Kei te mataku anō hoki koe ina hoatu he rongoā whakamoe ā-rohe ki a koe? Me kōrero tātou mō te LAST (Local Anesthetic Systemic Toxicity)!

Kua tangohia e koe he rongoā whakamoe ā-rohe hei tango i te niho, hei tuitui i te patunga, hei pokanga iti rānei? Kātahi ka ngoikore noa iho koe, ā, kāore he mea e puta? He ahua rerekē pea, engari he mea tino nui tēnei rongoā whakamoe i roto i te rongoā. Heoi, he tino onge, arā, he tino onge, ka pā mai he raruraru iti ki tō tātou tinana i tēnei rongoā whakamoe. Koinei te mea e kiia nei e tātou ko te Local Anesthetic Systemic Toxicity , ko te LAST rānei. Kaua e manukanuka, he tino onge tēnei. Engari he mea pai kia mōhio koe ki tēnei.

Nā, he aha te LAST (Paitini Pūnaha Ārai Mate Pāwera ā-Rohe)?

Ki te kī māmā noa, ko te WHAKAMUTUNGA te pānga o te rongoā ki ngā pūnaha o te tinana ina horomia, inā koa te Pūnaha Io Matua (CNS), arā, te roro me te taurakira, me te Pūnaha Ngākau me ngā Cardiovascular, arā, te ngākau me ngā uaua toto.

Whakaarohia te mahi a ngā rongoā whakamamae mamae. Ka āraia e rātou ngā io (ngā io ā-taha) i tētahi wāhanga o tō tātou tinana mō te wā poto. Kātahi ka mutu te tuku atu a aua io i ngā kare ā-roto pērā i te mamae me te pā ki te roro. Koia te take e rite ana tātou ki te ngau kino i taua wāhi. Ka puta mai ēnei rongoā whakamamae mamae i roto i te āhua o ngā werohanga, ngā hinu, me ngā rehu.

Nō reira, ka puta te LAST i roto i ngā meneti i muri i te tango i te rongoā mamae. Engari ko te mea pai rawa atu, he rongoā kei reira mō tēnei. Ki te kite tō tākuta i ēnei tohu, ka tere tana mahi.

He aha ngā tohu o te LAST? Me pēhea tātou e mōhio ai?

Ko te LAST te nuinga e pā ana ki te pūnaha io matua (CNS). Ko ngā tohu tuatahi pea ko:

Ngā tohu e pā ana ki te pūnaha io matua (CNS):

• Ngā mate hopuhopu: Koinei te tohu tino kitea. Ka puta ngā wiri ohorere me te ngaro o te māramatanga.
• Te ohorere, te pōhēhē rānei: Te kore e taea te noho marino, te kore e taea te arotahi, me te kore e mārama ki ngā mea e tupu ana.
• Ngā panonitanga o te taringa: He tangi tonu i roto i ngā taringa (Tinnitus) .
• Te ngenge huri noa i tō waha: Te ngenge huri noa i tō waha, pērā i te werohanga rongoā a te tākuta niho.
• Te reka konganuku i roto i te mangai: He rite te reka ki te wahi rino i roto i te mangai.
• Te kōrero pōturi (Dysarthria): Ka pōturi ngā kupu, ā, ka uaua ki te kōrero mārama.
• Te moemoeā: Te kitenga, te rongo rānei i ngā mea kāore i te tino kitea.
• Ngā rerekētanga o te nekehanga o ngā kanohi: Ka neke haere ngā kanohi me te kore e taea te whakahaere, te āhua nei ka neke mai i tetahi taha ki tetahi taha.

Ngā tohu e pā ana ki te pūnaha manawa:

Ka pā anō hoki te āhuatanga WHAKAMUTUNGA ki tō tātou ngākau. Kātahi ka puta pea ngā tohu pēnei i ēnei:

• Te toto toto iti:Kei te heke te pēhanga.
• Ngā huringa o te tere o te ngakau: Tērā pea ka puhoi rawa te tere o te ngakau (Bradycardia) , ka tere rawa rānei (Tachycardia) , ka rerekē rānei ngā manawataki o te ngakau (Arrhythmias) .
• Te poto o te manawa (Dyspnea): Te uaua ki te manawa, te wheezing.
• Te aukati o te manawa: Te mutu ohorere o te mahi hiko o te manawa. Ka puta pea tēnei i te ngaronga katoa o te mahi hiko i roto i te manawa (asystole) , i te tere me te koretake rānei o te patu a ngā pūtau o te manawa (ventricular fibrillation) .

He mea nui: Ki te kore e tere te rongoā, ka taea e te LAST te arahi ki te aukati manawa , te koma rānei.

I te nuinga o te wā ka puta mai ēnei tohu i roto i ngā meneti e rima i muri i te tango i te rongoā mamae. I ētahi wā ka tīmata ēnei tohu ki te tino ngawari, ka piki haere, ka tere rānei te kino. Koia te take ka tirotirohia koe e ngā tākuta i muri i te hoatutanga o te rongoā mamae ki a koe, inā koa he nui te tūponotanga ki te whakawhanake i te LAST.

He aha i MUTUNGA ai tēnei? He aha ngā take?

Ko te tino take o LAST ko te werohanga tūpono o te rongoā mamae ki roto i te uaua toto. Whakaarohia, ko te tikanga me werohanga te rongoā mamae tata ki te io. Engari i ētahi wā, ki te uru ki roto i te uaua toto, ka tere te horapa o te rongoā puta noa i te tinana, ā, ka puta tēnei mate.

E ai ki ngā pūrongo, ko te mōrearea o te LAST i te wā e mahi ana i ngā aukati io e whakangāwari ana i ngā peka he tata ki te 20%. Heoi, ehara i te mea koia anake:

• Kua whakawhanakehia hoki a LAST hei rongoā kiri e pania ana ki te kiri hei tiēre .
• Kua puta hoki te LAST i ngā rongoā e whakapataritari ana i ngā kiriuhi mucous o te waha, te korokoro, me ngā ara manawa .

Ko te tikanga o tēnei, ka puta pea te LAST ahakoa te whakamahinga o te rongoā mamae. Heoi anō, kei te piki ake tēnei mōrearea e ētahi āhuatanga.

Ko wai kei te mōrearea nui ake ki te whakawhanake i te LAST? (Ngā Take Mōrearea)

Tērā pea ētahi mea e pā ana ki tō hauora ka piki ake tō tupono ki te whakawhanake i te LAST.

Ngā āhuatanga mōrearea e pā ana ki tō hauora:

• Te waikawa pūmua: Ina huri te taurite matū i roto i te tinana, ā, ka piki ake te waikawa.
• Te iti o te hāora i roto i te tinana (Hypoxia): Ina heke te nui o te hāora i roto i te toto.
• Ngā mate ngakau kua pā mai i mua: Ina koa ko te hunga whai mate pēnei i te ischemia , te arrhythmias , te rerekētanga o te kawe manawa , me te iti o te ejection fraction .
• Ngā tāngata neke atu i te 65 tau te pakeke:Waihoki, he nui ake te mōrearea o ngā pēpi kei raro iho i te 4 marama te pakeke ki te pāngia e te LAST.
• Mate ate, mate tākihi rānei: Ko te hunga whai ēnei āhuatanga ka pāngia pea i te wā roa rawa atu nā te mea ka roa ake te wehenga atu o te rongoā i te tinana.
• Te haputanga.
• Ngā mate mitochondrial: Ko ēnei ngā mate e pā ana ki ngā wāhanga whakaputa pūngao o ō tātou pūtau e kiia nei ko te mitochondria.

Ngā āhuatanga mōrearea e pā ana ki te rongoā Hiri:

Ko ētahi rongoā whakangāwari, pērā i te bupivacaine , he nui ake te tūponotanga ka puta te LAST i ētahi atu. Waihoki, ka piki ake te mōrearea ina hoatu ngā rongoā whakangāwari ki ngā horopeta teitei ake .

Ngā āhuatanga mōrearea e pā ana ki te tikanga rongoā ā-waha:

Tērā pea ka piki ake te mōrearea o te LAST i ētahi tikanga hoatu rongoā whakamamae. I kitea i roto i tētahi rangahau o ngā kēhi 125 o LAST:

• Ko ngā tikanga whakauru he tikanga e werohia ai te rongoā ki raro i te kiri. Koinei te 20% o ngā take whakamutunga.
• Ko ngā aukati neuraxial pokapū, pērā i ngā aukati epidural me ngā aukati caudal, ka tukuna ki te tuaiwi. E 15% pea o ngā kēhi katoa i pūrongohia.
• Tata ki te 13% kua pūrongohia nā te werohanga tonu o te rongoā mamae, pērā i te tote .

Hei whakamutunga, he nui ake te tūponotanga ka puta a LAST ina werohia ngā rongoā whakangote ki ngā wāhi he nui ngā toto toto . Hei tauira, he nui ake te pūrongo mō ngā kēhi LAST ina mahia ngā aukati io o te ure .

Me pēhea te tātaritanga a ngā tākuta i te LAST? (Tauātanga)

Ka tātaritatia te mate LAST e ngā tākuta i runga i ō tohumate . Nā te mea he āhuatanga ohorere te mate LAST e hiahia ana kia rongoatia tonutia, kāore e taea te whakaroa i te tātarita. He tino onge, ka tono pea tō tākuta i tētahi EKG (electrocardiogram) hei āwhina i te whakaū i tēnei.

He aha ngā maimoatanga mō te LAST?

He āhuatanga ohorere hauora te paitini pūnaha whakangote ā-rohe. Nō reira, ka tere tonu te tīmatanga o te maimoatanga a ngā tākuta. Ko ngā maimoatanga noa koia ēnei:

• Te whakahaere i te ara manawa: Ka hoatu tonutia te rongoā hāora hei pupuri i tō manawa, ā, ka hoatu he manawa whakapūhau mēnā e tika ana.
• Te ārai, te rongoā rānei i te hopukanga: Kei roto i tēnei ko te hoatu rongoā pēnei i te benzodiazepines .
• Te werohanga ā-iwi o te whakamomona ngako: He rongoā motuhake tēnei e tukuna ana ki roto i te uaua . Mā te mimiti i ngā rongoā whakamamae mamae mai i te toto me ngā kiko ka mahi. Ka whakaitihia te kukū o ngā rongoā whakamamae mamae e tae atu ana ki te roro me te ngākau.
• CPR (Whakaora Manawa me te Pūkahukahu):Mena ka pāngia te mahi a te ngākau e te LAST, ka whakahaerehia e ngā tākuta te CPR , ā, ka whakamahia ētahi atu tikanga hei whakau i te ngākau.

I muri i te maimoatanga, ka tirotirohia koe e te rata mō te ono hāora te iti rawa hei tirotiro mēnā kei te angitu te maimoatanga, me te mea hoki he raruraru kē atu.

He aha te mea ka pā ki te tangata kua mau te LAST? (Matapae)

Ko te hunga kua tātaitia, kua rongoatia wawetia hoki, he pai ake te hua. Ka taea e te maimoatanga te whakakore i te āhua o LAST.

Heoi, ki te kore e rongoatia wawetia te LAST kino, ka taea e ia te arahi ki te koma, ki te mate rānei. Heoi, he tino onge tēnei. Hei tauira, e ai ki ngā raraunga mai i ngā pokapū whakahaere paitini i te Hononga o Amerika, e whā noa iho ngā mate i puta mai i ngā rongoā whakamamae i te tau 2016.

Ka taea te ārai i te LAST?

Kāore e taea te ārai i ngā wā katoa i te MUTUNGA, engari ka whakamahia e ngā tākuta ētahi tikanga me ngā aratohu hei whakaiti i tēnei mōrearea.

Hei tauira, ka whakamahia e tō tākuta te horopeta iti rawa o te rongoā mamae e hiahiatia ana . I ētahi wā, ka whakamahia e rātou te whakaahua ultrasound hei hoatu i te werohanga, kia kore ai e uru noa ki roto i te uaua toto.

Mena kei a koe ngā āhuatanga mōrearea mō te whakawhanake i te LAST, ka āta whakaarohia e tō tākuta te rongoā mamae haumaru rawa atu, te inenga, me te huarahi hoatutanga māu.

Ina haere koe ki te tiki rongoā mamae, kāore pea koe e tino whakaaro ki a LAST. Tērā pea ka nui ake tō āwangawanga mō te mamae o te werohanga, mō te kore rānei e tino māuiui. He mea noa tēnā, nā te mea he tino onge te LAST. Engari kia mahara, ka tiakina koe e tō tākuta i muri i te hoatutanga o te rongoā mamae ki a koe. Mēnā ka puta ngā tohu o LAST ki a koe, ka tere tonu tā rātou mahi.

Hei whakamutunga, he karere hei kawe ki te kāinga:

Mena he pātai, he āwangawanga, he ruarua rānei āu mō tō rongoā whakamoe, kaua e mangere ki te pātai ki tō tākuta. Kei reira rātou hei āwhina i a koe. Kāore he mea e wehi ai te Paheketanga Pūnaha Ārai ā-Rohe (LAST) , he tino onge hoki, ā, he pai ngā maimoatanga. Ko te mea nui ko te mōhio ki tēnei me te kōrero tuwhera ki tō tākuta. Kātahi ka taea e koe te aro atu ki tētahi maimoatanga hauora me te rangimarie o te hinengaro.

` Paitini Pūnaha Whakamamae ā-Rohe, LAST, paitini whakamamae, ngā pānga taha whakamamae, pūnaha io, pūnaha manawa, tohu, maimoatanga