He aha kāu e ʻike ai e pili ana i ka anesthesia kahua niho

Anter

• He aha nā ʻano o nā anesthetics niho?
• Anesthesia kūloko
• Hoʻoiho
• Anesthesia laulā
• He aha nā hopena o ka anesthesia niho?
• Nā hana kūikawā i ka wā e lawe ana i nā anesthetics niho
• Hapai keiki
• Nā pono kūikawā
• Nā mākua makua
• Nā pilikia o ke ake, ka hakuʻala, ka hū, a me nā puʻuwai
• Nā kūlana neurologic kekahi
• Nā kūlana ʻē aʻe
• He aha nā pilikia o ka anesthesia niho?
• ʻO ka lawe lawe ʻana

Hoʻonohonoho ʻia ʻoe no kahi hana niho a he mau nīnau e pili ana i ka anesthesia?

Puni o ka poʻe i ka hopohopo a me ka hopohopo e pili ana i ka ʻeha me nā niho kaʻina hana. Hiki i ka pīhoihoi ke hoʻolohi i ka loaʻa ʻana o ka lāʻau a ʻoi aku ka maikaʻi o ka pilikia.

Ma kahi o 175 mau makahiki ka Anesthetics! ʻO ka ʻoiaʻiʻo, ʻo ke kaʻina hana i hoʻopaʻa mua ʻia me kahi anesthetic i hana ʻia ma 1846 e hoʻohana ana i ka ether.

Ua hele lōʻihi mākou mai ia manawa, a ʻo nā anesthetics kahi mea hana nui i ke kōkua ʻana i nā mea maʻi e ʻoluʻolu i ka wā o nā kaʻina niho.

Me nā koho ʻokoʻa he nui i loaʻa, hiki i ka anesthesia ke huikau. Haki mākou iā ia no laila e ʻike ʻoe i ka hilinaʻi hou ma mua o kāu kau niho hou.

He aha nā ʻano o nā anesthetics niho?

ʻO Anesthesia ke kumu o ka nele a i ʻole ka nalo o ka naʻau. Hiki i kēia ke me a me ka ʻole o ka ʻike.

I kēia lā he nui nā koho i loaʻa no nā anesthetics niho. Hiki ke hoʻohana hoʻokahi ʻia nā lāʻau a hui ʻia no ka hopena ʻoi aku. Hoʻonohonoho pilikino ʻia ia no kahi hana palekana a holomua hoʻi.

Pili ke ʻano o nā anesthetics i ka makahiki o ke kanaka, ke olakino, ka lōʻihi o ke kaʻina hana, a me nā hopena maikaʻi ʻole i nā anesthetics i ka wā i hala.

Hana nā anesthetics i nā ʻano like ʻole e pili ana i nā mea i hoʻohana ʻia. Hiki i nā anesthetics ke hana pōkole ke noi pololei ʻia i kahi wahi a i ʻole hana no nā manawa lōʻihi ke koi ʻia ka ʻoki ʻana i pili.

ʻO ka kūleʻa o ka anesthesia kahua niho kaukaʻi iā:

• ka lāʻau
• ke anesthetized kahi
• ke kaʻina hana
• nā mea pākahi

ʻO nā mea ʻē aʻe e hoʻopili i ka anesthesia niho me ka manawa o ke kaʻina hana. hōʻike pū ʻia hiki i ka mumū ke hopena maikaʻi ʻole i ka kūleʻa o nā anesthetics.

Eia kekahi, no ka anesthesia kūloko, ʻoi aku ka paʻakikī o nā niho i ka iwi ā lalo (mandibular) o ka waha e anesthetize ma mua o nā niho ʻoi kiʻekiʻe (maxillary).

ʻEkolu ʻano nui o ka anesthesia: kūloko, hoʻoluʻu, a me ka laulā. He hoʻohana kūikawā kā kēlā me kēia. Hiki ke hoʻohui pū ʻia kēia mau mea me nā lāʻau ʻē aʻe.

Anesthesia kūloko

Hoʻohana ʻia ka anesthesia kūloko no nā hana maʻalahi e like me ka hoʻopiha ʻana o ka lua, kahi e koi ai i kahi manawa pōkole e hoʻopau a ʻoi aku ka liʻiliʻi o ka paʻakikī.

