Loaʻa iā ʻoe ka ʻeha mau ma kou ʻāʻī, ke poʻo, ka lima, a i ʻole ka umauma luna ʻaʻole e nalowale me ka lāʻau lapaʻau? I kekahi manawa, ʻo ke kumu o kēia ʻano ʻeha he pilikia liʻiliʻi paha ia i loko o kā mākou ʻōnaehana nerve. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau kūikawā, ʻokoʻa iki a nā kauka e hoʻohana ai i ia mau hihia. Ua kapa ʻia kēia he 'Stellate Ganglion Block'. ʻOiai paha he paʻakikī iki ka inoa, e hoʻomaopopo wale kākou i ka hana a kēia.
He aha ka Stellate Ganglion Block (SGB)?
I ka ʻōlelo maʻalahi, ʻo ka Stellate Ganglion Block (SGB) he inikini o kahi anesthetic. Akā, ʻaʻole kēia he inikini maʻamau. Hoʻokomo ʻia ia i loko o kahi hui kūikawā o nā aʻalolo i loko o ko mākou ʻāʻī, ma nā ʻaoʻao ʻelua o ko mākou pahu leo. Ua kapa ʻia kēia hui o nā aʻalolo ʻo 'Stellate Ganglion'.
ʻElua mau kumu nui no ka lawelawe ʻana i kēia lāʻau pale:
1. No ka hōʻoluʻolu ʻana i kekahi ʻeha nui a mau loa ma ke poʻo, ka ʻāʻī, nā lima o luna, a me ka umauma o luna.
2. Ke kahe ʻana o ke koko i nā lima, ʻo ia hoʻi, ka hoʻomaikaʻi ʻana i ke kahe ʻana o ke koko.
ʻAe, he aha kēia ganglion stellate?
ʻO ka ganglion kahi hui o nā hunaola aʻalolo e hui pū ana, e like me kahi huina ma ke kahua kaʻaahi, kahi kikowaena kahi e hoʻouna ʻia ai nā leka aʻalolo i mua a i hope.
ʻO ka ganglion stellate kekahi o ia mau hui aʻalolo. Aia ia ma ke alo o ko kākou ʻāʻī, ma lalo pono o ka iwi ʻāʻī, kokoke i ka iwi ʻaoʻao mua. Loaʻa iā kākou nā ganglions e like me kēia ma nā ʻaoʻao ʻelua o ko kākou ʻāʻī. ʻO ke ʻano o ka huaʻōlelo 'stellate' ʻo ia hoʻi 'e like me ka hōkū'. ʻO ia hoʻi, hiki ke hoʻohālikelike ke ʻano o kēia hui aʻalolo i ke ʻano o ka hōkū.
No ka 'Sympathetic Nervous System' kēia hui o nā aʻalolo, ʻo ia kekahi hapa o kā mākou Autonomic Nervous System. I ka ʻōlelo maʻalahi, ʻo kēia ka ʻōnaehana 'hakakā a lele paha' o ko mākou kino, ʻo ia hoʻi, ka ʻōnaehana e hoʻomākaukau iā mākou e hakakā a holo paha i kahi pilikia, i ka wā e makaʻu ai a hopohopo paha mākou. Pili ia i nā mea he nui a ko mākou kino e hoʻomalu ai me ka ʻole o ko mākou noʻonoʻo ʻana iā lākou, e like me ka helu o ka puʻuwai, ke koko, a me ka hou ʻana. No laila, ʻo ka hapa nui o nā leka aʻalolo sympathetic e hele ana i ke poʻo, ka ʻāʻī, nā lima, a me ka umauma luna e hoʻouna ʻia ma o kēia stellate ganglion.
Loaʻa i nā kānaka a pau kēia Stellate Ganglion?
He mea kupanaha iki nō hoʻi kēia. ʻOiaʻiʻo, ʻaʻole i loaʻa kēia ganglion stellate i loko o ke kino o kēlā me kēia kanaka. I mea e hana ai kēia ganglion, pono e hui pū ʻia nā hui aʻalolo ʻelua i loko o ko kākou ʻāʻī, ʻo ia hoʻi ka `inferior cervical ganglion` a me ka `first thoracic ganglion`.
Akā, ʻo 80% wale nō o nā kānaka o ka honuaHoʻohui pū kēia mau puʻupuʻu aʻalolo ʻelua ma kēia ʻano e hana i ka ganglion stellate. Ma nā 20% ʻē aʻe o nā hihia, ua hoʻonohonoho ʻokoʻa ʻia kēia mau mea, ua hoʻokaʻawale ʻia kekahi mai kekahi.
