Izinketho Zokubulala Izinzwa Zendawo Ekuhlinzeni Komlomo
Ukuhlinzwa ngomlomo kuyigatsha lodokotela bamazinyo elihlanganisa izinqubo eziningi ezahlukene, kusukela ekukhishweni kwamazinyo kuya ekuhlinzeni okuyinkimbinkimbi njengokususwa kwama-cyst noma izimila zomlomo. I-anesthesia yendawo iyingxenye ebalulekile yokuhlinzwa ngomlomo, okuvumela iziguli ukuthi zihlale zikhululekile futhi zingenabuhlungu ngesikhathi senqubo. Kunezinketho ezahlukene ze-anesthesia yendawo ezitholakalayo, ngayinye inezinzuzo zayo kanye nokungalungi kwayo. Lesi sihloko sizoxoxa ngezinhlobo ezahlukene ze-anesthesia yendawo ezisetshenziswa ekuhlinzeni ngomlomo, ukuthi zisebenza kanjani, izinkomba zazo, iziphambeko, kanye nokucatshangelwa okukhethekile lapho ukhetha uhlobo olufanele lwe-anesthesia.
Izinhlobo ze-Anesthesia Yendawo
1. I-Lidocaine
I-Lidocaine ingenye yemithi yokubulala izinzwa yendawo esetshenziswa kakhulu ekuhlinzeni ngomlomo. I-Lidocaine isebenza ngokuvimba iziteshi ze-sodium ezingxenyeni zamaseli ezinzwa, okuvimbela izimpawu zobuhlungu ukuthi zingafiki ebuchosheni. Le ndlela yokubulala izinzwa iqala ngokushesha, cishe imizuzu emi-2-5, kanye nobude obungaba amahora angu-1-2. Ngaphezu kwalokho, i-lidocaine ivame ukuhlanganiswa ne-epinephrine ukuze kwandiswe isikhathi somphumela wokubulala izinzwa futhi kuncishiswe ukopha ngesikhathi sokuhlinzwa.
2. I-Articaine
I-Articaine, eyaziwa nangokuthi i-septocaine, iyi-anesthetic yendawo enekhono eliphezulu lokudambisa ubuhlungu. I-Articaine iqala ngokushesha kakhulu ukusebenza, cishe imizuzu eyi-1-2, kanye nobude besikhathi sokusebenza obude, obusukela emahoreni ayi-1-2,5. Enye yezinzuzo ze-articaine yikhono layo lokungena ezicutshini zethambo ngempumelelo kakhulu kunezinye izinzwa zendawo. Lokhu kwenza i-articaine ivame ukusetshenziswa ezinqubweni ezidinga i-anesthesia ejulile, njengokuhlinzwa kwezinyo lokuhlakanipha.
3. I-Mepivacaine
I-Mepivacaine ivame ukusetshenziswa ezigulini ezingakwazi ukuthola i-epinephrine ngenxa yezimo ezithile zezokwelapha, njengesifo senhliziyo. I-Mepivacaine iqala ngokushesha ukusebenza cishe imizuzu eyi-1-2 kanye nobude besikhathi sokubulala izinzwa esingaba amahora ayi-1-3. Nakuba ingasebenzi kahle njenge-articaine ekungeneni kwezicubu eziqinile, i-mepivacaine isalokhu iyisinqumo esihle ezinqubweni eziningi zokuhlinzwa ngomlomo.
4. I-Bupivacaine
I-Bupivacaine iyi-anesthetic yendawo eyaziwa ngokusebenza kwayo isikhathi eside, ehlala amahora angama-4-8. Le anesthetic ngokuvamile ayisetshenziswa njenge-anesthetic yokuqala yezinqubo ezilula zokuhlinzwa ngomlomo, njengoba i-anesthesia ende ingabangela ukungakhululeki ngemva kwenqubo. Kodwa-ke, ekuhlinzweni okudinga i-anesthesia ende noma ezigulini ezifuna ukulawula ubuhlungu ngemva kokuhlinzwa, i-bupivacaine ingaba yisinqumo esihle kakhulu.
5. I-Prilocaine
I-Prilocaine inephrofayili efanayo ne-lidocaine kodwa inamandla aphansi okuba nobuthi. Lokhu kwenza kube ukukhetha okuhle ezigulini ezingase zibe sengozini enkulu yemiphumela emibi evela emithini yokubulala izinzwa yendawo. I-Prilocaine iqala ukusebenza cishe imizuzu emi-2-4 kanye nobude besikhathi sokubulala izinzwa esingaba amahora angu-1-2.
Izinkomba kanye nokuphikisana ekusetshenzisweni kwe-Anesthesia Yendawo
Isibonakaliso
I-anesthesia yendawo isetshenziswa ezinqubweni ezahlukene zokuhlinzwa ngomlomo ukuze kuncishiswe noma kuqedwe ubuhlungu. Izinkomba zifaka phakathi ukukhishwa kwamazinyo, ukwelashwa kwama-cyst omlomo noma amathumba, ukuhlinzwa kokufakelwa kwamazinyo, kanye nokunye ukulungiswa kwezicubu ezithambile emlonyeni.