E noʻonoʻo ʻoe a hiki ke kamaʻilio ke loaʻa iā ʻoe kahi anesthetic kūloko. E palaka ka wahi, no laila ʻaʻole ʻoe e ʻeha.

ʻO ka hapa nui o nā anesthetics kūloko e holo wikiwiki (ma waena o 10 mau minuke) a hala ka 30 a 60 mau minuke. I kekahi manawa hoʻohui ʻia kahi vasopressor e like me epinephrine i ka anesthetic e hoʻonui ai i kona hopena a mālama i ka hopena anesthetic mai ka hoʻolaha ʻana i nā wahi ʻē aʻe o ke kino.

Loaʻa nā anesthetics kūloko ma luna o ka pāʻai a ma ke ʻano he kauka i ka gel, mea hamo, kaʻaila, ʻehu, pāʻina, wai, a me nā ʻano i hoʻokomo ʻia.

Hiki iā lākou ke hoʻohana topically (hoʻopili pololei i ka wahi i pā ʻia e numb) a i ʻole injected i loko o ka wahi e mālama ʻia. I kekahi manawa, hoʻohui ʻia ka sedation māmā i nā anesthetics kūloko e kōkua ai i ka hoʻomaha ʻana i ke kanaka.

• articaine
• bupivacaine
• lidocaine
• ʻo mepivacaine
• prilocaine

Hoʻoiho

He pae ko ka sedation a hoʻohana ʻia e hoʻomaha ai ke kanaka i loaʻa ka hopohopo, kōkua me ka ʻeha, a i ʻole mālama iā lākou no ke kaʻina hana. Hiki iā ia ke kumu i ka amnesia hana.

E ʻike piha paha ʻoe a hiki iā ʻoe ke pane i nā kauoha, semiconscious, a i ʻole ʻike maka ʻole paha. Hoʻokaʻawale ʻia ka sedation ma ke ʻano he akahai, akahai, a hohonu paha.

Hiki ke kāhea ʻia ka hoʻoluʻu hohonu i ka mālama anesthesia nānā ʻia a i ʻole MAC. I loko o ka sedation hohonu, ʻaʻole ʻoe i ʻike i kāu mau wahi a hiki ke pane wale i ka hoʻoulu pinepine ʻana a ʻehaʻeha hoʻi.

Hāʻawi waha ʻia ka lāʻau lapaʻau (tablet a wai paha), inhaled, intramuscularly (IM), a i ʻole intravenously (IV).

Aia kekahi mau mea ʻoi aku ka pilikia me ka hoʻohiamoe IV. Pono e nānā pono i ka helu o kou puʻuwai, ke kahe o ke koko, a me ka hanu ʻana i ka sedation haʻahaʻa a hohonu paha.

• diazepam (Valium)
• midazolam (ʻōlelo)
• propofol (Diprivan)
• ʻokikene nika

Anesthesia laulā

Hoʻohana ʻia ka anesthesia laulaha no nā kaʻina hana lōʻihi, a inā he nui kou hopohopo e hoʻopilikia paha i kāu lāʻau.

E makaʻu loa ʻoe, ʻaʻohe ʻeha, e hoʻomaha kou mauʻiʻo, a loaʻa ka amnesia mai ke kaʻina hana.

Hāʻawi ʻia ka lāʻau i loko o ka pale maka a i ʻole IV. Pili ka pae o ka anesthesia i ke kaʻina hana a me ka mea hoʻomanawanui. Aia nā pilikia ʻokoʻa me ka anesthesia ākea.

• propofol
• ketamine
• etomidate
• midazolam
• diazepam
• methohexital
• ʻokikene nika
• desflurane
• isoflurane
• sevoflurane

He aha nā hopena o ka anesthesia niho?

Pili nā hopena o ka anesthesia niho ma ke ʻano o ka anesthetic i hoʻohana ʻia. ʻOi aku nā pilikia o ka anesthesia ākea me ka hoʻohana ma mua o ka anesthesia kūloko a i ʻole ka sedation. Hoʻololi pū kekahi nā hopena ma muli o nā kumu pākahi.

