Pono maoli nā opioids ma hope o kahi ʻāpana C?

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Ke loli nei ka honua o ka hana a me ka lawe ʻana, wikiwiki. ʻAʻole wale i loaʻa i nā ʻepekema kahi ala e wikiwiki ai i ka hana, akā ke koho nei nā wahine i nā ʻano C-section maʻalahi. ʻOiai ʻaʻole ʻōlelo ʻia nā ʻāpana C e ka World Health Organization inā ʻaʻole i manaʻo ʻia he lāʻau pono, i kekahi manawa. he pono. A ʻo ka holomua ʻepekema hou loa e hiki ke hoʻolalelale i ke kaʻina hana hou, ʻoi aku ka ʻeha, a me ka liʻiliʻi o ka addicting.

ʻOiaʻiʻo, nā ʻāpana C lakou iho ʻAʻole hoʻohui ʻia, akā hoʻohana pinepine ʻia nā lāʻau lapaʻau i ke kaʻina hana hoʻōla-opioids e like me Percocet a i ʻole Vicodin-are. A ua ʻike ʻia kahi hōʻike hou mai ka QuintilesIMS Institute e loaʻa ana i ka 9 i loko o 10 nā mea maʻi ʻokiʻoki i ka opioid RX e mālama i ka ʻeha postsurgical. Hāʻawi ʻia lākou i ka awelika o 85 mau pila i kēlā me kēia-he helu kiʻekiʻe paha, ʻoiai ua ʻike pū ʻia ka hōʻike ʻana i ka overprescribing opioids ma hope o ka hana ʻana i hopena i 3.3 biliona mau huaʻai i hoʻohana ʻole ʻia ma 2016 wale nō.

Ua paʻi ʻia kahi noiʻi hou ma Nā Obstetrics & Gynecology e kākoʻo i kēlā no nā wāhine e ho'ōla ana mai ka ʻāpana C. Ma hope o ka nānā ʻana i nā maʻi maʻi 179, ʻike lākou ʻoiai ʻo 83 ka nui o ka hoʻohana ʻana i ka opioids no ka awelika o ʻewalu mau lā ma hope o ka hoʻokuʻu ʻia ʻana, ʻo 75 ka nui o nā lāʻau i hoʻohana ʻole ʻia. He mea pōʻino loa ia no nā wahine, ʻoiai ua ʻike ʻia ka hōʻike QuintilesIMS he 40 pakeneka ka nui o nā wahine e lilo i mea hoʻohana opioid mau ma hope o ka ʻike.

No laila, inā ʻoi aku ka nui o nā wahine i ka opioids, e kū mai kekahi nīnau: Aia kahi ala e hoʻōki ai i ka hilinaʻi ʻana iā lākou i ka wā e hoʻihoʻi ai mai kahi ʻāpana C? Hoʻokahi kauka-Richard Chudacoff, M.D., he ob-gyn ma Dumas, TX-manaʻo ʻo ka pane he mea kani. ae.

Ua ʻōlelo ʻo Kauka Chudacoff, ua hoʻohana ʻo ia i nā kaʻina hoʻoponopono ʻeha ʻē aʻe no nā makahiki he nui i hala aku nei, ʻoiai ʻo ia i ʻike ai i ka poʻe maʻi i lalo e hiki ke loaʻa iā lākou iho i ka wā e lawe ai i nā opioids. "He mea kupanaha ka hopena hau hau i hiki iā lākou ke loaʻa," wehewehe ʻo ia. "ʻAʻole lawe ka opioids i ka ʻeha, ʻaʻole lākou e mālama iā ʻoe aia ka ʻeha, ʻo ia hoʻi, ʻaʻole ʻoe e mālama i nā mea āpau." Akā inā e wehe ʻoe i nā opioids mai ka hoʻohālikelike, ʻōlelo ʻo Kauka Chudacoff e ʻoi aku ka maikaʻi o ka noʻonoʻo ma hope o ka hānau ʻana.

Ma luna o kēlā, ua manaʻo ʻo Kauka Chudacoff ʻo ka hapa nui o ka poʻe me ka opioid a i ʻole ka heroin addiction i hoʻomaka me ka lawe ʻana i nā lāʻau ʻeha, ma hope paha o ka ʻoki ʻana e like me ka ʻāpana C, no ka mea, ʻo ia ka mea i ʻike mua ʻia e kekahi. "E hoʻi ʻoe i ka home me kēia ʻōmole pila a he maʻalahi ka hoʻohana ʻana ia mau mea e kōkua iā ʻoe e hiamoe, neʻe, a e hōʻoluʻolu iā ʻoe inā he kaumaha iki ʻoe." (ʻOi aku ka maʻamau o ke kaumaha o ka postpartum ma mua o kou manaʻo.)

Eia nō naʻe, ʻo nā ʻāpana C he a loa ʻoki nui a makemake ʻoe i ka hoʻomaha ʻeha inā makemake ʻoe i kekahi. (E heluhelu hou aʻe ma Parents.com: Kaumaha nā poʻe loea i nā pono a me nā mea maikaʻi o ka lawe ʻana i nā Opioids ma hope o kahi C-Section) A no ka pololei, nui nā wahine e lawe i nā painkillers no ka manawa pōkole me ka pilikia ʻole. ʻO ka hoʻohana maʻamau kahi e hoʻomaka ai ʻoe i nā pilikia - akā nui kēia mau pilikia. Ua ʻike nā Centers for Disease Control and Prevention (CDC) ua hoʻonui ʻia ka nui o ka make mai ka opioids mai ka makahiki 1999, ʻo ia ka helu o 15,000 mau make ma 2015.