Izimo zokuphikisana
Izimo zokusetshenziswa kwe-anesthetic yendawo zincike emlandweni wezokwelapha wesiguli kanye nohlobo lwe-anesthetic olukhethiwe. Ezinye izimo ezivamile zokuphikisana zifaka:
– Ukungezwani komzimba nemithi yokubulala izinzwa yendawo: Iziguli ezinomlando wokungezwani komzimba nemithi ethile yokubulala izinzwa, njenge-lidocaine noma i-articaine, kufanele zigweme ukusebenzisa le mithi yokubulala izinzwa.
– Isifo sesistimu: Iziguli ezinesifo senhliziyo, umfutho wegazi ophakeme, noma izinkinga ze-thyroid kufanele ziqaphele lapho zisebenzisa imithi yokubulala izinzwa yendawo equkethe i-epinephrine.
– I-Methemoglobinemia: Lesi simo singase senzeke ngokusetshenziswa kwe-prilocaine nezinye izinhlobo eziningana zemithi yokubulala izinzwa, ngakho-ke iziguli ezinomlando we-methemoglobinemia kufanele zigweme ukusebenzisa le ndlela yokubulala izinzwa.
Izinto Okufanele Uzicabangele Ekukhetheni I-Anesthesia Yendawo
Ukusebenza kahle kanye nesivinini sokuqala
Ukukhetha i-anesthetic yendawo kuvame ukusekelwe esivinini sokuqala kwayo kanye nobude besenzo. Isibonelo, ngezinqubo zokuhlinzwa zomlomo ezilula nezisheshayo, i-lidocaine noma i-mepivacaine zingase zanele. Kodwa-ke, ngezinqubo eziyinkimbinkimbi nezinde, i-articaine noma i-bupivacaine zingase zifaneleke kakhulu ngenxa yesikhathi sazo eside se-anesthesia.
Iphrofayela Yokuphepha
Ukuphepha kwesiguli kuhlala kuyinto eza kuqala. Ezigulini ezinomlando wokungezwani komzimba nemithi ethile yokubulala izinzwa noma izimo zezokwelapha ezithinta ukusebenza kwemithi kanye nokukhishwa kwayo, ukukhetha imithi yokubulala izinzwa kufanele kwenziwe ngokuqapha. Isibonelo, i-mepivacaine ivame ukunconywa kakhulu ezigulini ezinesifo senhliziyo ngoba ayinayo i-epinephrine.
Ubude Benqubo kanye Nokulawulwa Kobuhlungu Ngemva Kokuhlinzwa
Ekuhlinzweni ngomlomo, isikhathi sokuhlinzwa kwe-anesthesia sibalulekile ukuqinisekisa ukuthi inqubo ihamba kahle ngaphandle kobuhlungu. Ngaphezu kwalokho, ukulawula ubuhlungu ngemva kokuhlinzwa nakho kubalulekile. I-Bupivacaine iyisinqumo esihle sezinqubo ezidinga ukulawula ubuhlungu isikhathi eside ngemva kokuhlinzwa.
Ukutholakala kanye nolwazi lwezokwelapha
Ukutholakala kwemithi yokubulala izinzwa yendawo emtholampilo kanye nolwazi lodokotela wezokwelapha nakho kuthonya ukukhetha imithi yokubulala izinzwa. Ezinye imithi yokubulala izinzwa yendawo zingase zingatholakali kuyo yonke imitholampilo, noma udokotela angase abe nolwazi oluthe xaxa ngezinhlobo ezithile zemithi yokubulala izinzwa ngakho-ke aqiniseke kakhulu ekusebenziseni kwayo.
Isiphetho
Ukubulala izinzwa kwendawo kudlala indima ebalulekile ekuhlinzeni ngomlomo, kunikeza induduzo kanye nokuqeda ubuhlungu ngesikhathi senqubo. Njengoba kunezinketho eziningi zokubulala izinzwa zendawo ezitholakalayo, okuhlanganisa i-lidocaine, i-articaine, i-mepivacaine, i-bupivacaine, kanye ne-prilocaine, odokotela bamazinyo bangakwazi ukwenza umuthi wokubulala izinzwa uvumelane nezidingo ezithile zesiguli ngasinye. Izici ezifana nesivinini sokuqala, ubude besenzo, iphrofayili yokuphepha, kanye nesimo sesiguli kumele kucatshangelwe ngokucophelela ukuqinisekisa ukukhethwa okuhle komuthi wokubulala izinzwa.
Ezimweni zezokwelapha eziyinkimbinkimbi, ukubonisana nodokotela wezinzwa noma omunye uchwepheshe wezokwelapha kungadingeka ukuze kunqunywe isu elihle kakhulu lokubulala izinzwa. Ngokukhetha okulungile kwe-anesthesia yendawo, izinqubo zokuhlinzwa ngomlomo zingenziwa ngempumelelo, ngokuphephile, nangokukhululekile kwesiguli.