ʻO kekahi mau hopena i hōʻike ʻia me nā sedation a me nā lāʻau anesthesia āpau e komo pū me:

• nausea a luaʻi paha
• ʻeha poʻo
• ka houʻu a haʻalulu paha
• hallucination, delirium, a huikau paha
• haʻi waha
• waha maloʻo a ʻeha paha ka ʻāʻī
• ʻeha ma ke kahua o ka hoʻopili
• ʻūpā
• luhi
• ʻōlohelohe
• lockjaw (trismus) i hoʻokumu ʻia e ka trauma mai ke ʻoki kino; hoʻemi ʻia ka wehe ʻana o ka iwi ā i kekahi manawa

ʻO nā vasoconstrictors e like me epinephrine i hoʻohui ʻia i nā anesthetics hiki ke hana i nā pilikia puʻuwai a me ke koko.

Eia kekahi mau hopena i hōʻike ʻia o nā anesthetics. E nīnau i kāu hui mālama niho e pili ana i kāu lāʻau lapaʻau kikoʻī a me nā hopohopo āu e pili ana i ka lāʻau.

Nā hana kūikawā i ka wā e lawe ana i nā anesthetics niho

Aia nā kūlana a me nā kūlana e kūkākūkā ai ʻoe a me kāu kauka a kauka niho paha inā ʻo ke anesthesia kahua niho ka mea koho maikaʻi loa nāu.

ʻO ka ʻae ʻana he mea nui ia i ke kūkākūkā pretreatment. E nīnau i nā nīnau e pili ana i nā pilikia a me nā hana palekana e lawe ʻia e hōʻoia i kahi hopena maikaʻi.

Hapai keiki

Inā hāpai ʻoe, e kūkākūkā kāu kauka niho a kauō paha i nā pōpilikia me nā pōmaikaʻi o nā anesthetics nāu a me kāu pēpē.

Nā pono kūikawā

Pono nā keiki a me nā mea me nā pono kūikawā e loiloi pono i ke ʻano a me ka pae o nā anesthetics e pono ai. Pono paha nā keiki i ka hoʻoponopono ʻana i ka hopena e hōʻalo i nā hopena maikaʻi ʻole a i ʻole overdose.

Ua hoʻolaha aku ka Food and Drug Administration (FDA) i kahi ʻōlelo aʻoaʻo e pili ana i nā mea numbing āpau i hoʻohana mau ʻia no ka ʻeha niho. ʻAʻole palekana kēia huahana no ka hoʻohana ʻana i nā keiki ma lalo o ka makahiki 2. Mai hoʻohana i kēia mau lāʻau me ke kūkākūkā ʻole ʻia me kahi kauka olakino.

Loaʻa paha i nā keiki a me nā mākua me nā pono kūikawā nā pilikia olakino ʻē aʻe e hoʻonui ai i nā pilikia me nā anesthetics. ʻO kahi laʻana, loaʻa nā keiki me ka lolo lolo ka helu kiʻekiʻe loa o nā hopena hopena e pili ana i ke ea i ka anesthesia ākea.

Nā mākua makua

Pono nā mākua ʻelemakule me kekahi mau pilikia olakino i ka hoʻoponopono ʻana o ka lāʻau a me ka nānā pono ʻana i ka wā a ma hope o ke kaha ʻana e hōʻoia i ko lākou palekana.

ʻIke paha kekahi poʻe i ka delirium a i ʻole ka huikau a me nā pilikia hoʻomanaʻo ma hope o ke kahakaha ʻana.

Nā pilikia o ke ake, ka hakuʻala, ka hū, a me nā puʻuwai

ʻO ka poʻe me ke ake, ka hakuʻala, ka māmā, a me nā pilikia o ka puʻuwai e pono paha i nā hoʻoponopono ʻana no ka mea ʻoi aku ka lōʻihi o ka lāʻau e haʻalele i ke kino a loaʻa ka hopena ikaika.

Nā kūlana neurologic kekahi

Inā loaʻa kahi moʻolelo o ka hahau ʻana, ka maʻi ʻo Alzheimer, ka maʻi ʻo Parkinson, ka maʻi thyroid, a me nā maʻi noʻonoʻo paha, e hoʻonui ʻia paha ka pilikia me ka anesthesia āpau.

Nā kūlana ʻē aʻe

E hoʻomaopopo pono i kāu pūʻulu niho inā loaʻa iā ʻoe kahi hiatal hernia, reflux acid, nā maʻi a i ʻole nā ​​ʻeha hāmama i ka waha, nā maʻi āpau, ka nausea nui a me ka luaʻi me nā anesthetics, a i ʻole ke lawe nei ʻoe i nā lāʻau e hiki ai ke hiamoe e like me nā opioids.

ʻOi aku ka kiʻekiʻe o nā pilikia no ka poʻe me:

• ʻāpana moe
• maʻi ʻaʻai
• momona
• kahe koko kiʻekiʻe
• pilikia puʻuwai
• nā keiki me ka nānā a i ʻole nā ​​ʻano hana
• maʻi pulmonary pulupulu paʻa (COPD)
• ʻoki kino by gastric
• hoʻohana pono ʻole i ka lāʻau a hoʻohana maʻi paha

He aha nā pilikia o ka anesthesia niho?

ʻAʻole ʻike ka hapa nui o ka poʻe i nā hopena maikaʻi ʻole me ka anesthesia kūloko. Nui aʻe nā pilikia me ka hoʻohiamoe a me ka anesthesia āpau, keu hoʻi i nā mākua a me nā kānaka me nā pilikia olakino ʻē aʻe.

Aia kekahi piʻi nui me ka moʻaukala o nā maʻi kahe o ke kahe a i ʻole me nā lāʻau e hoʻonui i ka makaʻu o ke kahe e like me ka aspirin.

Inā ʻoe e lawe i nā lāʻau ʻeha e like me opioids a i ʻole gabapentin, a i ʻole nā ​​lāʻau hopohopo e like me benzodiazepines, e hoʻomaopopo i kāu kauka niho a i ʻole ke kauka paha i hiki iā lākou ke hoʻoponopono i kāu anesthetic e like me ia.

ʻO nā pilikia o ka anesthesia me:

• kahi hopena maʻi ʻaʻano. E hoʻomaopopo pono i kāu kauka niho e ʻike e pili ana i nā maʻi āpau āu i loaʻa ai; pili pū kēia i nā kala a i ʻole nā ​​mea ʻē aʻe. Māmā a paʻakikī paha nā hopena a komo pū me ka hū, ka makaʻu, ka pehu ʻana o ke alelo, nā lehelehe, ka waha, a me ka ʻāʻī, a me ka paʻakikī e hanu.
• anesthetics articaine and prilocaine at 4% concentrations may cause nerve pinsala, i ʻike ʻia ʻo paresthesia
• ka hopu ʻana
• koma
• kū ana hanu
• puʻuwai puʻuwai
• maʻi hohola
• hahau
• haʻahaʻa haʻahaʻa haʻahaʻa
• hyperthermia malignant, kahi hoʻonui weliweli o ka mahana o ke kino, ka paʻakikī o ka ʻū, nā pilikia hanu, a i ʻole ka hoʻonui ʻia o ka helu o ka puʻuwai

ʻO ka lawe lawe ʻana

ʻO ka hopohopo e pili ana i nā kaʻina hana niho he mea maʻamau akā hiki ke hana maʻalahi. He mea nui e kūkākūkā i kāu mau hopohopo āpau e pili ana i ke kaʻina hana a me kāu mau mea i manaʻo ai me kāu hui mālama niho ma mua.

E nīnau i nā nīnau e pili ana i nā lāʻau e hoʻohana ai a me nā mea āu e manaʻo ai i ka wā a ma hope o ka mālama ʻana.

E kaʻana like i kāu mōʻaukala olakino, me nā maʻi āpau a me nā lāʻau ʻē aʻe āu e lawe nei. E nānā pono i kēia me nā lāʻau laikini, nā kuhikuhi, a me nā mea hoʻopiha.

E nīnau e pili ana i nā ʻōlelo aʻoaʻo kūikawā āu e pono ai e hāhai ma mua a ma hope o ke kaʻina hana. Hoʻopili kēia i ka meaʻai a me ka mea inu ma mua a ma hope o ka mālama ʻana.

E nīnau inā pono ʻoe e hoʻonohonoho no ka halihali ma hope o ke kaʻina hana a me nā ʻike ʻē aʻe e pono ai ʻoe e ʻike.

E hāʻawi kāu mea mālama niho iā ʻoe i nā ʻōkuhi e hāhai ma mua a ma hope o ke kaʻina hana. E hāʻawi pū lākou i kahi ala e hoʻopili aku ai iā lākou inā he pilikia a nīnau paha kāu.