Kodi mumamvanso mantha pang'ono mukapatsidwa mankhwala oletsa ululu am'deralo? Tiyeni tikambirane za LAST (Local Anesthetic Systemic Toxicity)!

Kodi munayamba mwatengapo mankhwala oletsa ululu am'deralo kuti muchotse dzino, kusoka bala, kapena kuchitidwa opaleshoni yaying'ono? Kenako mumangomva dzanzi ndipo palibe chomwe chimachitika? Zingamveke zachilendo, koma mankhwala oletsa ululu awa ndi chinthu chofunikira kwambiri mu zamankhwala. Komabe, kawirikawiri, ndiko kuti, kawirikawiri, mankhwala oletsa ululu awa angayambitse vuto laling'ono m'thupi lathu. Ndicho chimene timachitcha kuti Local Anesthetic Systemic Toxicity , kapena LAST . Musadandaule, izi sizichitika kawirikawiri. Koma ndi bwino kudziwa pang'ono za izi.

Ndiye kodi LAST (Local Anesthetic Systemic Toxicity) ndi chiyani?

Mwachidule, CHOTSIMIKIZIRA ndi momwe mankhwala akamwedwa, amakhudzira thupi lathu, makamaka Central Nervous System (CNS), yomwe ndi ubongo ndi msana, komanso Cardiovascular System, yomwe ndi mtima ndi mitsempha yamagazi.

Ganizirani momwe mankhwala opha ululu amagwirira ntchito. Amatseka mitsempha kwakanthawi (mitsempha ya m'mphepete) m'thupi lathu. Kenako mitsempha imeneyo imasiya kutumiza kumva ngati kupweteka ndi kukhudza ubongo. Ndicho chifukwa chake timamva ngati tikugwedezeka m'dera limenelo. Mankhwala opha ululu awa amabwera ngati jakisoni, ma gels, ndi ma spray.

Kotero, LAST imachitika patangopita mphindi zochepa kuchokera pamene mwamwa mankhwala ochepetsa ululu. Koma chabwino kwambiri ndichakuti, pali chithandizo cha izi. Ngati dokotala wanu awona zizindikirozi, adzachitapo kanthu mwachangu.

Kodi zizindikiro za matenda a LAST ndi ziti? Kodi timazizindikira bwanji?

LAST imakhudza kwambiri dongosolo lathu la mitsempha (CNS). Zizindikiro zoyamba zingakhale:

Zizindikiro zokhudzana ndi dongosolo la mitsempha yapakati (CNS):

• Kukomoka: Ichi ndi chizindikiro chofala kwambiri. Pali kukomoka mwadzidzidzi komanso kutaya chidziwitso.
• Kusokonezeka kapena kusokonezeka: Kumva ngati sungathe kukhala chete, sungathe kukhazikika, komanso sungathe kumvetsa zomwe zikuchitika.
• Kusintha kwa khutu: Kulira kosalekeza m'makutu (Tinnitus) .
• Kusanza pakamwa panu: Kusanza pakamwa panu, monga momwe dokotala wa mano amachitira akamabaya mankhwala.
• Kukoma kwachitsulo mkamwa mwanu: Kumakoma ngati kukhala ndi chidutswa cha chitsulo mkamwa mwanu.
• Kulankhula molakwika (Dysarthria): Mawu amakhala osokonezeka ndipo zimakhala zovuta kulankhula momveka bwino.
• Kuona zinthu m'maganizo: Kuona kapena kumva zinthu zomwe sizilipo kwenikweni.
• Kusayenda bwino kwa maso: Maso amayenda mosalamulirika, akuoneka ngati akuyenda kuchokera mbali imodzi kupita ku ina.

Zizindikiro zokhudzana ndi matenda a mtima:

Matenda OTSIRIZA amathanso kukhudza mtima wathu. Kenako zizindikiro ngati izi zingachitike:

• Kuthamanga kwa magazi kotsika:Kupanikizika kukuchepa.
• Kusintha kwa kugunda kwa mtima: Kugunda kwa mtima kungakhale kochedwa kwambiri (Bradycardia) , mofulumira kwambiri (Tachycardia) , kapena kugunda kwa mtima kosasinthasintha (Arrhythmias) .
• Kupuma movutikira (Dyspnea): Kuvutika kupuma, kupuma movutikira.
• Kuima kwa mtima: Kusiya kugwira ntchito kwa magetsi kwa mtima mwadzidzidzi. Izi zitha kuchitika chifukwa cha kutayika kwathunthu kwa ntchito yamagetsi mumtima (asystole) , kapena chifukwa cha kugunda kwa maselo a mtima mofulumira kwambiri komanso mosakhazikika (ventricular fibrillation) .

Chofunika: Ngati sichilandira chithandizo mwachangu, LAST ingayambitse kulephera kupuma kapena kukomoka .