No ke aha e hana ʻia ai kahi Stellate Ganglion Block? No nā maʻi hea?
Hoʻohana nā kauka i kēia lāʻau lapaʻau no ʻelua mau kumu nui.
1. No ka hōʻoia ʻana: E ʻike inā ua hana ʻia kekahi ʻeha e ka hana o ka ʻōnaehana nerve sympathetic i ʻōlelo ʻia ma mua. Ua kapa ʻia kēia ʻo 'sympathetically mediated pain (SMP)'.
2. Ma ke ʻano he lāʻau lapaʻau: E kāohi i nā ʻano ʻeha like ʻole, nā maʻi aʻalolo, a me nā pilikia kahe koko.
Aia ma ka papa ma lalo nei kekahi o nā kūlana i hoʻohana pinepine ʻia ai kēia lāʻau.
| Maʻi/ʻEha | He wehewehe maʻalahi |
|---|---|
| ʻO ka Syndrome ʻEha ʻĀpana Paʻakikī (CRPS) | ʻEha nui, lōʻihi, a ʻeha wela e kū mai ana ma hope o kahi ulia ma ka lima a i ʻole ka wāwae. |
| Maʻi ʻAla Kino Peripheral | Nā pilikia o ke kaʻina hana o ke kaʻina hana e ka lahilahi o nā kīʻaha koko e hoʻolako ana i ke koko i nā lima a me nā wāwae. |
| ʻEha Limb Phantom | Ke ʻeha mau nei ma ka lima a i ʻole ka wāwae i wehe ʻia e ke ʻoki ʻana. |
| ʻO ka Neuralgia Postherpetic | ʻEha aʻalolo e mau ana ma hope o ka ho'ōla ʻia ʻana o ka herpes zoster (shingles), i hoʻokumu ʻia e ka maʻi herpes e pili ana i ka chickenpox. |
| ʻO ka Hyperhidrosis | Ka hou nui ʻana ma nā wahi e like me nā poho lima. |
| ʻO ka maʻi Raynaud | Lilo nā manamana lima i ke keʻokeʻo, polū, a mae wale ke kino i ka wā e anu ai a i ʻole ke kaumaha. |
| Nā ʻeha poʻo hui | ʻEha ʻeha nui loa a ʻūlū hoʻi. |
Eia kekahi, hoʻohana ʻia kēia lāʻau lapaʻau no nā kūlana e like me 'Scleroderma', 'ʻeha Orofacial', 'ʻeha umauma atypical', a me 'ka maʻi Ménière'.
Hoʻohana ʻia kēia no nā pilikia olakino noʻonoʻo?
ʻAe, he kumuhana kēia a ka poʻe he nui e kamaʻilio nei i kēia manawa. Ke hana nei ka noiʻi mai ka makahiki 1990, ʻoi aku hoʻi ma ka hoʻohana ʻana i ka SGB ma ke ʻano he lāʻau lapaʻau no kahi maʻi noʻonoʻo i kapa ʻia ʻo Post-Traumatic Stress Disorder (PTSD) .
He maʻi noʻonoʻo ka PTSD e ulu ana ma hope o ka loaʻa ʻana o kahi hanana traumatic koʻikoʻi. Loaʻa i ka poʻe me kēia maʻi nā pae kiʻekiʻe loa o kekahi mau kemika i loko o ko lākou lolo, e like me ka `norepinephrine` a me ka `nerve growth factor`. Manaʻo nā kānaka noiʻi e hiki i kēia injection ke hōʻemi i kēlā mau pae a kāohi i ka hoʻāla mau ʻana o ka pane `hakakā a lele paha`.
Akā, ua hui pū ʻia nā hopena o kēia mau haʻawina. Ua ʻike kekahi poʻe i ka emi nui ʻana o nā hōʻailona PTSD, a ʻo kekahi poʻe ʻaʻole i ʻike i kahi loli. No laila, ʻaʻole i ʻae kūhelu ʻia nā keʻena e like me ka U.S. Food and Drug Administration i ka SGB ma ke ʻano he lāʻau lapaʻau no ka PTSD. Eia nō naʻe, inā ʻaʻole i holo pono nā lāʻau lapaʻau ʻē aʻe (aʻoaʻo ʻana, lāʻau lapaʻau), hiki i ke kauka ke kūkākūkā i kēia me ka mea maʻi a hāʻawi iā ia ma ke ʻano he lāʻau lapaʻau 'off-label'.
