Yu kin fil bak fɔ fred smɔl we dɛn gi yu lokal anestetik? Lɛ wi tɔk bɔt LAST (Local Anesthetic Systemic Toxicity)!

Yu dɔn ɛva tek lokal anestetik fɔ pul yu tut, stich wund, ɔ fɔ mek dɛn du smɔl ɔpreshɔn? En den yu jos fil numb en notin de hapun? I kin tan lɛk se i strenj, bɔt dis anestetik na rili impɔtant tin na mɛrɛsin. Bɔt, na smɔl tɛm nɔmɔ, dat na, na smɔl tɛm nɔmɔ, dis anestetik kin mek wi bɔdi gɛt smɔl prɔblɛm. Na dat wi kin kɔl Local Anesthetic Systemic Toxicity , ɔ LAST . Nɔ wɔri, dis nɔ kin apin so ɔltɛm. Bɔt i fayn fɔ no smɔl bɔt dis.

So wetin na LAST (Lכkal Anεsthεtik Sεstεmik Tכksisiti)?

Fɔ tɔk am simpul wan, LAST na di ifɛkt we we dɛn it wan mɛrɛsin, i kin gɛt pan wi bɔdi in sistɛm dɛn, mɔ di Sɛntral Nɛvɔs Sistɛm (CNS), we na di bren ɛn spɛshal kɔd, ɛn di Kadiovaskyuɛl Sistɛm, we na di at ɛn blɔd vesel dɛn.

Tink bɔt aw mɛrɛsin dɛn we de mek pɔsin fil pen kin wok. Dɛn kin blok di nerves (peripheral nerves) na wan patikyula pat na wi bɔdi fɔ sɔm tɛm. Dɔn dɛn nɛv dɛn de kin stɔp fɔ sɛn tin dɛn lɛk pen ɛn tɔch to di bren. Na dat mek wi kin fil lɛk se wi de tingly na da eria de. Dɛn mɛrɛsin ya we de mek pɔsin fil pen kin kam lɛk injɛkshɔn, jel, ɛn sprɛy.

So, LAST kin apin insay sɔm minit afta yu tek di pen kil. Bɔt di bɛst pat na dat, tritmɛnt de fɔ dis. If yu dɔktɔ si dɛn sayn ya, dɛn go du sɔntin kwik kwik wan.

Wetin na di sayn dɛm fɔ LAST? Aw wi kin no am?

LAST de mεntal afekt wi sεntri nεv sεstem (CNS). Di fɔs sayn dɛm kin bi:

di simptom dεm we de fכ di sεntri nεv sεstem (CNS):

• Seizure: Dis na di sayn wae kin kam pan pɔrsin. I kin gɛt kɔnvulshɔn wantɛm wantɛm ɛn i nɔ kin no natin.
• Agitation or confusion: Na filin wae yu nɔr ebul fɔ sidɔm, yu nɔr ebul fɔ pe atɛnshɔn, ɛn yu nɔr ɔndastand wetin de apin.
• Iya chenj: Na tin we de ring ɔltɛm na di yes (Tinnitus) .
• Numbness around your mouth: Numbness around yu maut, lɛk we dɛntist injekt mɛrɛsin.
• Mɛtal teist na yu mɔt: I te lɛk se yu gɛt wan pat pan ayɛn na yu mɔt.
• Slurred speech (Dysarthria): Wɔd dɛn kin bi slurred ɛn i kin at fɔ tɔk klia wan.
• Hallucinations: Fɔ si ɔ yɛri tin dɛn we nɔ rili de.
• di ay muvmεnt abnכmaliti: di yay dεm de muv we dεn nכ de kכntro, i tan lεk se dεn de muv frכm wan say to di כda say.

Di simptom dɛm wae gɛt fɔ du wit di Kadivaskyul Sistɛm:

Di LAST kɔndishɔn kin afɛkt wi at bak. Dɔn, sɔm kayn sik dɛn lɛk dis kin apin:

• Lɔw blɔd prɛshɔn:Di prɛshɔn de go dɔŋ.
• di chenj dεm we de apin na di at rεt: di at rεt kin tu slo (Bradycardia) , tu fast (Tachycardia) , כ di at ritm dεm we nכ de rεgεl (Arrhythmias) .
• Shortness of breath (Dyspnea): I nɔ kin izi fɔ blo, i kin swɛt.
• Cardiac arrest: Na we di at kin stɔp fɔ wok wantɛm wantɛm. dis kin bi we di ilektrikal aktiviti we de na di at lכs kכmplit (asystole) , כ we di at in sεl dεm de bit bכku bכku wan εn i nכ de bit (ventricular fibrillation) .

Impɔtant: If dɛn nɔ trit am kwik, LAST kin mek yu nɔ ebul fɔ blo ɔ yu kin kɔma .