Zizindikiro zimenezi nthawi zambiri zimawonekera mkati mwa mphindi zisanu mutamwa mankhwala ochepetsa ululu. Nthawi zina zizindikirozi zimatha kuyamba pang'onopang'ono kwambiri ndikuwonjezeka pang'onopang'ono, kapena zimatha kukhala zazikulu mwadzidzidzi. Ichi ndichifukwa chake madokotala amakuyang'anirani mosamala akakupatsani mankhwala ochepetsa ululu, makamaka ngati muli pachiwopsezo chachikulu chotenga matenda otsiriza.

N’chifukwa chiyani izi zimachitika? Kodi zifukwa zake ndi ziti?

Chifukwa chachikulu cha LAST ndi kubayidwa mwangozi kwa mankhwala opha ululu m'mitsempha yamagazi. Taganizirani izi, mankhwala opha ululu amayenera kubayidwa pafupi ndi mitsempha. Koma nthawi zina akalowa m'mitsempha yamagazi, mankhwalawa amatha kufalikira mwachangu mthupi lonse ndikuyambitsa vutoli.

Zanenedwa kuti chiopsezo cha LAST kuchitika pochita zotchinga za mitsempha zomwe zimachititsa dzanzi miyendo ndi pafupifupi 20%. Komabe, si zokhazi:

• LAST yapangidwanso ngati mankhwala apakhungu omwe amapakidwa pakhungu ngati gel .
• LAST yayambanso chifukwa cha mankhwala omwe amakwiyitsa nembanemba ya mkamwa, pakhosi, ndi m'njira zopumira .

Izi zikutanthauza kuti LAST ikhoza kuchitika mosasamala kanthu za momwe mugwiritsira ntchito mankhwala ochepetsa ululu. Komabe, pali zinthu zina zomwe zimawonjezera chiopsezochi.

Ndani ali pachiwopsezo chachikulu chotenga matenda otsiriza? (Zinthu Zoopsa)

Zinthu zina zokhudzana ndi thanzi lanu zingakulitse chiopsezo chanu chotenga matenda a CHUMA.

Zinthu zoopsa zokhudzana ndi thanzi lanu:

• Kagayidwe kachakudya ka thupi: Pamene mphamvu ya mankhwala m'thupi ikusintha ndipo asidi imawonjezeka.
• Mpweya wochepa m'thupi (Hypoxia): Pamene mpweya m'magazi ukuchepa.
• Matenda a mtima omwe analipo kale: Makamaka omwe ali ndi matenda monga ischemia , arrhythmias , matenda olakwika a conduction , ndi low ejection fraction .
• Anthu azaka zopitilira 65:Komanso, makanda osakwana miyezi inayi ali pachiwopsezo chachikulu chotenga matenda a MTIMA.
• Matenda a chiwindi kapena impso: Anthu omwe ali ndi matendawa amatha kudwala mochedwa chifukwa zimatenga nthawi yayitali kuti mankhwalawo achoke m'thupi.
• Mimba.
• Matenda a Mitochondria: Awa ndi matenda omwe amakhudza ziwalo zomwe zimapanga mphamvu m'maselo athu otchedwa mitochondria.

Zinthu zoopsa zokhudzana ndi mankhwala a Hiri:

Mankhwala ena oletsa ululu, monga bupivacaine , ndi omwe amachititsa kuti munthu ayambe kupweteka kwambiri kuposa ena. Komanso, chiopsezo chimawonjezeka pamene mankhwala oletsa ululu aperekedwa mopitirira muyeso .

Zinthu zoopsa zokhudzana ndi njira yogwiritsira ntchito mankhwala omwa:

Njira zina zoperekera mankhwala ochepetsa ululu zingawonjezere chiopsezo cha LAST. Kafukufuku wa milandu 125 ya LAST adapeza:

• Njira zolowetsera mankhwala ndi njira zomwe mankhwala amabayidwira pansi pa khungu. Izi zimayimira pafupifupi 20% ya milandu YOTSIRIZA.
• Ma block apakati a neuraxial, monga ma block a epidural ndi caudal, amaperekedwa kumsana. Amawerengera pafupifupi 15% ya milandu yonse yomwe yanenedwa.
• Pafupifupi 13% yanenedwapo chifukwa cha kumwa mankhwala ochepetsa ululu mosalekeza, monga saline .

Pomaliza, LAST imachitika kawirikawiri ngati mankhwala oletsa ululu aperekedwa m'malo omwe ali ndi mitsempha yambiri yamagazi . Mwachitsanzo, milandu ya LAST imachitika kawirikawiri pamene mitsempha ya mbolo imatsekedwa.

