Yini i-Dexmedetomidine: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Dexmedetomidine iyimithi ekhethekile yokuthulisa odokotela abayisebenzisayo ezibhedlela ukusiza iziguli ukuba zizizwe zizolile futhi ziphumulele ngesikhathi sokuhlinzwa noma ngesikhathi zisebenzisa imishini yokuphefumula. Le mithi isebenza ngendlela ehlukile kunezinye izidakamizwa eziningi ngoba ingakugcina ukhululekile ngenkathi usakwazi ukuphendula uma kudingeka.

Ngokuvamile uzohlangana nale mithi eminyangweni yokunakekelwa okukhulu, emagumbini okuhlinzela, noma ngesikhathi sokuhlinzwa okuthile lapho ukuthulisa okulawulwayo kubalulekile. Ukuqonda ukuthi isebenza kanjani nokuthi yini ongayilindela kungasiza ukunciphisa noma yikuphi ukukhathazeka ongase ube nakho mayelana nokuthola lokhu kwelashwa.

Yini i-Dexmedetomidine?

I-Dexmedetomidine iyimithi kadokotela eyingxenye yeqembu lezidakamizwa ezibizwa ngokuthi ama-alpha-2 agonists. Inikezwa ngomugqa we-IV (intravenous) ngqo egazini lakho, okuvumela odokotela ukuthi balawule imiphumela ngokuqondile.

Le mithi ihluke kakhulu ezidakamizweni zendabuko ngoba ikhiqiza lokho odokotela abakubiza ngokuthi

E-ICU, lo muthi usiza iziguli ezidinga ukungeniswa komoya ngomshini kodwa ezingadingi ukuqwashiswa okujulile. Ungase uwuthole uma usululama emsebenzini wokuhlinzwa, ubhekene nokugula okukhulu, noma udinga ukusekelwa kokuphefumula ngenkathi umzimba wakho ululama.

Ngesikhathi sokuhlinzwa kwezokwelapha, i-dexmedetomidine ingakusiza ukuthi uhlale ukhululekile futhi ungenabo ubuhlungu ngenkathi ikuvumela ukuthi ulandele imiyalelo elula. Lokhu kuwusizo ikakhulukazi ezinqubweni lapho ukubambisana kwakho kungase kudingeke, njengezinhlobo ezithile zokuhlinzwa noma izivivinyo zokuxilonga.

Abanye odokotela bayayisebenzisa futhi ezigulini ezinobunzima bokukhathazeka noma ukucasuka endaweni yasesibhedlela. Kungasiza ekudaleni indawo yokuphulukisa enethezekile ngenkathi kugcinwa ikhono lakho lokuxhumana nethimba lakho lokunakekelwa kwezempilo.

Isebenza Kanjani I-Dexmedetomidine?

I-Dexmedetomidine isebenza ngokukhomba izamukeli ezithile ebuchosheni bakho ezibizwa ngokuthi ama-alpha-2 adrenergic receptors. Uma ibopha kula ma-receptor, inciphisa umsebenzi wesimiso sakho sezinzwa ngendlela elawulwa kakhulu.

Cabanga ngayo njengokwehlisa kancane ivolumu ohlelweni lokuqwashisa lobuchopho bakho. Ngokungafani nemithi ethile enamandla yokuthulisa engashintsha ngempela “icime” ukuqwashisa, i-dexmedetomidine idala isimo esifana nokulala kwemvelo lapho usengavuselelwa uma kudingeka.

Lo muthi ubhekwa njengomuthi wokuthulisa onamandla aphakathi nendawo. Unamandla kunemithi yokukhathazeka emnene kodwa ithambile kune-anesthesia ejwayelekile. Inzuzo eyingqayizivele ukuthi ayicindezeli ukushayela kwakho ukuphefumula njengoba kwenza eminye imithi yokuthulisa.

Imiphumela ngokuvamile iqala kungakapheli imizuzu engu-15 ngemuva kokuqala ukumnika nge-IV, futhi umuthi ungalungiswa ngokuqhubekayo ukuze kugcinwe izinga elifanele lokuthulisa izidingo zakho ezithile.

Kufanele Ngiyithathe Kanjani I-Dexmedetomidine?

Awuvele "uthatha" i-dexmedetomidine ngokwakho - ihlala inikezwa ochwepheshe bezokwelapha abaqeqeshiwe ngomugqa we-IV endaweni yasesibhedlela. Umuthi uza njengesixazululo esicacile esixutshwe nezinye iziphuzo ze-IV futhi zilethwa ngepompo yokufaka elawulwayo.

