ʻO ka mālama ʻeha hope loa i nā mākua

ʻO ka ʻeha ke hana ma hope o ke kaha ʻana he mea nui e hopohopo ai. Ma mua o kāu ʻoki ʻana, ua kūkākūkā paha ʻoe a me kāu kaukukukū i ka nui o ka ʻeha āu e manaʻo ai a pehea e mālama ʻia ai.

Hoʻoholo kekahi mau mea i ka ʻeha āu i loaʻa ai a pehea e hoʻokele ai:

• ʻO nā ʻano ʻoki loa a me nā ʻoki ʻana (ʻokiʻoki) kumu i nā ʻano ʻokoʻa a me nā nui o ka ʻeha ma hope.
• ʻO kahi ʻoki lōʻihi a ʻoi loa hoʻi, ʻoi aku ke kumu o ka ʻeha ʻana, hiki ke lawe i nā mea hou aʻe mai iā ʻoe. ʻO ka hoʻōla hou ʻana mai kēia mau hopena ʻē aʻe o ke kaha ʻana hiki ke paʻakikī ka hana ʻana me ka ʻeha.
• Manaʻo kēlā me kēia kanaka a hana i ka ʻeha ʻokoʻa.

He mea nui ka kaohi ʻana i kou ʻeha no kou ola hou ʻana. Pono ka mālama ʻeha maikaʻi i hiki iā ʻoe ke ala aʻe a hoʻomaka e neʻe. He mea nui kēia no ka mea:

• Hoʻoiho ia i kou makaʻi no ke kahe o ke koko i kou mau wāwae a i ʻole nā ​​akemāmā, a me nā akemāmā a me nā maʻi urinary.
• E loaʻa iā ʻoe kahi hale maʻi ʻoi aku ka pōkole i hoʻi ai ʻoe i ka hale ma kahi e wikiwiki ai ʻoe e hoʻi ai.
• ʻAʻole paha ʻoe e loaʻa i nā pilikia ʻeha mau.

Nui a hewahewa nā ʻano maʻi ʻeha. Kaukaʻi ʻia i kou ʻoki kino a me kou olakino holoʻokoʻa, loaʻa iā ʻoe kahi lāʻau hoʻokahi a i ʻole ka hui pū ʻana o nā lāʻau.

Hōʻike nā noiʻi i nā poʻe e hoʻohana i ka lāʻau ʻeha ma hope o ke kaha ʻana e kaohi i ka ʻeha e hoʻohana pinepine i nā lāʻau ʻeha ma mua o ka poʻe e hoʻāʻo e hōʻalo i ka lāʻau ʻeha.

ʻO kāu hana ma ke ʻano he mea hoʻomanawanui e haʻi aku i kāu poʻe lawelawe olakino ke loaʻa iā ʻoe ka ʻeha a inā nā lāʻau āu e loaʻa nei kaohi i kou ʻeha.

Ma hope pono o ke kaha ʻana, loaʻa paha iā ʻoe nā lāʻau ʻehaʻeha i loko o kou mau uaua ma o ka laina intravenous (IV). Holo kēia laina i loko o ka pauma. Hoʻonohonoho ʻia ka pauma e hāʻawi iā ʻoe i kekahi nui o ka lāʻau ʻeha.

I ka manawa pinepine, hiki iā ʻoe ke kaomi i ke pihi e hāʻawi iā ʻoe iho i ka ʻeha ke hōʻoluʻolu ke pono ʻoe. Kapa ʻia kēia he anesthesia kaohi hoʻomanawanui (PCA) no ka mea mālama ʻoe i ka nui o nā lāʻau keu i loaʻa iā ʻoe. Polokalamu ʻia no laila ʻaʻole hiki iā ʻoe ke hāʻawi iā ʻoe iho i ka nui.

Hāʻawi ʻia nā lāʻau ʻeha Epidural ma o ka paipu palupalu (catheter). Hoʻokomo ʻia ka paipu i kou kua i loko o ka wahi liʻiliʻi ma waho pono o ka iwi kuamoʻo. Hiki ke hāʻawi mau ʻia ka lāʻau ʻeha iā ʻoe a i ʻole nā ​​kaha liʻiliʻi ma o ka paipu.

