Izinqubo Zokubulala Izinzwa Zokuhlinzwa Kwezilwane
I-Pendahuluan
I-anesthesia iyisici esibalulekile kunoma iyiphi inqubo yokuhlinzwa, hhayi kubantu kuphela kodwa nasezilwaneni. Izinqubo zokubulala izinzwa ziyadingeka ukuqinisekisa ukuhlinzwa okubushelelezi kanye nobuhlungu obuncane kanye nokucindezeleka kwesilwane. Lezi zinqubo kumele zilandelwe ngokucophelela udokotela wezilwane kanye nethimba lakhe lezokwelapha ukuqinisekisa inhlalakahle yesilwane ngesikhathi nangemva kokuhlinzwa.
Izigaba ku-Anesthesia Protocol
Izinqubo zokubulala izinzwa zingahlukaniswa ngezigaba eziningana: ukulungiswa kwangaphambi kokubulala izinzwa, ukuqaliswa, ukugcinwa, ukuqapha, kanye nokululama ngemva kokubulala izinzwa. Isigaba ngasinye sinemigomo nezinqubo ezithile.
1. Ukulungiselela Ngaphambi Kokubulala Izinzwa
Ukuhlolwa Kwezokwelapha
Ngaphambi kokunikeza i-anesthesia, udokotela wezilwane kumele enze ukuhlolwa okuphelele kwezokwelapha. Lokhu kufaka phakathi ukuhlolwa ngokomzimba, ukuqoqwa komlando wezokwelapha, kanye nokuhlolwa kwelebhu njengokuhlolwa kwegazi nomchamo, uma kudingeka. Lolu lwazi luzosiza ekunqumeni impilo yesilwane kanye nanoma yiziphi izinto ezingaba yingozi.
Ngokushesha
Izilwane eziningi zidinga ukuzila ukudla ngaphambi kokuhlinzwa ukuze kuvinjelwe ukufuthwa kwamaphaphu ngesikhathi sokuhlinzwa. Isincomo esijwayelekile ngokuvamile amahora angu-8-12 okudla okuqinile kanye namahora angu-2-4 amanzi, kodwa lokhu kungahluka kuye ngohlobo kanye nesimo sempilo yesilwane.
Ukwelapha kusengaphambili
Imithi yokwelapha ngokuvamile inikezwa ukunciphisa ukukhathazeka, ukukhiqiza ukudambisa ubuhlungu, nokunciphisa umthamo wemithi yokubulala izinzwa edingekayo. Eminye imithi evame ukusetshenziswa ifaka phakathi ama-tranquilizers afana ne-acepromazine, ama-opioid afana ne-morphine, kanye nama-anticholinergics afana ne-atropine ukunciphisa ingozi ye-bradycardia kanye nokukhishwa kokuphefumula ngokweqile.
2. Ukungeniswa kwe-Anesthesia
Ukwethulwa kwe-anesthesia yisigaba lapho isilwane sishintsha khona sisuka ekuqondeni okugcwele siye ekulahlekelweni kokuqwasha okufiswayo. Lokhu kungafezwa ngokujova ngemithambo noma ngokuphefumula.
Umjovo Wemithambo Yegazi
Indlela yokujova ngemithambo isebenzisa imithi efana ne-propofol, i-thiopental, noma i-ketamine, eqala ngokushesha. Izinzuzo zale ndlela inqubo yayo esheshayo kanye nokulula komthamo.
Ukuphefumula
Ama-anesthetics okuphefumula njenge-isoflurane noma i-sevoflurane anikezwa ngemaski noma igumbi lokungeniswa. Le ndlela ivame ukubhekwa njengephephile ezilwaneni ezisengozini enkulu ngoba ivumela ukulawula okungcono ukujula kwe-anesthesia.
3. Ukunakekelwa Kwe-Anesthesia
Ukunakekelwa kuhlose ukugcina isimo esizinzile se-anesthesia yesilwane ngesikhathi sokuhlinzwa. I-anesthesia yokuphefumula iyindlela evame kakhulu yokunakekelwa ngoba inikeza ukulawula okulula kokujula kwe-anesthesia. Umshini wokubulala izinzwa usetshenziselwa ukukala amazinga egesi aphefumulayo naphumayo kanye nokuqinisekisa ukuthi umoya ungena ngokwanele.
Imithi eyengeziwe efana nemithi yokunciphisa ubuhlungu (isib. ama-opioid) kanye nemithi yokuphumula imisipha ingadingeka kuye ngohlobo lokuhlinzwa.
4. Ukuqapha Ukubulala Izinzwa
Ukuqapha okuqhubekayo kubalulekile ekuphepheni kwesilwane ngesikhathi sokubulala izinzwa. Ezinye izimiso okufanele ziqashwe zifaka:
Izinga Lenhliziyo Nesigqi: I-heart monitor noma i-ECG ingathola i-bradycardia, i-tachycardia, noma i-arrhythmia.
Umfutho Wegazi: Kukalwa umfutho wegazi ukuqinisekisa ukugeleza kwegazi okwanele. Amadivayisi asetshenziswa kakhulu ahlanganisa i-Doppler kanye ne-oscillometric.