ʻO ke kī ke nānā ʻana i kāu mau koho me kāu kauka ma mua. Ma keʻano he ʻokoʻa, ua hoʻohana ʻo Kauka Chudacoff i ka Exparel, kahi ʻinikua non-opioid i lawelawe ʻia i ka wā o ka ʻoki ʻana a hoʻomaha mālie i ka ʻeha ma luna o 72 mau hola. Ua aʻo ʻo ia e pili ana i ka anesthetic i ka wā i haʻi aku ai kona hoa pili, ka luna hoʻokele o kahi kikowaena hana ʻokiʻoki, e pili ana i ka hoʻohana ʻia ʻana e nā kaukaʻi kala e mālama ana i nā maʻi hemorrhoid, me nā kauka e hana ana i nā ʻoki kuli. Ke hōʻike nei ka poʻe maʻi i ka nele o ka ʻeha no nā lā ʻehā, no laila ua hana ʻo Kauka Chudacoff i kahi noiʻi hou e ʻike inā hiki ke hana i nā ʻāpana C a me nā hysterectomies.

I ka hopena, ua hana ʻo ia i kāna ʻāpana C-ʻole opioid mua loa a ʻōlelo ʻo ia ʻaʻole i koi ka mea maʻi i kahi ʻōlelo kuhikuhi postsurgical. Pēlā nō i kēlā me kēia mea āna i hana ai mai ia manawa mai. "ʻAʻole au i kākau i nā ʻōlelo kuhikuhi no nā opioid postoperative i ʻekolu mahina," wahi āna, me ka wehewehe ʻana e hoʻololi ana kāna maʻamau o ka mālama ʻana ma waena o ka acetaminophen (Tylenol) a i ʻole ibuprofen (Motrin) e "hana mua i ka ʻeha ma ke ʻano non-opioid; ka pilikia o ka addiction."

Ma luna o kēlā, ʻōlelo ʻo Kauka Chudacoff, ʻo kāna mau maʻi Exparel, ma ka awelika, mai kahi moe a hele i loko o ʻekolu mau hola o ka ʻoki ʻana, a "99 pakeneka ua hele wāwae, pipi, a ʻai i loko o ʻeono mau hola. 1.2 lā. " Wahi a ka American Congress of Obstetricians and Gynecologists (ACOG) ʻo ka maʻamau o ka hale maʻi no ka ʻāpana C he ʻelua a ʻehā lā, no laila he ʻokoʻa nui kēlā.

ʻOiai ua like kēia me ka pane i ka pule ʻeha a kēlā me kēia wahine hana, ʻaʻole hiki mai ka lāʻau lapaʻau me ka ʻole o nā hōʻailona. ʻO ka mua, he pipiʻi. Ua ʻōlelo ʻo Kauka Chudacoff, ʻo ka haukapila āna e hana nei i kēia manawa e uhi i ke kumukūʻai o ka lāʻau lapaʻau no nā maʻi, akā ʻaʻole ia ka protocol maʻamau, a ʻo ke kumukūʻai kūʻai nui no ka vial 20-mL o Exparel ma kahi o $285. "He mea hou loa kēia o kahi lāʻau lapaʻau, ma ka liʻiliʻi loa no nā ʻāpana C, ʻaʻole ʻike ka hapa nui o nā ob-gyns," wahi āna. ʻAʻole i uhi ʻia e ka ʻinikua, hoʻohui ʻo ia, ʻo ia ke kumu e ʻōlelo ai ʻo ia e nānā me kāu haukapila kūloko e pili ana i nā kumukūʻai olakino hou āu e kuleana ai ma mua o ke kau inoa ʻana ma ka laina kiko.

ʻAʻole ʻo ke kumukūʻai wale nō ka mea e hopohopo nei. Ua ʻike ʻia ʻelua mau haʻawina ʻaʻole ʻoi aku ka maikaʻi o ka lāʻau lapaʻau i ka hoʻomaha ʻana i ka ʻeha o ka ʻoki ʻana i ke kuli ma mua o ka bupivacaine, kahi maʻi maʻi spinal injectable ʻo ia ke ʻano o ka mālama ʻana i nā ʻoki like ʻole, me nā ʻāpana C. Akā, ʻaʻole ia he manaʻo ʻaʻole kūpono ia i ka hōʻemi ʻana i ka hoʻohana ʻana i ka opioid. I ka wā i hāʻawi ai nā mea noiʻi iā Exparel i nā mea maʻi o ka ʻoki kuli-ma kahi o ka bupivacaine-ka pau ʻana o ka opioid i hoʻemi ʻia e 78 pākēneka i nā hola 72 mua ma hope o ke ʻoki ʻana, me 10 pākēneka i koe o ka opioid-noa, e like me kahi noiʻi i paʻi ʻia. Nūpepa o Arthroplasty. Maikaʻi kēlā me ka noʻonoʻo ʻana he 60 mau hola ka lōʻihi o Exparel.

"ʻO kēia ka hoʻomaka ʻana o kahi holomua nui," wahi āna. "Inā ʻoe e noʻonoʻo ʻo C-section kekahi o nā kaʻina hana maʻamau ma ʻAmelika Hui Pū ʻIa, ma 1.2 miliona i ka makahiki, ʻo ia ka mea hiki iā ʻoe ke hoʻokuʻu i ka helu o nā ʻōlelo opioid ma mua o hoʻokahi miliona i kēlā me kēia makahiki, he mea nui ia no ka hakakā ʻana maʻi ahulau a mākou i kēia manawa. "

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