ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯑꯅꯥꯕꯒꯤꯗꯃꯛ ꯄꯤꯕꯥ ꯑꯈꯟꯅꯕꯥ ꯍꯤꯗꯥꯛ ꯑꯃꯥ: ꯕꯨꯄꯤꯚꯥꯀꯦꯟ ꯏꯃꯞꯂꯥꯟꯇꯀꯤ ꯃꯇꯥꯡꯗꯥ ꯈꯉꯁꯤ?

ꯑꯗꯣꯝꯅꯥ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯇꯃꯗꯥ ꯁꯔꯖꯔꯤ ꯇꯧꯕꯥ ꯇꯥꯈꯤꯕꯔꯥ? ꯅꯠꯔꯒꯥ ꯇꯨꯡꯗꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯁꯦꯃꯒꯠꯅꯕꯥ ꯊꯧꯔꯥꯡ ꯇꯧꯔꯤꯕꯔꯥ? ꯑꯁꯤꯒꯨꯝꯕꯥ ꯃꯇꯝ ꯑꯁꯤꯗꯥ ꯑꯩꯈꯣꯌꯅꯥ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯆꯥꯎꯕꯥ ꯑꯀꯤꯕꯥ ꯑꯁꯤ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯊꯣꯀꯄꯥ ꯑꯋꯥꯕꯥ ꯑꯁꯤꯅꯤ꯫ ꯑꯗꯨꯕꯨ ꯍꯧꯖꯤꯛꯇꯤ ꯃꯦꯗꯤꯀꯦꯜ ꯁꯥꯏꯟꯁꯇꯥ ꯑꯍꯣꯡꯕꯥ ꯂꯥꯀꯄꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯑꯋꯥꯕꯥ ꯑꯁꯤꯕꯨ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯅꯕꯥ ꯄꯥꯝꯕꯩ ꯀꯌꯥ ꯑꯃꯥ ꯂꯩꯔꯦ꯫ ꯋꯥꯐꯝ ꯑꯁꯤ ꯉꯁꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯅꯨꯃꯤꯠ ꯈꯔꯅꯤꯒꯤ ꯑꯣꯏꯅꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯊꯣꯀꯄꯥ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯀꯟꯠꯔꯣꯜ ꯇꯧꯕꯥ ꯑꯈꯟꯅꯕꯥ ꯍꯤꯗꯥꯛ ꯑꯃꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯅꯔꯤ꯫

ꯃꯁꯤ ꯕꯨꯄꯤꯚꯥꯀꯦꯟ ꯏꯃꯞꯂꯥꯟꯇ ꯑꯁꯤ ꯀꯔꯤꯅꯣ?

ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯃꯁꯤ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯊꯣꯀꯄꯥ ꯑꯅꯥꯕꯥ ꯑꯗꯨ ꯊꯤꯡꯅꯕꯥ ꯄꯤꯕꯥ ꯅ꯭ꯌꯨꯝꯕꯤꯡ ꯍꯤꯗꯥꯛ ꯑꯃꯅꯤ꯫ ꯍꯥꯀꯆꯥꯡ ꯂꯧꯊꯣꯛꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯈꯣꯡꯎꯞ ꯑꯗꯨ ꯁꯣꯀꯍꯅꯕꯒꯨꯝꯅꯥ, ꯍꯤꯗꯥꯛ ꯑꯁꯤꯅꯥ ꯁꯔꯖꯤꯀꯦꯜ ꯁꯥꯏꯠ ꯑꯗꯨꯒꯤ ꯑꯀꯣꯌꯕꯗꯥ ꯂꯩꯕꯥ ꯈꯣꯡ ꯑꯃꯁꯨꯡ ꯇꯤꯁꯨꯁꯤꯡ ꯑꯗꯨ ꯁꯣꯀꯍꯜꯂꯤ꯫ ꯑꯗꯨꯕꯨ ꯃꯁꯤ ꯆꯥꯡ ꯅꯥꯏꯅꯥ ꯑꯦꯅꯥꯁ꯭ꯇꯦꯇꯤꯛ ꯏꯅꯖꯦꯀꯁꯅꯒꯨꯝꯅꯥ ꯅꯠꯇꯦ꯫