Ukugcwala kwe-oxygen kanye ne-CO2: I-pulse oximetry isetshenziselwa ukuqapha ukugcwala kwe-oxygen, kuyilapho i-capnography ilinganisa amazinga e-CO2 akhishwayo.
Izinga Lokushisa Lomzimba: Ukushisa komzimba ngokweqile kuyingozi enkulu ngesikhathi sokuhlinzwa, ngakho-ke ukuqapha izinga lokushisa kubalulekile futhi kuvame ukusetshenziswa izingubo zokufudumeza noma izifudumezi zoketshezi.
5. Ukululama Ngemva Kokudambisa Ubuhlungu
Ukululama yisigaba lapho isilwane sivuswa khona ngemva kokuhlinzwa. Phakathi nalesi sigaba, ukuqapha kuyaqhubeka kuze kube yilapho isilwane sesiqaphile ngokuphelele futhi sikwazi ukugcina indawo yaso yomzimba.
Ukuphathwa Kobuhlungu
Ukuphathwa kobuhlungu ngemva kokuhlinzwa kubalulekile. Imithi yokunciphisa ubuhlungu efana nama-opioid, ama-NSAID, noma imithi yokubulala izinzwa yendawo ingase inikezwe uma kudingeka.
Ukuqapha Okusheshayo
Ukuqapha ngesikhathi sokululama kubalulekile. Qinisekisa ukuthi isilwane sigcinwe endaweni ethule futhi siqashwe ngokucophelela ukuze kutholakale izinkinga ezifana nokushisa komzimba, ukucindezeleka kokuphefumula, noma ukopha ngemva kokuhlinzwa.
Izinto Ezibalulekile Ezisekelwe Ezinhlotsheni
Izinhlobo ezahlukene zezilwane zinezidingo ezahlukene uma kukhulunywa nge-anesthesia. Nazi ezinye izinto ezibalulekile okufanele uzicabangele ngezinhlobo ezahlukene zezilwane:
Izinja namakati
Izinja namakati yizilwane ezivame ukudanjiswa i-anesthesia emitholampilo yezilwane. Ukusetshenziswa kwemithi yokudambisa ubuhlungu kanye nemithi yokunciphisa ubuhlungu kuvame ukufana nalokho okusetshenziswa kubantu. Kodwa-ke, kuneminye imehluko, njengokusetshenziswa okuvamile kwe-acepromazine ezinjeni ukuze kusetshenziswe imithi yangaphambi kwesikhathi.
Izilwane Ezingavamile
Ezilwaneni ezingavamile njengonogwaja, izingulube ze-Guinea, noma izilwane ezihuquzelayo, kufanele kuqashelwe ngokukhethekile ngenxa yokwehluka kwazo ngokomzimba nangokomzimba. Isibonelo, onogwaja basengozini enkulu yokufuthwa futhi badinga umuthi othize kusengaphambili. Ukuphefumula nge-anesthesia ngezinye izikhathi kunzima kakhulu ukunikeza lezi zilwane, futhi izindlela zokujova zivame ukuba yindlela ehlukile.
Izilwane Ezinkulu
Amahhashi nemfuyo zidinga izindlela ezikhethekile zokubulala izinzwa ezenzelwe ubukhulu bawo kanye nokusetshenziswa kwawo. Ukufakwa nokugcinwa kwawo kuyinkimbinkimbi kakhulu futhi kuvame ukuhilela inhlanganisela yemithi namasu.
Izinkinga Nokwelashwa Kwazo
Ukubulala izinzwa kwezilwane, njengokubulala izinzwa kwabantu, akunawo umthelela wezinkinga ezingase zenzeke, okuhlanganisa:
Ukuzwela ngokweqile: Ukusabela kokungezwani komzimba nemithi yokubulala izinzwa.
Ukucindezeleka Kokuphefumula: Ukwehla kwesilinganiso sokuphefumula okungenzeka ngenxa yokudlula ngokweqile imithi yokubulala izinzwa.
Ukushisa komzimba ngokweqile: Ukwehla kwezinga lokushisa komzimba kungenzeka ngenxa yemiphumela yokubulala izinzwa.
Ukuphatha lezi zinkinga kudinga ukulungiselela okuphelele okuvela eqenjini lezokwelapha. Ukuphathwa kwemithi yokwelapha, ukuphefumula ngesandla, kanye nokuqapha okujulile kuvame ukudingeka ukuze kuxazululwe lezi zimo eziphuthumayo.
Isiphetho
Izindlela zokubulala izinzwa zokuhlinzwa kwezilwane ziyizinqubo eziyinkimbinkimbi ezidinga ukunakwa ngokucophelela kuzo zonke izigaba, kusukela ekulungiseleleni ngaphambi kokuhlinzwa kuya ekululameni ngemva kokuhlinzwa. Ukuphepha kwezilwane kanye nenhlalakahle kumele kube yinto eza kuqala kunoma iyiphi inqubo yokubulala izinzwa. Ngokunakwa okufanele kanye nezinqubo ezifanele, ingozi yezinkinga ingancishiswa futhi ukuhlinzwa kungaphumelela.
