Local anesthetic pek i nih hian i hlau deuh bawk em? LAST (Local Anesthetic Systemic Toxicity) chungchang hi han sawi ila!

Ha lak chhuah nan te, hliam i stitch up nan te, emaw, operation tenau tak neih nan local anesthetic i ei tawh em? Tin, chutah chuan i rilru a buai mai mai a, engmah a thleng lo em ni? Mak tak maiin a ri thei a, mahse he anesthetic hi damdawi lamah chuan thil pawimawh tak a ni. Mahse, a tlem hle, chu chu a tlem hle tihna a ni, he anesthetic hian kan taksa tan harsatna tlemte a thlen thei a ni. Chu chu Local Anesthetic Systemic Toxicity , emaw LAST kan tih chu a ni. Ngaihtuah buai suh, hei hi a tlem hle. Mahse hemi chungchang hi tlem tal hriat a tha.

Chuti a nih chuan LAST (Local Anesthetic Systemic Toxicity) hi eng nge ni?

A awlsam zawngin sawi ila, LAST hi damdawi ei hian kan taksa system, a bik takin Central Nervous System (CNS), thluak leh ruhro, leh Cardiovascular System, thinlung leh thisen kalna kawng a nghawng dan hi a ni.

Painkillers hian engtin nge hna a thawh tih hi han ngaihtuah teh. Kan taksa peng pakhata nerve (peripheral nerves) te chu rei lo te chhungin an block thin. Tichuan chu nerve te chuan thluak lama natna leh khawih ang chi hriatna thawn chu an titawp ta a ni. Chuvang chuan chu lai hmunah chuan kan tingly ang maiin kan inhria. Heng natna tidamtu te hi injection, gel, leh spray ang chi te a ni.

Chuvangin, LAST hi painkiller ei atanga minute tlemte chhungin a thleng thin. Mahse a tha ber chu, hei hi enkawlna a awm. I doctor-in heng symptoms te hi a hmuh chuan a che nghal vat ang.

LAST natna lan chhuah dan chu engte nge ni? Engtin nge kan hriat chian?

LAST hian kan central nervous system (CNS) a nghawng ber a ni. A lan chhuah hmasak ber chu:

Central nervous system (CNS) nena inzawm natna lan chhuah dan:

• Seizures: Hei hi a lan chhuah tam ber a ni. Sudden convulsion leh hriatna hloh a awm bawk.
• Agitation emaw confusion: Ngawi reng thei lo, ngaihtuahna seng thei lo, thil thleng hrethiam lo.
• Beng inthlak danglamna: Beng chhunga ri reng reng (Tinnitus) .
• I hmui vel a natna: I hmui vel a natna, ha enkawltuin damdawi a inject lai ang chi.
• I ka chhunga metallic taste: I ka chhunga thir chi khat ang maia thlum a ni.
• Slurred speech (Dysarthria): Thumal a slurred a, chiang taka sawi a harsa thin.
• Hallucinations: Thil awm tak tak lo hmuh emaw hriat emaw.
• Mit che vel dan dik lo: Mit hi thunun theih lohvin a che a, a sir lehlamah a kal ang maiin a lang.

Cardiovascular System nena inzawm natna lan chhuah dan:

Thil awmdan HNUHNUNG hian kan thinlung a nghawng thei bawk. Tichuan hetiang symptoms hi a lo awm thei a ni:

• Thisen sang hniam: 1.1.Pressure a tlahniam zel a.
• Heart rate inthlak danglamna: Heart rate a slow lutuk (Bradycardia) , rang lutuk (Tachycardia) , emaw heart rhythm mumal lo (Arrhythmias) .
• Thâwk harsa (Dyspnea): Thâwk harsa, thawk hah.
• Cardiac arrest: Thinlung electric hnathawh tihtawp nghal mai. Hei hi thinlunga electrical activity hloh vek (asystole) vang a ni thei a, thinlung cell-te chu rang tak leh mumal lo taka thawk (ventricular fibrillation) vang pawh a ni thei.

