I-Sevoflurane iyisibulala-zinzwa esihogelayo esisetshenziswa kakhulu esaziwa ngokuqala kwayo ngokushesha kanye nokwehla, okuyenza ibe yinto ethandwayo ezilungiselelweni zezokwelapha ezihlukahlukene. Kodwa-ke, njenganoma yikuphi ukungenelela kwezokwelapha, ukuphathwa kwe-sevoflurane kudinga ukucatshangelwa ngokucophelela kwezinyathelo zokuphepha ukuze kuqinisekiswe ukuphepha kwesiguli kanye nokwandisa izinzuzo zokwelapha ze-anesthetic. Ake sihlole izindlela zokuphepha ezibalulekile ezihlobene nokusetshenziswa kwe-sevoflurane.
Umlando Wesiguli kanye Nezimo Zangaphambili
1. Umlando Wezempilo:
Ngaphambi kokuphatha i-sevoflurane, ukubuyekezwa okuphelele komlando wezokwelapha wesiguli kubalulekile. Ukunakekelwa okukhethekile kufanele kunikezwe kunoma yimuphi umlando wokungezwani komzimba, izimo zokuphefumula, ukuphazamiseka kwesibindi noma izinso, kanye nezinkinga zenhliziyo nemithambo yegazi. Ukuqonda isimo sempilo yesiguli kubalulekile ekunqumeni umthamo ofanele kanye nokuqapha ngesikhathi sokuphatha.
2. Ukukhulelwa Nokuncelisa:
Ukuqapha kuyelulekwa lapho kucatshangelwa ukusetshenziswa kwe-sevoflurane kubantu abakhulelwe noma abancelisayo. Nakuba kunobufakazi obulinganiselwe bemiphumela emibi, ukubonisana nomhlinzeki wezokunakekelwa kwempilo kuyadingeka ukuze kukalwe izingozi ezingase zibe khona kanye nezinzuzo, kuqinisekiswe inhlalakahle yabo bobabili umama kanye nengane engakazalwa noma esancela.
Ukucatshangelwa Kokuphefumula
1. Umsebenzi Wokuphefumula:
Ukuqapha umsebenzi wokuphefumula kubalulekile ngesikhathi sokuphathwa kwe-sevoflurane. Iziguli ezinezimo zokuphefumula esezivele zikhona ngaphambili, njengesifuba somoya noma isifo esingamahlalakhona sokuphefumula kwamaphaphu (COPD), zingase zibe lula kakhulu ekucindezelekeni kokuphefumula. I-titration ngokucophelela ye-anesthetic nokuqapha njalo amazinga okugcwala komoyampilo kubalulekile ezimweni ezinjalo.
2. Ukuphathwa Kwendiza:
Ukuphathwa komzila womoya ngendlela efanele kubalulekile ukuze kuvinjelwe izinkinga ngesikhathi sokuphathwa kwe-sevoflurane. Lokhu kuhlanganisa nokuqinisekisa ukutholakala kwemishini efanele yokufaka intubation kanye nokukhipha umoya, ikakhulukazi ezigulini ezinezinselele ezingase zibe khona zomoya. I-preoxygenation eyanele iyanconywa ukuze kuthuthukiswe izindawo zokugcina umoya-mpilo uma kwenzeka kuba nokucindezeleka kokuphefumula.
Izinyathelo Zokuqapha Zenhliziyo
1. Ukuqapha I-Hemodynamic:
Ukuqapha okuqhubekayo kwemingcele yenhliziyo kubalulekile ngesikhathi i-sevoflurane izinzwa. Iziguli ezinezimo zenhliziyo nemithambo yegazi noma lezo ezisengozini yokuntengantenga kwe-hemodynamic zidinga ukubhekwa ngokuqapha. Umthelela wokubulala izinzwa kumfutho wegazi nezinga lokushaya kwenhliziyo kufanele ulandelelwe eduze ukuze kubhekwane nanoma yikuphi ukuguquguquka ngokushesha.
2. Ingozi ye-Arrhythmia:
Iziguli ezinomlando we-arrhythmias yenhliziyo zingase zibe lula emiphumeleni ye-arrhythmogenic ye-sevoflurane. Ukuqapha okuseduze kanye nokuba khona kwemithi elwa nokuvuvukala kanye nemishini ye-defibrillation kuyanconywa ezimweni ezinjalo.
Ukusebenzisana Kwezidakamizwa
Kumelwe kucatshangelwe ngokucophelela ukusebenzisana kwezidakamizwa okungenzeka lapho kunikezwa i-sevoflurane. Imithi ethile, efana ne-beta-blockers kanye ne-calcium channel blockers, ingaba nomthelela emiphumeleni yenhliziyo nemithambo ye-sevoflurane. Ukubuyekezwa okuphelele kohlobo lwemithi yesiguli kubalulekile ukuze kuhlonzwe ukusebenzelana okungase kube khona.
Ukuchayeka emsebenzini
Ukuchayeka emsebenzini ku-sevoflurane ukukhathazeka kwabasebenzi bezokunakekelwa kwempilo ababambe iqhaza ekuphathweni kwemithi ebulala izinzwa. Ukungena komoya owanele kanye nokusetshenziswa kwezinhlelo zokukhipha isisu kuyanconywa ukuze kuncishiswe ubungozi bokuchayeka. Abahlinzeki bezempilo kufanele balandele imihlahlandlela yokuphepha emisiwe ukuze bazivikele emiphumeleni engaba khona yokuchayeka isikhathi eside.
Isiphetho
Sengiphetha, nakuba i-sevoflurane iyithuluzi elibalulekile ku-anesthesia, ukuphathwa kwayo okuphephile kudinga ukuqonda okuphelele kwezinyathelo zokuphepha ezihambisanayo. Umlando wesiguli, ukucatshangelwa kokuphefumula kanye nenhliziyo, ukusebenzisana kwezidakamizwa, nezinyathelo zokuphepha emsebenzini konke kudlala indima ebalulekile ekuqinisekiseni umphumela omuhle. Abahlinzeki bezempilo kufanele baqaphele, baqaphe ngokucophelela iziguli, futhi balungele ukubhekana nanoma yiziphi izinselele ezingase ziphakame ngesikhathi sokuphathwa kwe-sevoflurane.
Uma uneminye imibuzo mayelana nezinyathelo zokuphepha ze-sevoflurane noma unentshisekelo yokuthola lesi sibulala-zinzwa, sicela ungangabazi Xhumana nathi. Njengomphakeli owethembekile, sizinikele ekuhlinzekeni ochwepheshe bezokunakekelwa kwempilo ngemithi yekhwalithi ephezulu kanye nokuqinisekisa ukusetshenziswa okuphephile nokusebenzayo kwemikhiqizo yezokwelapha.
Isikhathi sokuthumela: Jan-29-2024