Ngā Kōwhiringa Whakamamae ā-Rohe i roto i te Pokanga Waha
Ko te pokanga waha he peka o te mahi niho e uru ana ki ngā tikanga maha, mai i te tango niho ki ngā mahi uaua ake pērā i te tango i ngā kiore, i ngā pukupuku waha rānei. He wāhanga nui te rongoā whakamoe ā-rohe o te pokanga waha, e āhei ai ngā tūroro ki te noho whakamarie me te kore mamae i te wā e mahia ana te tikanga. He maha ngā kōwhiringa rongoā whakamoe ā-rohe e wātea ana, he painga me he ngoikoretanga o ia momo. Ka matapakihia e tēnei tuhinga ngā momo rongoā whakamoe ā-rohe e whakamahia ana i roto i te pokanga waha , me pēhea te mahi, ō rātou tohu, ngā ārai, me ngā whakaaro motuhake ina whiriwhiria te momo rongoā whakamoe tika.
Ngā Momo Whakamamae ā-Rohe
1. Lidocaine
Ko te Lidocaine tētahi o ngā rongoā whakangote ā-rohe e whakamahia whānuitia ana i roto i te pokanga waha. Mā te Lidocaine ka aukati i ngā awa konutai i roto i ngā kiriuhi pūtau io, ka ārai i ngā tohu mamae kia tae atu ki te roro. He tere te tīmatanga o te mahi a tēnei rongoā whakangote, tata ki te 2–5 meneti, ā, tata ki te 1–2 hāora te roa. Hei tāpiri, he maha ngā wā ka honoa te lidocaine me te epinephrine hei whakaroa i te roanga o te pānga rongoā whakangote me te whakaiti i te toto i te wā pokanga. ngā tikanga pokanga.
2. Articaine
Ko te Articaine, e mōhiotia ana ko te septocaine, he rongoā whakangote ā-rohe, he kaha ki te whakamamae i te mamae. He tere rawa te tīmatanga o te mahi a te Articaine, tata ki te 1–2 meneti, ā, he roa te roa o te mahi, mai i te 1–2,5 hāora. Ko tētahi o ngā painga o te articaine ko tōna kaha ki te uru atu ki te kiko wheua me te whai hua ake i ētahi atu rongoā whakangote ā-rohe. Nā tēnei ka whakamahia pinepine te articaine i roto i ngā tikanga e hiahia ana ki te whakangote hohonu ake, pērā i te pokanga niho whakaaro nui.
3. Mepivacaine
He maha ngā wā ka whakamahia te Mepivacaine mō ngā tūroro kāore e taea te whiwhi epinephrine nā ētahi āhuatanga hauora, pērā i te mate ngakau. He tere te tīmatanga o te mahi a te Mepivacaine mō te 1-2 meneti pea, ā, ko te roanga o te rongoā whakamoe mō te 1-3 hāora pea. Ahakoa kāore i te rite te whai huatanga ki te articaine ki te wero i ngā kiko mārō, he pai tonu te mepivacaine mō ngā tikanga pokanga ā-waha maha.
4. Bupivacaine
He rongoā whakangote ā-rohe te Bupivacaine, e mōhiotia ana mō tōna roa o te mahi, tae atu ki te 4–8 hāora. Kāore tēnei rongoā whakangote e whakamahia hei rongoā whakangote tuatahi mō ngā pokanga waha ngāwari, nā te mea ka pāngia te ngākau roa e te whakangote. Heoi, mō ngā pokanga e hiahia ana ki te whakangote roa, mō ngā tūroro rānei e rapu ana i te whakahaere mamae pai ake i muri i te pokanga, he pai rawa te bupivacaine.
5. Prilocaine
He rite te āhua o te Prilocaine ki te lidocaine engari he iti ake te kaha o te paitini. Nā tēnei he kōwhiringa pai mō ngā tūroro e tino mōrearea ana ki te ngā pānga taha He rongoā whakangote ā-rohe. Ka tīmata te mahi a te Prilocaine i roto i te 2-4 meneti, ā, ka roa mō te 1-2 hāora.
Ngā Tohu me ngā Ārai i te Whakamahinga o te Anesthesia ā-Rohe
Tohu
Ka whakamahia ngā rongoā whakamoe ā-rohe i roto i ngā momo pokanga ā-waha hei whakaiti, hei whakakore rānei i te mamae. Ko ngā tohu e whai ake nei: te tango niho, te rongoā i ngā pukupuku, i ngā whēkau rānei o te waha, te pokanga whakatō niho, me ētahi atu whakatikatika kiko ngohengohe i roto i te kōhao waha.
Ngā ārai
Ko ngā ārai mō te whakamahinga o te rongoā whakangote ā-rohe e whakawhirinaki ana ki te hītori hauora o te tūroro me te momo rongoā whakangote i whiriwhiria. Ko ētahi o ngā ārai noa ko:
– Mate pāwera ki ngā rongoā whakangote ā-rohe: Me karo te whakamahi i ēnei rongoā whakangote mēnā he mate pāwera tō ngā tūroro kua pāngia e ētahi wāhanga rongoā whakangote, pērā i te lidocaine, te articaine rānei.
– Mate pūnaha: Me tūpato ngā tūroro e mate ana i te ngakau, te toto toto tiketike, te mate tairoi rānei i te wā e whakamahi ana i ngā rongoā whakamoe ā-rohe kei roto ko te epinephrine.
– Methemoglobinemia: Ka puta pea tēnei āhuatanga mā te whakamahi i te prilocaine me ētahi atu momo rongoā whakangote, nō reira me karo ngā tūroro kua pāngia e te methemoglobinemia i te whakamahi i tēnei rongoā whakangote.
Ngā Whakaaroaro i te Kōwhiringa i te Whakamamae ā-Rohe
Te Whai Huatanga me te Tere o te Tīmatanga
Ko te whiriwhiri i te rongoā whakamoe ā-rohe e hangai ana ki te tere o te tīmatanga me te roa o te mahi. Hei tauira, mō ngā mahi pokanga ā-waha māmā me te tere, he rawaka pea te lidocaine, te mepivacaine rānei. Heoi, mō ngā mahi uaua me te roa, he pai ake pea te articaine, te bupivacaine rānei nā te mea he roa ake te roa o te rongoā whakamoe.
Kōtaha Haumarutanga
Ko te haumaru o te tūroro te mea nui rawa atu. Mō ngā tūroro he mate pāwera ki ētahi rongoā whakangote, ki ngā āhuatanga hauora rānei e pā ana ki te pākia o te rongoā me te tukunga atu, me tūpato te whiriwhiri i te rongoā whakangote. Hei tauira, he maha ake te tūtohutanga o te mepivacaine mō ngā tūroro e mate ana i te ngākau nā te mea kāore he epinephrine i roto.
Te Roanga o te Tukanga me te Mana Mamae I muri i te pokanga
I roto i te pokanga waha, he mea nui te roa o te wā e whakamahia ana te rongoā whakamoe kia pai ai te haere o te mahi me te kore e mamae te tūroro. Hei tāpiri, he mea nui te whakahaere i te mamae. muri i te pokanga He mea tika hoki kia whakaarohia te Bupivacaine. He kōwhiringa pai te Bupivacaine mō ngā tikanga e hiahia ana kia roa te wā e whakahaere ana i te mamae i muri i te pokanga.
Te Wātea me te Wheako Hauora
Ko te wātea o ngā rongoā whakangote ā-rohe i te whare rongoā me te wheako haumanu o te rata ka pā ki te whiriwhiri i te rongoā whakangote. Tērā pea kāore ētahi rongoā whakangote ā-rohe e wātea ana i ngā whare rongoā katoa, tērā pea he nui ake te wheako o te rata ki ētahi momo rongoā whakangote, nō reira he nui ake tōna māia ki te whakamahi.
Whakamutunga
He mea nui te mahi a te rongoā whakamoe ā-rohe i roto i te pokanga waha, e whakarato ana i te whakamarie me te whakamamae i te mamae i te wā e mahia ana. Mā te whānuitanga o ngā momo rongoā whakamoe ā-rohe e wātea ana, tae atu ki te lidocaine, te articaine, te mepivacaine, te bupivacaine, me te prilocaine, ka taea e ngā tākuta niho te whakarite i te rongoā whakamoe kia rite ki ngā hiahia o ia tūroro. Me whai whakaaro nui ki ngā āhuatanga pēnei i te tere o te tīmatanga, te roa o te mahi, te āhua haumaru, me te āhua haumanu o te tūroro kia pai ai te whiriwhiri i te rongoā whakamoe.
I ngā āhuatanga hauora uaua, me kōrero pea ki tētahi tohunga whakamoe, ki tētahi atu tohunga hauora rānei, hei whakatau i te rautaki whakamoe pai rawa atu. Mā te whiriwhiri tika i te whakamoe ā-rohe, ka taea te mahi i ngā mahi pokanga ā-waha me te whai hua, te haumaru, me te whakamarie hoki mō te tūroro.