Pawimawh: Enkawl vat loh chuan LAST hian thawkna a titawp emaw, coma emaw a thlen thei a ni.

Heng symptoms te hi painkiller ei atanga minute nga chhungin a lang tlangpui. A châng chuan heng symptoms te hi a na lo hle a, zawi zawiin a pung thei a, a nih loh leh rang takin a na thei bawk. Chuvangin doctor ten painkiller an pek hnuah uluk takin an enkawl ang che, a bik takin LAST vei theihna risk sang tak i neih chuan.

Engvangin nge he thil hi a HUN THIN? A chhan engte nge ni?

LAST awm chhan ber chu thisen kalna kawnga natna tidamtu (painkiller) accident-a injection a ni. Ngaihtuah teh, painkiller hi nerve bulah inject tur a ni . Mahse a chang chuan thisen kalna kawngah a luh chuan damdawi chu taksa pum puiah a darh nghal vat thei a, he natna hi a thlen thei bawk.

Limbs ti na thei nerve block tih hian LAST a awm theihna chance chu 20% vel a ni tih an sawi. Mahse, hei hi a ni lo:

• LAST hi topical medication angin an siam bawk a , chu chu vunah gel angin an hnawih thin .
• LAST hi ka, rilru, leh thawkna kawng (mucous membrane) ti na thei damdawi avanga lo awm a ni bawk .

Hei hian damdawi i hman danah pawh LAST a awm thei tihna a ni. Mahse, thil ṭhenkhat chuan he hlauhawmna hi a tipung a ni.

Tute nge LAST vei theihna chance sang zawk? (Risk Factor hrang hrang) 1.1.

I hriselna dinhmun nena inzawm thil thenkhat chuan LAST vei theihna a tipung thei a ni.

I hriselna nena inzawm risk factors:

• Metabolic acidosis: Taksa chhunga chemical balance a inthlak a, acidity a san chuan.
• Taksa a oxygen level hniam (Hypoxia): Thisen a oxygen awm zat a tlahniam chuan.
• Lung natna awm tawh: A bik takin ischemia , arrhythmias , conduction abnormalities , leh ejection fraction hniam ang chi natna nei te.
• Kum 65 chunglamte chu:Tin, naute thla 4 hnuai lam pawh LAST vei theihna a sang zawk bawk.
• Liver emaw kidney natna: Hetiang natna vei te hian delayed LAST an nei thei a, a chhan chu damdawi taksa atanga a chhuah hun rei zawk a nih vang a ni.
• Naupai lai.
• Mitochondrial diseases: Heng natnate hi kan cell-a chakna siamtu peng mitochondria an tihte tichhe thei natna a ni.

Hiri damdawi nena inzawm risk factors:

Anesthetics thenkhat, bupivacaine , te hian a dang aiin LAST a thlen tam zawk. Tin, anesthetics hi a tam zawk pek a nih chuan a hlauhawmna a sang hle bawk .

Damdawi ei dan nena inzawm risk factors:

Painkiller pek dan thenkhat pawh hian LAST vei theihna a tipung thei bawk. LAST vei mi 125 te zirchiannaah chuan:

• Infiltration technique hi vun hnuaia damdawi inject dan a ni. Hei hi LAST case 20% vel a ni.
• Central neuraxial block, epidural leh caudal block ang chi te chu ruhroah pek a ni. Report zawng zawng zinga 15% vel an ni.
• 13% vel chu natna damdawi, saline ang chi infusion chhunzawm zel vang niin an sawi.

A tawp berah chuan LAST hi vascularity sang tak awmna hmuna anesthetics inject a nih chuan a awm tam zawk a ni . Entirnan, LAST case hi penile nerve block an tih hian an report tam zawk.

Engtin nge doctor te hian LAST hi an diagnose? (Diagnosis) tih a ni.

