ndipo zimathandizanso mphindi zochepa atagona, zomwe zimatha kuphatikizidwa ndi zizindikilo zina monga nseru, khosi lolimba komanso kuchepa kumva. Pakati pazochitikazo, mutuwu umatha msanga mkati mwa sabata, koma kungakhale kofunikira kuyamba mankhwala omwe akuwonetsedwa ndi anesthesiologist.

4. Sedation ochititsa dzanzi

Sedation anesthesia imayendetsedwa kudzera m'mitsempha ndipo imagwiritsidwa ntchito limodzi ndi anesthesia am'madera kapena am'deralo, kuti mulimbikitse munthuyo.

Kukhala pansi kumatha kukhala kofatsa, komwe munthu amakhala womasuka koma wogalamuka, wokhoza kuyankha mafunso kuchokera kwa adotolo, moyenera momwe munthuyo amagonera panthawi yovomerezekayo, koma amatha kugalamuka mosavuta akafunsa funso kapena mkati momwe munthuyo wagona munthawi yonseyi, osakumbukira zomwe zidachitika kuyambira pomwe opaleshoni idaperekedwa. Kaya ndi wofatsa, wosapitirira kapena wozama, mtundu uwu wa anesthesia umatsagana ndi kuwonjezera kwa oxygen.

Ziwopsezo zake ndi ziti

Ngakhale ndizochepa, zovuta zomwe zimachitika, kupuma movutikira, kusintha kwamitima ya mtima, nseru, kusanza, delirium, thukuta ndi matenda pamalo obayira zimatha kuchitika.