I kēia mau lā iho nei, ua hoʻomaka ka noiʻi ʻana i nā hopena o SGB ma nā kūlana noʻonoʻo ʻē aʻe, e like me ke kaumaha a me ka hopohopo.
Pehea e hana ʻia ai kēia Stellate Ganglion Block?
E noʻonoʻo ua kuhikuhi kekahi kauka i kēia lāʻau lapaʻau nou. A laila, ma ke keʻena lapaʻau a i ʻole ka haukapila, hana ʻia kekahi mea e like me kēia:
1. Hoʻomākaukau: ʻO ka mea mua, e noi ʻia ʻoe e moe i luna ma kahi moe. No kou ʻoluʻolu a me ka hoʻomaha, hiki ke hāʻawi ʻia iā ʻoe kahi mea hoʻomaha iki (he mea hoʻomaha) ma o kahi laina intravenous (IV).
2. Hoʻomaʻemaʻe: E hoʻomaʻemaʻe pono ke kauka i ka wahi o kou ʻāʻī kahi e hāʻawi ʻia ai ka inikini me kahi hopena antiseptic.
3. ʻO ka inikini mua (hemp):A laila, hoʻokomo ʻia kahi liʻiliʻi o ka anesthetic kūloko i loko o ka wahi me ka hoʻohana ʻana i kahi nila lahilahi loa. E kōkua kēia iā ʻoe ʻaʻole e ʻike i ka ʻeha o ka injection aʻe.
4. ʻO ka inikini nui: A laila hoʻokomo ʻia ka lāʻau anesthetic nui. Akā, ʻaʻole kēia he kuhi wale nō. Hoʻohana ke kauka i kahi scan 'Ultrasound' a i ʻole kahi ʻano X-ray kūikawā i kapa ʻia ʻo 'Fluoroscopy' , nānā i ke ala o ka nila ma kahi pale, a laila wale nō e hana ʻia ai ka inikini ke kokoke pono ka nila i ka hui nerve i kapa ʻia ʻo ka stellate ganglion. Hoʻemi kēia i ka manawa kūpono o ka inikini ʻana ma kahi kūpono ʻole.
ʻO ka maʻamau, ʻaʻole ma mua o 30 mau minuke ka lōʻihi o kēia kaʻina hana holoʻokoʻa.
He aha ka mea e hana ʻia ma hope o ka inikini?
Ma hope o ke kuʻi ʻana, e mālama ʻia ʻoe i loko o kahi lumi hoʻōla no kekahi manawa. ʻO ka maʻamau no kahi 40 a 60 mau minuke, e nānā ke kahu maʻi a kauka paha i kou kūlana (ke koko, ka helu o ka puʻuwai). Ke hōʻoia ʻia nā mea āpau, e hāʻawi ʻia ʻoe i nā kuhikuhi e hahai ai ma ka home a laila ʻae ʻia e hoʻi i ka home.
ʻO ka mea nui loa: Ma hope o kēia lāʻau lapaʻau, ʻaʻole hiki iā ʻoe ke hoʻi i ka home ma kāu iho, no laila he mea nui e loaʻa i kekahi e hoʻokele iā ʻoe i ka home.
Pehea ka maikaʻi o kēia lāʻau lapaʻau? Pehea ka lōʻihi o kona mau ʻana?
ʻAʻohe pane hoʻokahi i kēia nīnau no ka mea ʻokoʻa loa ia mai kēlā kanaka a kēia kanaka.
- No kekahi poʻe, nalo koke ka ʻeha ma hope o ke inikini ʻana, akā hiki ke hoʻi hou mai ka ʻeha ma hope o kekahi mau hola ke pau ka lāʻau hoʻomake.
- Hoʻomaha ka ʻeha o kekahi poʻe no nā lā a i ʻole nā pule. I loko o kēia manawa, hiki iā lākou ke hoʻēmi i kā lākou lāʻau ʻeha a komo i nā hana e like me nā hoʻomaʻamaʻa physiotherapy.
ʻO ka maʻamau, ʻaʻole hāʻawi pinepine kahi inikini hoʻokahi i ka hōʻoluʻolu piha. No ka hōʻoluʻolu lōʻihi, pono kahi moʻo o nā inikini, ʻo ia hoʻi, pono ʻoe e hana i kēia i nā manawa he nui. I kekahi manawa hiki iā ʻoe ke loaʻa nā hopena i ʻelua mau kau wale nō, aʻo kekahi poʻe e pono paha e hana ia ma mua o ʻumi mau manawa. Akā ʻo ka nūhou maikaʻi , me kēlā me kēia kau, hiki ke hoʻonui ʻia ka lōʻihi o ka hōʻoluʻolu ʻeha .