Hele paha ʻoe i waho o kahi ʻoki me kēia catheter i kahi ma kahi. A i ʻole kauka (anesthesiologist) e hoʻokomo i ka catheter i kou kua i lalo ʻoiai ʻoe e moe ana ma kou ʻaoʻao i ka moe o ka haukapila ma hope o kāu ʻoki.

Kākaʻikahi nā pilikia o nā poloka epidural akā hiki ke hoʻopili ʻia:

• E kulu i ke kaomi koko. Hāʻawi ʻia nā wai i loko o kahi aa (IV) e kōkua i ka paʻa o kou kahe koko.
• Headache, dizziness, paʻakikī hanu, a me ka hopu ʻana.

ʻO ka lāʻau ʻeha Narcotic (opioid) i lawe ʻia e like me nā pila a i ʻole hāʻawi ʻia e like me ke kī ʻana i hiki ke hāʻawi i kahi hōʻoluʻolu ʻeha. Hiki ke loaʻa iā ʻoe kēia lāʻau i kēia manawa koke ma hope o ke kahakaha ʻana. ʻO ka pinepine, loaʻa iā ʻoe inā ʻaʻole ʻoe e pono hou i ka lāʻau epidural a i ʻole IV mau lāʻau.

Nā ala e loaʻa ai iā ʻoe nā pila a i ʻole nā ​​kī pū ʻana:

• Ma kahi papa manawa maʻamau, kahi āu e pono ʻole ai e noi no lākou
• Ke noi wale ʻoe i kāu kahu no lākou
• I kekahi mau manawa wale nō, e like me ke ala ʻana i waho o kahi moe e hele ai i ke alaloa a i ʻole hele i ka hoʻōla kino

Hāʻawi ka hapa nui o nā pila a pana paha i ke kōkua no 4 a 6 mau hola a ʻoi paha. Inā ʻaʻole mālama pono nā lāʻau i kou ʻeha, e nīnau i kāu mea hoʻolako e pili ana i:

• Ke loaʻa nei i kahi pila a kī pinepine ʻia paha
• Loaʻa i kahi lāʻau ikaika
• Ke hoʻololi nei i kahi lāʻau ʻokoʻa

Ma kahi o ka hoʻohana ʻana i ka lāʻau ʻeha opioid, hiki i kāu kauka lāʻau ke lawe iā ʻoe i ka acetaminophen (Tylenol) a i ʻole ibuprofen (Advil a me Motrin) e kaohi i ka ʻeha. I nā manawa he nui, ʻo kēia mau painkillers non-opioid e like ka maikaʻi me nā narcotics. Kōkua pū lākou iā ʻoe e hōʻalo i ka makaʻu o ka hoʻohana pono ʻole ʻana a me ka hōʻalo ʻana i nā opioids.

Hoʻomaha ʻeha hope

• Nā lāʻau ʻeha

Benzon HA, Shah RD, Benzon HT. Nā infopio nonopioid no ka hoʻoponopono ʻeha hope. I: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Nā mea nui o ka lāʻau lapaʻau ʻeha. ʻEhā ed. Piladelapia, PA: Elsevier; 2018: chap 12.

Chou R, Gordon DB, de Leon-Casasola OA, et al. Ka mālama ʻana i ka ʻeha postoperative: kahi papa kuhikuhi hana hoʻokolohua mai ka American Pain Society, ka American Society of Regional Anesthesia a me Pain Medicine, a me ke Kōmike ʻAmelika Hui Pū ʻIa Anesthesiologists no Regional Anesthesia, Kōmike Hoʻokele, a me ka Council Council J Pain. 2016; 17 (2): 131-157. PMID: 26827847 www.ncbi.nlm.nih.gov/pubmed/26827847.

ʻO Gabriel RA, ʻo Swisher MW, ʻo Sztain JF, ʻo furnish TJ, ʻo Ilfeld BM, ʻo ET. ʻO ka mokuʻāina o nā kiʻi opioid-sparing strategies no ka ʻeha hope ma hope o ka hana ʻana i nā mea maʻi ʻoki makua. ʻO ka loea ʻo Opin Pharmacother. 2019; 20 (8): 949-961. PMID: 30810425 www.ncbi.nlm.nih.gov/pubmed/30810425.

ʻO Hernandez A, Sherwood ER. Nā loina Anesthesiology, mālama ʻeha, a me ka sedation ʻike. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery: Ke kumu kumu olaola o ka hana ʻoki ʻana o kēia ao. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 14.

• Ma hope o ke kaha