Ngaphambi kokuthola umuthi, ithimba lakho lezokwelapha lizofaka i-IV catheter engalweni yakho noma esandleni sakho. Bazoxhuma lokhu epompini ekhethekile eletha umuthi ngesilinganiso esiqondile, esilawulwayo kuyo yonke imithi yakho.

Akudingeki ukuthi udle noma uphuze noma yini ekhethekile ngaphambi kokuthola i-dexmedetomidine, nakuba udokotela wakho angase akucele ukuthi ugweme ukudla isikhathi esithile kuye ngendlela yakho noma isimo sakho. Ithimba lezokwelapha lizosingatha zonke izici zobuchwepheshe zokuphatha.

Kuyo yonke imithi yakho, abahlengikazi nodokotela bazobheka izimpawu zakho ezibalulekile ngokuqhubekayo. Bangashintsha umthamo phezulu noma phansi ngokusekelwe endleleni ozabela ngayo nokuthi yiluphi izinga lokuthulisa okudingayo.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Dexmedetomidine?

Ubude bemithi ye-dexmedetomidine buqondene ngokuphelele nesimo sakho sezokwelapha nokuthi welashwa ngani. Abantu abaningi bayayithola izikhathi ezimfushane, ngokuvamile ezisukela emahoreni ambalwa kuya ezinsukwini eziningana.

Ngezindlela zokuhlinzwa, ungase uyithole ngesikhathi sokuhlinzwa kuphela nangesikhathi esifushane ngemva kwalokho. Kubantu abase-ICU abasebenzisa ama-ventilator, ukwelashwa kungase kuqhubeke izinsuku eziningana ngenkathi umzimba wakho uphola futhi uncishiswa kancane kancane emshinini wokuphefumula.

Ithimba lakho lezokwelapha lizohlola ngokuqhubekayo ukuthi usayidinga yini imithi. Bazobheka izinto ezinjengokuthi uzizwa kanjani, ukuthi uphefumula kahle kangakanani ngokwakho, nokuzinza kwakho konke kwezokwelapha.

Lapho sekuyisikhathi sokuyeka imithi, odokotela ngokuvamile banciphisa umthamo kancane kancane kunokuyeka kungazelelwe. Lokhu kusiza ekuvimbeleni noma yiziphi izimpawu zokuhoxisa futhi kuqinisekisa ukunethezeka kwakho ngesikhathi sokuguquka.

Ziyini Imiphumela Eceleni ye-Dexmedetomidine?

Njengayo yonke imithi, i-dexmedetomidine ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle uma isetshenziswa ngaphansi kokuqondisa okufanele kwezokwelapha. Imiphumela emibi evame kakhulu ngokuvamile ithambile futhi iyalawuleka.

Nansi imiphumela emibi ongase uyithole, iqala ngalezo ezivamile kakhulu:

• Ukwehla kwengcindezi yegazi (hypotension) - Lena imiphumela emibi evame kakhulu futhi yingakho ingcindezi yakho yegazi iqashwa ngokuqhubekayo
• Ukushaya kwenhliziyo okuhamba kancane (bradycardia) - Ukushaya kwenhliziyo yakho kungancipha, okuyilokho okulindelekile futhi okuqashwayo
• Umlomo owomile - Ungase uqaphele umlomo wakho uzizwa womile ngesikhathi sokwelashwa
• Isicanucanu - Abanye abantu bazizwa benesicanucanu esincane, ikakhulukazi lapho umuthi uqala ukusetshenziswa
• Ushukela wegazi ophansi - Amazinga akho kashukela egazini angase ehle kancane

Imiphumela emibi engavamile kodwa ebucayi ingabandakanya ubunzima bokuphefumula, ukwehla okukhulu kwengcindezi yegazi, noma izinguquko zesigqi senhliziyo. Nokho, ngenxa yokuthi usesimweni sesibhedlela esinokuqashwa okuqhubekayo, abasebenzi bezokwelapha bangakwazi ukubhekana ngokushesha nanoma yiziphi izimpawu ezikhathazayo.

Ngokuvamile, abanye abantu bangase bathole izimpawu zokuhoxiswa uma umuthi uyekiswa ngokushesha kakhulu ngemva kokusetshenziswa isikhathi eside. Yingakho odokotela ngokuvamile behlisa umthamo kancane kancane kunokuyeka ngokuphazima kweso.