Kodi madokotala amazindikira bwanji matenda a LAST? (Kuzindikira)

Madokotala amazindikira matenda a LAST makamaka potengera zizindikiro zanu. Popeza LAST ndi vuto ladzidzidzi lomwe limafuna chithandizo chadzidzidzi, matenda sangachedwe. Nthawi zambiri, dokotala wanu angakupatseni EKG (electrocardiogram) kuti atsimikizire izi.

Kodi mankhwala a LAST ndi ati?

Kupweteka kwa m'deralo ndi vuto la thanzi. Chifukwa chake, madokotala amayamba kulandira chithandizo mwachangu kwambiri. Mankhwala wamba ndi awa:

• Kusamalira mpweya: Chithandizo cha okosijeni chimaperekedwa nthawi yomweyo kuti mpweya wanu upitirire, ndipo mpweya umaperekedwa ngati pakufunika.
• Kupewa kapena kuchiza matenda a khunyu: Izi zimaphatikizapo kupereka mankhwala monga benzodiazepines .
• Kulowetsedwa kwa mafuta m'thupi m'mitsempha ya m'magazi: Iyi ndi mankhwala apadera omwe amaperekedwa mumtsempha . Amagwira ntchito poyamwa mankhwala ochepetsa ululu m'magazi ndi minofu. Izi zimachepetsa kuchuluka kwa mankhwala ochepetsa ululu omwe amafika muubongo ndi mumtima.
• CPR (Kubwezeretsa Mtima ndi Mapafu):Ngati LAST yakhudza ntchito ya mtima, madokotala amachita CPR ndipo amagwiritsa ntchito njira zina kuti mtima ukhazikike.

Mukamaliza kulandira chithandizo, mudzayang'aniridwa ndi dokotala kwa maola osachepera asanu ndi limodzi kuti muwone ngati chithandizocho chayenda bwino komanso ngati pali zovuta zina.

Kodi chidzachitike ndi chiyani kwa munthu amene ali ndi matenda otsiriza? (Zomwe zidzachitike ndi chiyani)

Anthu omwe apezeka ndi matendawa msanga nthawi zambiri amakhala ndi zotsatira zabwino. Chithandizo chingathandize kwambiri kusintha matenda a LAST.

Komabe, ngati LAST yoopsa sichitha kuchiritsidwa mwachangu, ingayambitse chikomokere kapena imfa. Komabe, izi sizichitika kawirikawiri. Mwachitsanzo, malinga ndi deta yochokera ku malo owongolera poizoni ku United States, panali anthu anayi okha omwe anamwalira chifukwa cha mankhwala ochepetsa ululu mu 2016.

Kodi LAST ingapewedwe?

LAST sichitha kupewedwa nthawi zonse, koma madokotala amagwiritsa ntchito njira ndi malangizo ena kuti achepetse chiopsezochi.

Mwachitsanzo, dokotala wanu adzagwiritsa ntchito mankhwala ochepetsa ululu omwe ndi otsika kwambiri . Komanso, nthawi zina amagwiritsa ntchito chithunzi cha ultrasound popereka jakisoni, kuti atsimikizire kuti salowa m'mitsempha yamagazi mwangozi.

Ngati muli ndi zinthu zomwe zingakupangitseni kukhala ndi LAST, dokotala wanu adzaganizira mosamala mankhwala ochepetsa ululu, mlingo, ndi njira yoperekera mankhwala.

Mukapita kukatenga mankhwala ochepetsa ululu, mwina simumaganizira kwambiri za LAST. Mwina mumakhala ndi nkhawa kwambiri ngati jakisoniyo adzakupwetekani kapena ngati mudzamva dzanzi kwambiri. Zimenezo n’zachibadwa, chifukwa LAST ndi yosowa kwambiri. Koma kumbukirani kuti dokotala wanu adzakusamalirani bwino akakupatsani mankhwala ochepetsa ululu. Ngati mutakhala ndi zizindikiro za LAST, adzachitapo kanthu mwachangu.

Pomaliza, uthenga woti mutenge kunyumba:

Ngati muli ndi mafunso, nkhawa, kapena kukayikira za mankhwala oletsa ululu, musazengereze kufunsa dokotala wanu. Alipo kuti akuthandizeni. Mankhwala Oletsa Ululu Wam'deralo (Local Anesthetic Systemic Toxicity) si chinthu choopa, chifukwa ndi osowa kwambiri ndipo ali ndi mankhwala abwino. Chofunika kwambiri ndikudziwa izi ndikukambirana momasuka ndi dokotala wanu. Kenako mutha kulandira chithandizo chilichonse chamankhwala ndi mtendere wamumtima.

Mankhwala Oletsa Kupweteka Kwam'deralo, Kuopsa Kwa Thupi, Kuopsa Kwa Mankhwala Oletsa Kupweteka, Zotsatirapo Za Mankhwala Oletsa Kupweteka, Mitsempha, Matenda a Mtima, Zizindikiro, Chithandizo