Dɛn sayn ya kin apin insay fayv minit afta yu tek mɛrɛsin fɔ mek yu fil pen. Sɔmtɛm dɛn kayn sik ya kin bigin fɔ rili smɔl ɛn smɔl smɔl, ɔr dɛn kin kam tranga wan wantɛm wantɛm. Na dat mek dɔktɔ dɛn go de wach yu gud gud wan afta dɛn dɔn gi yu wan mɛrɛsin fɔ mɛn yu pen, mɔ if yu de pan ay risk fɔ gɛt LAST.

Wetin mek dis LAST kin apin? Wetin na di rizin dɛn?

Di men tin we kin mek pɔsin gɛt LAST na we dɛn aksidɛntal injɛkshɔn wan mɛrɛsin we de mek pɔsin fil pen na wan blɔd vesel. Tink bɔt am, dɛn se dɛn fɔ injɛkt di mɛrɛsin we de mek pɔsin fil pen nia wan nerv. Bɔt sɔntɛnde if i go insay blɔd vesel, di mɛrɛsin kin skata ɔlsay na di bɔdi kwik kwik wan ɛn mek dis sik.

dεn ripot se di risk fכ LAST we de apin we dεn de du nεv blכk dεm we de numb di limb dεm na bכt 20%. Bɔt, nɔto ɔl dis nɔmɔ:

• Dɛn dɔn mek LAST bak as mɛrɛsin we dɛn kin put pan pɔsin in bɔdi we dɛn kin put pan di skin we tan lɛk jel .
• LAST dɔn kam bak bikɔs ɔf mɛrɛsin dɛn we de mek di mukɔs mɛmbran dɛn na di mɔt, trot, ɛn di say dɛn we di briz de blo .

Dis min se LAST kin apin ilɛk aw yu yuz di mɛrɛsin. Bɔt sɔm tin dɛn kin mek dis prɔblɛm kin bɔku.

Udat de pan ay risk fɔ gɛt LAST? (Di tin dɛn we kin mek pɔsin gɛt prɔblɛm)

Sɔm tin wae gɛt fɔ du wit yu wɛl bɔdi prɔblɛm kin mek yu gɛt mɔr risk fɔ gɛt LAST.

Risk factors wae gɛt fɔ du wit yu wɛl bɔdi:

• mεtabolik asidכsis: We di kεmikכl bεlε na di bכdi chenj εn di asid de inkrεs.
• כksijεn lεvεl dεm na di bכdi (Hypoxia): We di כksijεn we de na di bכdi dכn dכn.
• At sik we bin dɔn de bifo: Ɛspɛshali di wan dɛn we gɛt kɔndishɔn lɛk ischemia , aritmia , kɔndɔkshɔn abnɔmaliti , ɛn low ejection fraction .
• Pipul dɛn we dɔn pas 65 ia:כlso, pikin dεm we nכ rich 4 mכnt kin gεt hכy risk fכ gεt LAST.
• Liva ɔ kidni sik: Pipul wae gɛt dɛn kayn sik ya kin gɛt delayed LAST bikɔs i kin tek lɔng tɛm fɔ mek di mɛrɛsin kɔmɔt na di bɔdi.
• We uman gɛt bɛlɛ.
• Maytochכndrial sik dεm: Dis na sik dεm we de afekt di pat dεm we de prodyuz enεji na wi sεl dεm we dεn kכl maytochכndria.

Risk factors wae gɛt fɔ du wit Hiri mɛrɛsin:

Sɔm anestetik dɛm, lɛk bupivacaine , kin mek yu gɛt LAST pas ɔda wan dɛm. Dɔn bak, di prɔblɛm kin bɔku we dɛn gi dɛn anestetik mɔ .

Risk factors wae gɛt fɔ du wit di ɔral mɛrɛsin we dɛn de yuz:

Sɔm we dɛn fɔ gi mɛrɛsin fɔ mɛn pen kin mek bak di risk fɔ gɛt LAST. Wan stɔdi we dɛn du pan 125 kes dɛm fɔ LAST sho se:

• Infiltration techniques na di we aw dɛn kin injekt mɛrɛsin ɔnda di skin. Dis kin mek lɛk 20% pan di LAST kes dɛm.
• di sεntri nyuraksial blכk dεm, lεk di epidural εn kכdal blכk dεm, dεn de gi to di spayna. Dɛn kin mek lɛk 15% pan ɔl di kes dɛm we dɛn kin ripɔt.
• Dɛn dɔn ripɔt se na lɛk 13% bikɔs dɛn de kɔntinyu fɔ put mɛrɛsin fɔ mek dɛn fil pen, lɛk salin .

fכ finish, LAST kin apin mכr we dεn injεkt anεsthεtik na εria dεm we gεt hכy vaskulεriti . fכ egzampl, dεn kin ripot LAST kes dεm mכr we dεn du di penis nεv blכk .

Aw dɔktɔ dɛn kin no if pɔsin gɛt LAST? (Diagnosis) .

Dɔktɔ dɛn kin no di LAST mɔ bay di sayn dɛn we yu gɛt . Bikɔs LAST na imejensi we nid fɔ gɛt tritmɛnt kwik kwik wan, dɛn nɔ go ebul fɔ delay fɔ no di sik. Na smɔl tɛm nɔmɔ, yu dɔktɔ kin ɔda fɔ mek dɛn du EKG (ilɛktrokadiogram) fɔ ɛp fɔ kɔnfɔm dis.