Ubani Ongafanele Athole I-Dexmedetomidine?

Izimo ezithile zezokwelapha zenza i-dexmedetomidine ingaphephile noma ingafaneleki ukusetshenziswa. Odokotela bakho bazobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokunquma ukuthi lo muthi ukufanele yini.

Akufanele uthole i-dexmedetomidine uma une-heart block enzima (inkinga enkulu yesigqi senhliziyo) noma uma unokungezwani komzimba nomuthi ngokwawo. Abantu abanezinhlobo ezithile zesifo senhliziyo bangase badinge ezinye izinketho zokuthulisa.

Iziguli ezinomfutho wegazi ophansi kakhulu noma ukuhluleka kwenhliziyo okukhulu zidinga ukuqapha okwengeziwe, njengoba umuthi ungaqhubeka nokwehlisa umfutho wegazi. Uma unesifo sikashukela, ithimba lakho lezokwelapha lizobheka ushukela wakho wegazi eduze ngesikhathi sokwelashwa.

Abesifazane abakhulelwe nezingane badinga ukucatshangelwa okukhethekile, nakuba umuthi ungasetshenziswa kulaba bantu uma izinzuzo zidlula izingozi. Ithimba lakho lezokwelapha lizohlola zonke izici ngokucophelela ngaphambi kokwenza izinqumo zokwelapha.

Amagama Omkhiqizo we-Dexmedetomidine

I-Dexmedetomidine itholakala ngaphansi kwegama lomkhiqizo elithi Precedex, okuyilona okwaziwa kakhulu emitholampilo. Ungase futhi uhlangane nezinhlobo ezivamile zomuthi, oqukethe isithako esifanayo esisebenzayo.

Abakhiqizi abahlukene bangase bakhiqize izinhlobo ezivamile, kodwa zonke ziqukethe umuthi ofanayo futhi zisebenza ngendlela efanayo. Ikhemisi lesibhedlela sakho ngokuvamile lizogcina noma iyiphi inguqulo abayithandayo ngokusekelwe ekhwalithi nasekubhekeni izindleko.

Noma ngabe iyiphi inguqulo ethile yomkhiqizo noma ejwayelekile oyitholayo, umuthi uzolungiswa futhi unikezwe yizisebenzi zekhemisi nabanakekeli abaqeqeshiwe ngokulandela imithetho eqinile yokuphepha.

Ezinye izindlela ze-Dexmedetomidine

Eminye imithi eminingi ingahlinzeka ngemiphumela efanayo yokuthulisa, kuye ngezidingo zakho ezithile zezokwelapha. Ukukhethwa kwe-sedative kuncike ezintweni ezinjengenkambiso yakho, isimo sezokwelapha, nokuthi udinga isikhathi esingakanani ukuthuliswa.

Ezinye izindlela ezivamile zihlanganisa i-propofol, enikeza ukuthuliswa okujulile kodwa idinga ukuqapha okuningi, kanye ne-midazolam (i-benzodiazepine), esebenza ngendlela ehlukile kodwa engabangela ukudideka okwengeziwe ezigulini ezithile.

Ukuze uthuliswe isikhathi eside se-ICU, odokotela bangase bacabange ezinye izinketho ezinjenge-lorazepam noma ngisho nezindlela ezingezona zemithi ezihlanganiswe nokuthuliswa okulula. Ukukhetha okungcono kuncike ezimweni zakho.

Ithimba lakho lezokwelapha lizokhetha i-sedative efaneleka kakhulu ngokusekelwe ezidingweni zakho ezithile, umlando wakho wezokwelapha, kanye nohlobo lokunakekelwa olutholayo.

Ingabe i-Dexmedetomidine Ingcono Kune-Propofol?

Kokubili i-dexmedetomidine ne-propofol ziyizidakamizwa ezinhle kakhulu, kodwa zisebenza ngendlela ehlukile futhi zinezinzuzo ezihlukile ngokuya ngesimo sakho. Akukho noyedwa othi “ungcono” ngokujwayelekile - ukukhetha kuncike kulokho okudingayo ekuthuleni kwakho.

I-Dexmedetomidine inikeza inzuzo yokuthulisa ngokubambisana, okusho ukuthi usengavuka futhi uphendule uma kudingeka. Futhi ayicindezeli ukuphefumula njenge-propofol, okungabaluleka ezigulini ezithile.