ꯗ꯭ꯔꯒ ꯑꯁꯤ (Liposomal Bupivacaine) ꯑꯁꯤ ꯑꯄꯤꯀꯄꯥ, ꯇꯔꯨ-ꯇꯅꯥꯅꯕꯥ ‘ꯏꯃꯞꯂꯥꯟꯇ’ ꯑꯃꯥ ꯑꯣꯏꯅꯥ ꯂꯥꯀꯏ꯫ ꯅꯍꯥꯛꯅꯥ ꯍꯔꯅꯤꯌꯥ ꯑꯣꯄꯔꯦꯁꯟ ꯑꯃꯥ ꯇꯧꯔꯤ ꯍꯥꯌꯅꯥ ꯈꯅꯕꯤꯌꯨ꯫ ꯁꯔꯖꯔꯤꯅꯥ ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯁꯔꯖꯔꯤ ꯂꯣꯏꯔꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯑꯃꯁꯨꯡ ꯑꯁꯣꯀꯄꯥ ꯑꯗꯨ ꯁꯦꯡꯗꯣꯛꯠꯔꯤꯉꯩ ꯃꯃꯥꯡꯗꯥ ꯑꯁꯣꯀꯄꯥ ꯑꯗꯨꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯊꯝꯃꯤ꯫ ꯃꯁꯤꯒꯤ ꯑꯈꯟꯅꯕꯥ ꯋꯥꯐꯃꯗꯤ ꯃꯁꯤꯅꯥ ꯅꯨꯃꯤꯠ ꯀꯌꯥꯒꯤ ꯃꯇꯃꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯇꯞꯅꯥ ꯇꯞꯅꯥ ꯄꯦꯟ ꯀꯤꯂꯔ ꯑꯁꯤ ꯍꯀꯆꯥꯡꯗꯥ ꯊꯥꯗꯣꯀꯏ꯫ ꯃꯁꯤꯅꯥ ꯇꯥꯀꯄꯗꯤ ꯅꯍꯥꯛꯅꯥ ꯅꯨꯃꯤꯠ 2-3ꯅꯤ ꯊꯪꯟ-ꯊꯪꯅꯅꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯑꯋꯥꯕꯥ ꯑꯗꯨꯗꯒꯤ ꯑꯆꯧꯕꯥ ꯔꯤꯂꯤꯐ ꯑꯃꯥ ꯐꯪꯏ꯫ ꯃꯁꯤꯒꯤꯗꯃꯛꯇꯥ ꯕ꯭ꯔꯥꯟꯗ ꯅꯦꯝ ꯈꯔꯗꯤ `Xaracoll`ꯅꯤ꯫

ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯄꯤꯗ꯭ꯔꯤꯉꯩꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯈꯪꯖꯤꯅꯒꯗꯕꯥ ꯋꯥꯐꯃꯁꯤꯡ꯫

ꯃꯁꯤ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯜ ꯑꯃꯗꯥ ꯄꯤꯕꯥ ꯍꯤꯗꯥꯛ ꯑꯣꯏꯔꯕꯁꯨ, ꯗꯣꯛꯇꯔꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯁꯦꯂꯒꯤ ꯐꯤꯚꯃꯒꯤ ꯃꯄꯨꯡꯐꯥꯕꯥ ꯃꯁꯛ ꯈꯪꯗꯣꯀꯄꯥ ꯍꯥꯌꯕꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ , ꯃꯔꯃꯗꯤ ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯃꯦꯗꯤꯀꯦꯜ ꯀꯟꯗꯤꯁꯟ ꯈꯔꯒꯥ ꯃꯥꯟꯅꯗꯕꯥ ꯌꯥꯏ꯫

ꯋꯥꯐꯃꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯁꯣꯌꯗꯅꯥ ꯈꯪꯍꯅꯕꯤꯌꯨ:

• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯃꯃꯥꯡꯗꯥ ꯕꯨꯄꯤꯚꯥꯀꯦꯟ ꯅꯠꯠꯔꯒꯥ ꯑꯇꯩ ꯑꯦꯅꯥꯁ꯭ꯇꯦꯇꯤꯛ ꯍꯤꯗꯥꯛ ꯑꯃꯍꯦꯛꯇꯒꯤ ꯑꯦꯂꯥꯔꯖꯤꯒꯤ ꯔꯤꯑꯦꯛꯁꯟ ꯂꯩꯔꯕꯗꯤ꯫
• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯍꯥꯔꯇꯀꯤ ꯂꯥꯌꯅꯥ, ꯂꯤꯚꯔ ꯗꯤꯖꯤꯖ ꯅꯠꯠꯔꯒꯥ ꯀꯤꯗꯅꯤꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯔꯕꯗꯤ꯫
• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ G6PD ꯋꯥꯠꯄꯒꯨꯝꯕꯥ ꯕ꯭ꯂꯗ ꯗꯤꯁꯑꯣꯔꯗꯔ ꯑꯃꯥ ꯂꯩꯔꯕꯗꯤ꯫
• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯑꯦꯖꯃꯥꯒꯨꯝꯕꯥ ꯁ꯭ꯕꯔ ꯍꯣꯅꯕꯒꯤ ꯂꯥꯌꯅꯥ ꯂꯩꯔꯕꯗꯤ꯫
• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯕ꯭ꯂꯗ ꯄ꯭ꯔꯦꯁꯔ ꯅꯦꯝꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ꯫
• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯃꯤꯔꯣꯜꯂꯤꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ, ꯃꯤꯔꯣꯅꯕꯥ ꯍꯣꯠꯅꯔꯕꯗꯤ ꯅꯠꯠꯔꯒꯥ ꯈꯣꯝꯂꯥꯡ ꯄꯤꯊꯛꯂꯤꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ꯫

ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯀꯔꯝꯅꯥ ꯁꯤꯖꯤꯟꯅꯒꯅꯤ?

ꯃꯁꯤ ꯌꯨꯃꯗꯥ ꯄꯨꯔꯀꯄꯥ ꯌꯥꯕꯥ ꯍꯤꯗꯥꯛ ꯅꯠꯇꯦ꯫ ꯃꯁꯤ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯜ ꯅꯠꯠꯔꯒꯥ ꯀ꯭ꯂꯤꯅꯤꯛ ꯑꯃꯗꯥ ꯁꯔꯖꯔꯤ ꯇꯧꯕꯥ ꯃꯇꯃꯗꯥ ꯗꯣꯛꯇꯔ ꯑꯃꯅꯥ ꯁꯔꯖꯤꯀꯦꯜ ꯁꯥꯏꯠꯇꯥ ꯊꯝꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯅꯤ . ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯅꯍꯥꯛꯅꯥ ꯗꯣꯖ ꯑꯃꯥ ꯃꯥꯡꯈꯤꯕꯥ ꯅꯠꯠꯔꯒꯥ ꯌꯥꯝꯅꯥ ꯂꯧꯕꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯈꯜ ꯋꯥꯕꯥ ꯃꯊꯧ ꯇꯥꯗꯦ꯫

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯈꯪꯍꯧꯗꯅꯥ ꯍꯤꯗꯥꯛ ꯑꯁꯤꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯑꯆꯝꯕꯥ ꯂꯥꯏꯑꯣꯡ ꯑꯃꯠꯇꯥ ꯎꯕꯥ ꯐꯪꯂꯕꯗꯤ, ꯈꯨꯗꯛꯇꯥ ꯗꯣꯛꯇꯔ ꯅꯠꯠꯔꯒꯥ ꯅꯔꯁ ꯑꯃꯗꯥ ꯈꯪꯍꯅꯒꯗꯕꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯍꯤꯗꯥꯛ ꯑꯃꯍꯦꯛꯇꯒꯤ ꯑꯣꯚꯔꯗꯣꯖꯒꯤ ꯆꯤꯡꯅꯕꯥ ꯂꯩꯔꯕꯗꯤ, ꯑꯩꯈꯣꯌꯒꯤ ꯂꯩꯕꯥꯛ ꯑꯁꯤꯗꯥ, ꯅꯍꯥꯛꯅꯥ ꯀꯣꯂꯝꯕꯣ ꯅꯦꯁꯅꯦꯜ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯂꯗꯥ ꯂꯩꯕꯥ ꯅꯦꯁꯅꯦꯜ ꯄꯣꯏꯖꯅꯁ ꯏꯅꯐꯣꯔꯃꯦꯁꯟ ꯁꯦꯟꯇꯔꯗꯥ ꯍꯀꯊꯦꯡꯅꯅꯥ ꯐꯣꯟ ꯇꯧꯒꯗꯕꯅꯤ꯫ ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ, ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯜ ꯑꯃꯗꯥ ꯂꯩꯔꯕꯗꯤ, ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯐꯕꯥ ꯊꯕꯛ ꯑꯗꯨꯗꯤ ꯈꯨꯗꯛꯇꯥ ꯏꯃꯔꯖꯦꯟꯁꯤ ꯇ꯭ꯔꯤꯇꯃꯦꯟꯇ ꯌꯨꯅꯤꯠ (ETU)ꯗꯥ ꯆꯠꯄꯅꯤ꯫

ꯑꯇꯣꯞꯄꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡꯗꯥ ꯈꯨꯗꯣꯡꯆꯥꯗꯕꯥ ꯊꯣꯀꯄꯥ ꯌꯥꯕ꯭ꯔꯥ? (ꯗ꯭ꯔꯒ ꯏꯟꯇꯔꯦꯛꯁꯅꯁꯤꯡ)

ꯍꯣꯌ, ꯍꯤꯗꯥꯛ ꯈꯔꯗꯤ ꯕꯨꯄꯤꯚꯥꯀꯦꯅꯒꯥ ꯏꯟꯇꯔꯦꯛꯇ ꯇꯧꯕꯥ ꯌꯥꯏ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ, ꯅꯍꯥꯛꯀꯤ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯃꯥꯡꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯂꯧꯔꯤꯕꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯛ ꯄꯨꯝꯅꯃꯛ, ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯄꯤꯕꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯑꯗꯨ ꯈꯛꯇꯥ ꯅꯠꯇꯅꯥ, ꯑꯣꯚꯔ-ꯗꯤ-ꯀꯎꯟꯇꯔ ꯍꯤꯗꯥꯀꯁꯤꯡ, ꯚꯤꯇꯥꯃꯤꯅꯁꯤꯡ ꯑꯃꯁꯨꯡ ꯍꯔꯕꯦꯜ ꯄ꯭ꯔꯗꯛꯇꯁꯤꯡꯁꯨ ꯈꯪꯍꯅꯒꯗꯕꯅꯤ꯫

ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯛ ꯂꯧꯕꯥ ꯃꯇꯃꯗꯥ ꯆꯦꯀꯁꯤꯅꯒꯗꯕꯥ ꯋꯥꯐꯃꯁꯤꯡ꯫

ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯆꯠꯅꯕꯥ ꯍꯧꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯍꯥꯌꯕꯗꯤ ꯁꯔꯖꯔꯤ ꯇꯧꯈꯤꯕꯥ ꯃꯐꯝ ꯑꯗꯨ ꯂꯦꯡꯗꯅꯥ ꯂꯩꯔꯤꯉꯩꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯌꯥꯝꯅꯥ ꯆꯦꯀꯁꯤꯅꯒꯗꯕꯅꯤ꯫ ꯅꯍꯥꯛꯀꯤ ꯈꯣꯡꯗꯥ ꯁꯔꯖꯔꯤ ꯇꯧꯈ꯭ꯔꯦ ꯑꯃꯁꯨꯡ ꯍꯤꯗꯥꯛ ꯑꯁꯤ ꯅꯍꯥꯀꯄꯨ ꯄꯤꯈ꯭ꯔꯦ ꯍꯥꯌꯅꯥ ꯈꯅꯕꯤꯌꯨ꯫ ꯃꯐꯝ ꯑꯗꯨ ꯅꯣꯡꯃꯩ ꯀꯥꯞꯄꯅꯥ ꯃꯔꯝ ꯑꯣꯏꯗꯨꯅꯥ ꯃꯐꯝ ꯑꯗꯨꯗꯥ ꯁꯣꯀꯄꯥ, ꯆꯦꯅꯁꯤꯜꯂꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯁꯣꯀꯄꯥ ꯌꯥꯕꯥ ꯄꯣꯠꯁꯛ ꯑꯃꯠꯇꯥ ꯐꯥꯑꯣꯗꯦ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯃꯐꯝ ꯑꯗꯨꯗꯥ ꯑꯁꯣꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯑꯁꯣꯛ-ꯑꯄꯟ ꯑꯃꯠꯇꯥ ꯊꯣꯀꯍꯟꯗꯅꯕꯥ ꯃꯐꯝ ꯑꯗꯨ ꯌꯦꯡꯁꯤꯅꯕꯥ ꯑꯁꯤ ꯅꯍꯥꯛꯀꯤ ꯊꯧꯗꯥꯡꯅꯤ꯫

ꯃꯁꯤꯒꯤ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇꯁꯤꯡ ꯑꯗꯨ ꯀꯔꯤꯅꯣ?

ꯍꯤꯗꯥꯛ ꯑꯃꯍꯦꯛꯇꯒꯨꯝꯅꯥ, ꯃꯁꯤꯒꯤ ꯑꯃꯅꯥ ꯁꯥꯏꯗ ꯏꯐꯦꯛꯇ ꯈꯔꯥ ꯊꯣꯀꯍꯅꯕꯥ ꯌꯥꯏ꯫ ꯈꯔꯗꯤ ꯁꯤꯔꯤꯌꯁ ꯑꯣꯏ, ꯈꯔꯗꯤ ꯀꯃꯟ ꯑꯣꯏ꯫