Wetin na di tritmɛnt dɛm fɔ LAST?

Local Anesthetic Systemic Toxicity na wan mɛdikal imejensi. So, dɔktɔ dɛn go bigin fɔ trit dɛn kwik kwik wan. Di tritmɛnt dɛn we dɛn kin yuz na dɛn wan ya:

• Manejmɛnt fɔ di we aw yu de blo: Dɛn kin gi yu ɔksijɛn tritmɛnt wantɛm wantɛm fɔ mek yu ebul fɔ blo fayn, ɛn dɛn kin gi yu briz if nid de.
• Fɔ mek yu nɔ gɛt sik ɔ fɔ trit yu: Dis kin min fɔ gi mɛrɛsin lɛk bɛnzodiazepin .
• IV infusion of lipid emulsion: Dis na spɛshal mɛrɛsin we dɛn kin gi insay wan vein . I de wok bay we i de tek di mɛrɛsin dɛn we de mek pɔsin fil pen frɔm di blɔd ɛn di tisu dɛn. Dis kin ridyus di kɔnsɛntreshɔn fɔ di pen kil we kin rich na di bren ɛn at.
• CPR (Kadyopulmonari Risayz): .If LAST afɛkt di at wok, dɔktɔ dɛn kin du CPR ɛn yuz ɔda we fɔ mek di at stebul.

Afta di tritmɛnt, dɛn go kip yu ɔnda di mɛdikal ɔbshɔbishɔn fɔ at le siks awa fɔ si if di tritmɛnt dɔn wok fayn ɛn if ɛni ɔda prɔblɛm de.

Wetin go apin to pɔsin we gɛt LAST? (Prɔgnosis) .

Di wan dɛn we dɛn kin no bɔt ɛn trit dɛn kwik kwik wan kin gɛt bɛtɛ tin fɔ du. Tritmɛnt kin rili rivɛns di kɔndishɔn fɔ LAST.

Bɔt if dɛn nɔ trit siriɔs LAST kwik, i kin mek pɔsin kɔma ɔ ivin day. Bɔt, dis nɔ kin apin so ɔltɛm. Fɔ ɛgzampul, akɔdin to data frɔm pɔyzin kɔntrol sɛnta dɛn na Amɛrika, na 4 pipul dɛn nɔmɔ bin day bikɔs ɔf mɛrɛsin dɛn we de mek pɔsin fil pen insay 2016.

Yu tink se dɛn kin ebul fɔ mek LAST nɔ apin?

Dɛn nɔ kin ebul fɔ stɔp LAST ɔltɛm, bɔt dɔktɔ dɛn kin yuz sɔm we dɛn ɛn sɔm tin dɛn fɔ mek dɛn nɔ gɛt dis prɔblɛm.

Fɔ ɛgzampul, yu dɔktɔ go yuz di mɛrɛsin we smɔl pas ɔl fɔ mek yu fil pen . Dɔn bak, sɔm tɛm dɛn go yuz ɔltra saund imej fɔ gi di injɛkshɔn, fɔ mek shɔ se i nɔ aksidɛntli go insay blɔd vesel.

If yu gɛt tin dɛn we kin mek yu gɛt LAST, yu dɔktɔ go tek tɛm tink bɔt di mɛrɛsin we sef fɔ mek yu fil pen, di doz, ɛn di we aw dɛn fɔ gi yu.

We yu go tek pen kil, yu go mɔs nɔ tink bɔku bɔt LAST. Yu go mɔs de wɔri bɔt if di injɛkshɔn go at ɔ if yu go fil tumɔs. Dat na nɔmal tin, bikɔs LAST na rili rare. Bɔt mɛmba se yu dɔktɔ go tek kia ɔf yu gud gud wan afta i dɔn gi yu wan mɛrɛsin we de mek yu fil pen. If yu gɛt sayn dɛm fɔ LAST, dɛn go du sɔntin kwik kwik wan.

Fɔ dɔn, mɛsej we yu kin kɛr go na os:

If yu gɛt ɛni kwɛstyɔn, wɔri, ɔ dawt bɔt yu anestetik, nɔ shem fɔ aks yu dɔktɔ. Dɛn de de fɔ ɛp yu. Local Anesthetic Systemic Toxicity (LAST) nɔto natin fɔ fred, bikɔs i nɔ kin bɔku ɛn i gɛt gud tritmɛnt. Di tin we impɔtant pas ɔl na fɔ no bɔt dis ɛn tɔk to yu dɔktɔ opin wan. Dɔn yu kin fes ɛni mɛrɛsin wit pis na yu maynd.

` Lokal Anestetik Sεstεmik Tכksisiti, LAST, anεsthεtik tכksisiti, anεsthεtik sayd ifekt dεm, nεv sεstem, kכdivaskyul sistεm, simptom dεm, tritmεnt