I-Propofol, ngakolunye uhlangothi, inikeza ukuthulisa okujulile futhi isebenza ngokushesha. Ivame ukukhethwa ezinqubweni ezidinga ukungazi ngokuphelele noma lapho kudingeka izinguquko ezisheshayo ezingeni lokuthulisa.

Ithimba lakho lezokwelapha lizokhetha ngokusekelwe ezintweni ezinjengesimo sakho sokuphefumula, uhlobo lwenqubo, ukuthi udinga isikhathi esingakanani ukuthuliswa, kanye nesimo sakho sezokwelapha esiphelele. Zombili lezi zithako ziphephile futhi ziyasebenza uma zisetshenziswa ngendlela efanele.

Imibuzo Evame Ukubuzwa Mayelana ne-Dexmedetomidine

Q1. Ingabe i-Dexmedetomidine Iphephile Ezigulini Zenhliziyo?

I-Dexmedetomidine ingasetshenziswa ezigulini zenhliziyo, kodwa idinga ukuqapha okwengeziwe nokuqapha. Umuthi ungathinta izinga lokushaya kwenhliziyo nomfutho wegazi, ngakho isimo sakho senhliziyo sizohlolwa ngokucophelela ngaphambi kokusetshenziswa.

Ezigulini eziningi zenhliziyo, umuthi uphephile uma usetshenziswa ngaphansi kokuqondisa okufanele. Kodwa-ke, labo abanezinkinga ezithile zesigqi senhliziyo noma ukuhluleka kwenhliziyo okukhulu bangase badinge ezinye izinketho zokuthulisa.

Q2. Kufanele Ngenzeni Uma Ngithola Ngengozi I-Dexmedetomidine Eningi Kakhulu?

Akudingeki ukhathazeke ngokuthola ngengozi i-dexmedetomidine eningi kakhulu ngoba ngaso sonke isikhathi inikezwa ochwepheshe bezokwelapha abaqeqeshiwe besebenzisa amaphampu okufaka amanzi anembile. Umuthi ulawulwa futhi uqashwe ngokucophelela.

Uma kwenzeka ukuthi udlule ngemithamo eminingi, ithimba lakho lezokwelapha lingabona ngokushesha izimpawu (njengengcindezi yegazi ephansi kakhulu noma izinga lokushaya kwenhliziyo) futhi lithathe isinyathelo esifanele, okungase kuhlanganise ukuyeka umuthi nokunikeza ukunakekelwa okusekelayo.

Q3. Kufanele Ngenzeni Uma Ngeqa Umthamo We-Dexmedetomidine?

Akukho okuthi "ukuqa umthamo" nge-dexmedetomidine ngoba inikezwa njengokufakwa okuqhubekayo esibhedlela. Ithimba lakho lezokwelapha lilawula isikhathi nokulinganisa ngokuphelele.

Umuthi ugeleza ngokuqhubekayo nge-IV yakho, ngakho-ke akukho imithamo eyodwa okufanele uyikhumbule noma uyiphuthe. Uma ukufakwa kuphazamiseka nganoma yisiphi isizathu, abahlengikazi bakho bazokuqala kabusha ngokuya ngemiyalelo kadokotela wakho.

Q4. Ngingayeka Nini Ukuthatha I-Dexmedetomidine?

Awuthathi isinqumo sokuyeka i-dexmedetomidine ngokwakho - ithimba lakho lezokwelapha lizinqumela ukuthi kungcono nini ukuyeka umuthi ngokusekelwe ekuqhubekeleni phambili kwakho kwezokwelapha nezidingo zakho.

Ngokuvamile, umuthi uyekwa lapho ungasadingi ukuthuliswa, lapho usulungele ukuphefumula ngokwakho, noma lapho inqubo yakho yezokwelapha isiqediwe. Isikhathi sincike ngokuphelele esimweni sakho sezokwelapha.

Q5. Ngizokhumbula Yini Ngesikhathi Ngise-Dexmedetomidine?

Abantu abaningi banenkumbulo elinganiselwe yesikhathi sabo be-dexmedetomidine, nakuba lokhu kuhluka kumuntu nomuntu. Ungase ukhumbule ukuxhumana okuthile nethimba lakho lezokwelapha, ikakhulukazi lapho likuvusa ngokuqondile ukukuhlola.

Lo mphumela wenkumbulo engaphelele uvame ukubhekwa njengenzuzo, njengoba kusho ukuthi awuphumuli ngokuphelele kodwa futhi akunakwenzeka ukuthi ukhumbule izinqubo zezokwelapha ezingase zibe nengcindezi ngemininingwane.