Aia kekahi mau hopena ʻaoʻao a i ʻole nā pilikia i kēia?
E like me nā lāʻau lapaʻau āpau, aia nā hopena ʻaoʻao liʻiliʻi a me nā pilikia koʻikoʻi kākaʻikahi loa.
| Nā hopena ʻaoʻao maʻamau, manawa pōkole (e nalo i loko o kekahi mau hola) | |
|---|---|
| ʻEha a ʻeha paha ma kahi i hoʻokomo ʻia | Ka lihilihi o ka maka |
| ʻUlaʻula o nā maka | Nā waimaka e puka mai ana mai nā maka |
| Paʻa ihu | Ka leo haʻalulu |
| Manaʻo e like me he puʻupuʻu lā ma ka puʻu | Ka paʻakikī i ka ale ʻana i ka meaʻai |
| Manaʻo o ka mehana a i ʻole ka ʻeha i ka lima a i ʻole ka pālima | |
ʻO ka maʻamau, e hoʻopau loa nā hōʻailona i ʻōlelo ʻia ma luna nei i loko o kekahi mau hola, akā aia kekahi mau pilikia koʻikoʻi e hiki ke hana pinepine ʻole ʻia .
- Nā kūlana maʻi
- Ke kahe ʻana o ke koko ma muli o ke komo ʻana o ka nila i loko o kahi kīʻaha koko (e like me ke aʻa carotid)
- ka hōʻino ʻana i nā aʻalolo ʻē aʻe (aʻalolo vagus, aʻalolo laryngeal hou)
- Ka pōʻino o ka māmā (Pneumothorax)
- Ka hōʻino ʻana i ka ʻōpū thyroid, esophagus, a i ʻole trachea
He haʻahaʻa loa ka manawa kūpono o kēia mau mea, ʻoiai ke hana nei ke kauka akamai i kēia lāʻau me ka hoʻohana ʻana i ka ʻenehana e like me ka ultrasound.
I nā kūlana hea e pono ai iaʻu ke kāhea aku i ke kauka?
Ma hope o kou hoʻi ʻana i ka home ma hope o ka inikini, inā loaʻa iā ʻoe kekahi mau hōʻailona hou a i ʻole ke kānalua nei i kekahi mau pilikia , e kāhea koke i kāu kauka. ʻOi loa aku:
- Inā pehu, ʻulaʻula, a kuni paha kahi i inikini ʻia (nā hōʻailona o ka maʻi).
- Inā hoʻomau ka paʻakikī i ke ale ʻana ma hope o kekahi mau hola.
- Inā pilikia ʻoe i ka hanu ʻana.
Mai makaʻu a kānalua paha e pili ana i kēia lāʻau lapaʻau. E kamaʻilio ākea me kāu kauka e pili ana i ia mea. ʻO ka mea nui loa, ʻo ia ka hoʻolohe ʻana i kou mau hopohopo a pau a hana i kahi hoʻoholo naʻauao.
Leka Lawe-Home
- ʻO ka Stellate Ganglion Block (SGB) kahi lāʻau lapaʻau e pili ana i ka hoʻokomo ʻana i kahi anesthetic i loko o kahi hui nerve kūikawā ma ka ʻāʻī.
- Hoʻohana nui ʻia kēia no kekahi mau ʻeha mau loa a me nā pilikia kahe koko ma ke poʻo, ka ʻāʻī, nā lima, a me ka umauma o luna.
- Hoʻohana ʻia nō hoʻi ia i ka noiʻi ʻana no nā kūlana noʻonoʻo e like me PTSD, akā ʻokoʻa nā hopena mai kēlā kanaka a kēia kanaka.
- ʻOkoʻa loa ka holomua o kēia lāʻau a me ka lōʻihi o ka hoʻomaha ʻana i ka ʻeha mai kēlā kanaka a kēia kanaka, a koi pinepine ʻia kekahi mau inikini.
- Hiki ke loaʻa nā hopena ʻaoʻao no ka manawa pōkole e like me ka leo ʻōlinolino a me ke kuʻe ʻana o nā lihilihi maka, kahi e emi iho i loko o kekahi mau hola. He haʻahaʻa loa ka pilikia o nā pilikia koʻikoʻi.
- ʻO ka mea nui loa, ʻo ke kamaʻilio ʻana me kāu kauka e pili ana i kēia, e nīnau i kāu mau nīnau a pau, a e hoʻoholo i kahi hoʻoholo piha.
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo