Sarudzo dzeAnesthesia dzemunharaunda mukuvhiyiwa kwemuromo
Kuvhiya nemuromo ibazi rekurapa mazino rinosanganisira nzira dzakasiyana-siyana, kubva pakubviswa kwezino kusvika pakuvhiyiwa kwakaomarara kwakadai sekubviswa kwezvironda zvemumuromo kana bundu remuromo. Kuvhiya kwemumuromo chinhu chakakosha pakuvhiya nemuromo, zvichibvumira varwere kuti vagare vakasununguka uye vasina marwadzo panguva yekuvhiya. Kune nzira dzakasiyana-siyana dzekuvhiya dzemumuromo dziripo, imwe neimwe ine zvayakanakira nezvayakaipira. Chinyorwa chino chichakurukura mhando dzakasiyana dzemishonga yekuvhiya yemumuromo inoshandiswa mukuvhiya nemuromo, mashandiro ayo, zviratidzo zvayo, zvinopesana nazvo, uye zvinhu zvakakosha pakusarudza rudzi rwemishonga yekuvhiya yakakodzera.
Mhando dzeAnesthesia Yemunharaunda
1. Lidocaine
Lidocaine ndeimwe yemishonga inonyanya kushandiswa yekuvhiya nemuromo. Lidocaine inoshanda nekuvhara nzira dzesodium mumasero etsinga, izvo zvinodzivirira zviratidzo zvekurwadziwa kusvika kuuropi. Iyi mishonga inorwisa marwadzo inotanga kushanda nekukurumidza, ingangoita maminetsi maviri kusvika mashanu, uye inotora maawa angangoita 1-2. Pamusoro pezvo, lidocaine inowanzo sanganiswa ne epinephrine kuti iwedzere nguva yekuvhiya uye kuderedza kubuda ropa panguva yekuvhiyiwa.
2. Articaine
Articaine, inozivikanwawo septocaine, mushonga unonyaradza marwadzo munharaunda une simba guru rekunyaradza marwadzo. Articaine inotanga kushanda nekukurumidza, ingangoita maminetsi 1-2, uye inotora nguva yakareba, kubva paawa 1-2,5. Chimwe chezvakanakira zveArticaine kugona kwayo kupinda mumapfupa zvinobudirira kupfuura mamwe mishonga inonyaradza marwadzo munharaunda. Izvi zvinoita kuti Articaine ishandiswe kakawanda mumabasa anoda anesthesia yakadzika, akadai sekuvhiyiwa kwezino reuchenjeri.
3. Mepivacaine
Mepivacaine inowanzo shandiswa kuvarwere vasingakwanise kugamuchira epinephrine nekuda kwemamwe matambudziko ehutano, akadai sechirwere chemwoyo. Mepivacaine inotanga kushanda nekukurumidza kwemaminitsi 1-2 uye nguva yekunzwa kuneta kweawa 1-3. Kunyangwe isingashande searticaine mukupinda munyama dzakaoma, mepivacaine ichiri sarudzo yakanaka kune akawanda maitiro ekuvhiya nemuromo.
4. Bupivacaine
Bupivacaine mushonga wekurapa marwadzo unozivikanwa nekushanda kwawo kwenguva refu, unogara kwemaawa 4-8. Mushonga uyu hauwanzo shandiswa semushonga wekutanga wekurapa marwadzo pakurapwa kwemuromo, sezvo mushonga wekurwadziwa kwenguva refu unogona kukonzera kusagadzikana mushure mekuita oparesheni. Zvisinei, kune vanovhiyiwa vanoda mushonga wekurwadziwa kwenguva refu kana varwere vari kutsvaga kudzora marwadzo mushure mekuvhiyiwa, bupivacaine inogona kuva sarudzo yakanaka.
5. Prilocaine
Prilocaine ine chimiro chakafanana nelidocaine asi ine mukana mudiki wekuti iwedzere chepfu. Izvi zvinoita kuti ive sarudzo yakanaka kune varwere vanogona kunge vari panjodzi huru yekukanganiswa nemishonga inonyaradza marwadzo yemunzvimbo. Prilocaine inotanga kushanda kwemaminitsi maviri kusvika mana uye nguva yekunzwa kuneta kweanenge maawa 1-2.
Zviratidzo uye Zvipingamupinyi muKushandiswa kweAnesthesia Yemunharaunda
Chiratidzo
Nzira yekurara inoshandiswa mukuvhiya kwemuromo kwakasiyana-siyana kuderedza kana kubvisa marwadzo. Zviratidzo zvinosanganisira kubviswa kwezino, kurapwa kwezvironda zvemuromo kana bundu, kuvhiyiwa kwemazino akaiswa mudumbu, uye kugadziriswa kwenyama yakapfava mumuromo.
Zvinorambidzwa
Zvinorambidzwa kushandisa mushonga unonyaradza marwadzo munharaunda zvinoenderana nenhoroondo yemurwere uye rudzi rwemushonga unonyaradza marwadzo waakasarudza. Zvimwe zvinorambidzwa zvinosanganisira:
– Kurwara nemishonga inorwisa marwadzo yemunzvimbo: Varwere vane nhoroondo yekurwara nemimwe mishonga inorwisa marwadzo, yakadai se lidocaine kana articaine, vanofanira kudzivisa kushandisa mishonga iyi inorwisa marwadzo.
– Chirwere chemuviri: Varwere vane chirwere chemwoyo, BP, kana matambudziko ethyroid vanofanira kungwarira pavanoshandisa mishonga inonyaradza marwadzo ine epinephrine.
– Methemoglobinemia: Dambudziko iri rinogona kuitika nekushandisa prilocaine nedzimwe mhando dzakasiyana dzemishonga inopedza marwadzo, saka varwere vane nhoroondo yemethemoglobinemia vanofanira kudzivisa kushandisa mushonga uyu unopedza marwadzo.
Zvinhu Zvinofanira Kufungwa Nazvo Pakusarudza Anesthesia Yemunharaunda
Kushanda uye Kukurumidza kweOnset
Kusarudzwa kwemushonga unonyaradza marwadzo munharaunda kunowanzoenderana nekumhanya kwawo uye nguva yekushanda kwawo. Semuenzaniso, pakuvhiyiwa kwemuromo kuri nyore uye nekukurumidza, lidocaine kana mepivacaine zvinogona kukwana. Zvisinei, kune mamwe maitiro akaomarara uye akareba, articaine kana bupivacaine zvinogona kunge zvakakodzera nekuda kwenguva refu yemushonga unonyaradza marwadzo.
Mbiri Yekuchengetedza
Kuchengetedzeka kwemurwere kunonyanya kukosheswa. Kune varwere vane nhoroondo yekusawirirana nemishonga inonyaradza marwadzo kana mamiriro ehutano anokanganisa mashandiro emushonga uye kubuda kwawo, sarudzo yemishonga inonyaradza marwadzo inofanira kuitwa nekungwarira. Semuenzaniso, mepivacaine inowanzo kurudzirwa kune varwere vane chirwere chemwoyo nekuti haina epinephrine.
Nguva Yekuita Uye Kudzora Marwadzo Mushure mekuvhiyiwa
Mukuvhiyiwa kwemuromo, nguva yekuvhiyiwa kwemuromo kwakakosha kuti pave nechokwadi chekuti kuvhiyiwa kwacho kwakanyatsonaka pasina marwadzo. Uyezve, kudzora marwadzo mushure mekuvhiyiwa kwakakoshawo. Bupivacaine isarudzo yakanaka kune nzira dzinoda kudzora marwadzo kwenguva refu mushure mekuvhiyiwa.
Kuwanikwa uye Ruzivo rweKliniki
Kuwanikwa kwemishonga inonyaradza marwadzo munharaunda pakiriniki uye ruzivo rwechiremba rune chekuitawo nesarudzo yemishonga inonyaradza marwadzo. Mimwe mishonga inonyaradza marwadzo munharaunda ingasawanikwa mumakiriniki ese, kana kuti chiremba anogona kunge aine ruzivo rwakakura nemarudzi akasiyana emishonga inonyaradza marwadzo saka achivimba nekushandiswa kwayo.
Mhedziso
Kurapa kwemushonga wemumuromo kunoita basa guru mukuvhiyiwa kwemuromo, zvichipa nyaradzo nekuderedza marwadzo panguva yekuvhiyiwa. Nekushandisa nzira dzakasiyana-siyana dzekurapa kwemumuromo, dzinosanganisira lidocaine, articaine, mepivacaine, bupivacaine, uye prilocaine, vanachiremba vemazino vanogona kugadzirisa mushonga wemushonga wemumuromo kuti ukwane nezvinodiwa nemurwere wega wega. Zvinhu zvakaita sekumhanya kwekutanga, nguva yekushanda, kuchengetedzeka, uye mamiriro emurwere zvinofanirwa kutariswa zvakakwana kuti pave nechokwadi chekuti mushonga wemushonga wakasarudzwa zvakanaka.
Mumamiriro ezvinhu akaoma ekurapa, kubvunzana nachiremba weanesthesia kana mumwe nyanzvi yezvehutano kungave kwakakosha kuti vaone nzira yakanakisisa yeanesthesia. Nekusarudza kwakakodzera anesthesia yemunharaunda, kuvhiyiwa nemuromo kunogona kuitwa zvinobudirira, zvakachengeteka, uye zvakanaka kumurwere.