Doctor te chuan LAST hi i symptoms a zirin an diagnose ber thin . LAST hi emergency a nih avangin enkawl vat ngai a nih avangin diagnosis hi tihkhawtlai theih a ni lo. A tlem hle a, i doctor chuan hei hi nemnghet turin EKG (electrocardiogram) a order thei.

LAST enkawlna tur engte nge ni?

Local Anesthetic Systemic Toxicity hi damdawi lam thil pawimawh tak a ni. Chuvang chuan Doctor ten enkawlna an tan thuai dawn a ni. Enkawl dan pangngai chu hetiang hi a ni:

• Thlawhna kawng enkawl dan: I thawk dan tur venna atan oxygen therapy pek nghal a ni a, a tul chuan ventilation pek a ni bawk.
• Seizure venna emaw enkawl dan: Hei hian benzodiazepines ang chi damdawi pek a huam a ni.
• IV infusion of lipid emulsion: Hei hi damdawi bik a ni a, thisen zam chhunga pek thin a ni . Thisen leh tissue atanga natna tidamtu damdawi te chu a hip lut a, hna a thawk a ni. Hei hian thluak leh thinlung thlenga natna tidamtu (painkillers) concentration a ti tlem a ni.
• CPR (Thinlung leh lungphu tihnun): 1.1.LAST hian heart function a nghawng chuan doctor ten CPR an ti a, kawng dang hmangin heart stabilize an ti thin.

Enkawlna i neih zawh chuan darkar ruk tal medical observation hnuaiah dah i ni ang a, enkawlna a hlawhtling em tih leh harsatna dang a awm leh awm loh enfiah i ni ang.

LAST neitu chu engtin nge a awm ang? (Prognosis) tih a ni.

Hriatchhuah hmasak leh enkawl hma te hian result tha zawk an nei tlangpui. Enkawlna hian LAST dinhmun hi nasa takin a tidanglam thei a ni.

Mahse, LAST na tak chu enkawl vat a nih loh chuan coma emaw thihna thlengin a thlen thei a ni. Mahse, hei hi a tlem hle. Entirnan, United States-a poison control center-te data aṭanga a lan dan chuan kum 2016 chhung khan natna tidamtu damdawi vanga thi mi pali chauh an awm.

LAST hi ven theih a ni em?

LAST hi ven theih reng a ni lo va, mahse doctor-te chuan he hlauhawmna tihziaawm nan hian hmanraw leh kaihhruaina thenkhat an hmang thin.

Entirnan, i doctor chuan natna damdawi a mamawh tlem ber a hmang ang . Tin, a chang chuan ultrasound imaging hmangin injection an pe ang a, chu chu thisen kalna kawngah a lut palh loh nan.

LAST vei theihna tur risk factor i neih chuan i doctor chuan i tan natna damdawi him ber, a hman dan tur leh a pek dan tur chu uluk takin a ngaihtuah ang.

Painkiller ei tura i kal hian LAST hi i ngaihtuah vak lo mai thei. Injection hian a na dawn em tih emaw, i rilru a buai lutuk dawn em tih emaw i ngaihtuah zawk mai thei. Chu chu thil pangngai a ni, a chhan chu LAST hi a tlem hle. Mahse, i doctor-in natna tidamtu a pek hnuah a enkawl tha ang che tih hre reng ang che. LAST symptoms i neih chuan an che nghal vat ang.

A tawp berah chuan take-home message:

I anesthetic chungchanga zawhna, ngaihtuahna, rinhlelhna i neih chuan i doctor zawt hreh suh. I tanpui turin an awm reng a ni. Local Anesthetic Systemic Toxicity (LAST) hi hlauh tur a ni lo, a tlem hle a, enkawlna tha tak a nei bawk. A pawimawh ber chu hei hi hriat chian a, doctor nen zalen taka inbiakna neih hi a ni. Tichuan damdawi lam enkawlna eng pawh rilru thlamuang takin i hmachhawn thei ang.

` Local Anesthetic Systemic Toxicity, LAST, anesthetic toxicity, anesthetic side effects, nervous system, cardiovascular system, symptoms, enkawlna