Ko Opioids Inonyatsodiwa Mushure meC-Chikamu?

Zvemukati

• Ongororo ye

Nyika yevashandi nekutakura iri kuchinja, nekukurumidza. Kwete chete kuti masayendisiti akawana nzira yekumhanyisa basa, asi vakadzi vari kusarudzawo nzira dzakanaka dzeC-chikamu. Kunyange C-zvikamu zvisati zvichikurudzirwa neWorld Health Organisation kunze kwekunge zvaonekwa sezvakakodzera pakurapa, dzimwe nguva ivo vari zvakafanira. Uye kufambiswa kwesainzi kwazvino kunogona kuita kuti maitiro ekudzosa akurumidze, asarwadza, uye asanyanya kupindwa muropa.

Ehe, C-zvikamu pachavo haisi kupindwa muropa, asi mishonga inowanzoshandiswa mukugadzirisa-opioid sePercocet kana Vicodin-iri. Uye mushumo mutsva kubva kuQuintilesIMS Institute yakawana kuti 9 mu10 kuvhiya varwere vanogamuchira opioid RXs yekugadzirisa kurwadziwa kwepashure. Vanopihwa avhareji yemapiritsi makumi masere nemapfumbamwe-nhamba inogona kunge yakanyanya kukwirisa, sezvo mushumo wakaona zvakare kuti kunyanyisa opioid mushure mekuvhiyiwa kwakakonzera mapiritsi 3.3 mabhiriyoni asina kushandiswa muna2016 chete.

Chidzidzo chitsva chakaburitswa muna Obstetrics & Gynecology inotsigira izvo zvevakadzi vachipora kubva kuC-zvikamu. Mushure mekuongorora varwere zana nemakumi manomwe nenomwe, vakaona kuti nepo makumi mapfumbamwe neshanu muzana vaishandisa maopioid paavhareji yemazuva masere mushure mekubuda, makumi manomwe neshanu muzana vaive vachiri nemapiritsi asina kushandiswa. Izvi zvinonyanya kutyisa kuvakadzi, sezvo QuintilesIMS chirevo chakawana vakadzi vaive makumi mana muzana vangangoita vashandisi veopioid vanopfuurira mushure mekuratidzwa.

Nekudaro, kana vakadzi vari mukana wekupindwa muropa nemaopioid, mumwe mubvunzo unomuka: Pane nzira here yekumira kuvimba navo pavanenge vachipora kubva kuC-chikamu? Mumwe chiremba-Richard Chudacoff, MD, chiremba-gyn muDumas, TX-anofunga kuti mhinduro inonzwika. Ehe.

Dr. Chudacoff anoti anga achishandisa mamwe maitiro ekugadzirisa marwadzo kwemakumi emakore apfuura, sezvaakaona varwere vanodzika pasi vanogona kuzviwana ivo pachavo pavanotora opioid. "Zvinoshamisa maitiro echando avanogona kuve nawo," anotsanangura. "Opioid haibvisi marwadzo, inongoita kuti usava nehanya kuti marwadzo aripo, zvinoreva kuti hauna hanya nezvezvimwe zvose." Asi kana iwe ukabvisa maopioid kubva kuiyo equation, Dr. Chudacoff anoti varwere vanonzwa kujekeserwa kwepfungwa mushure mekusununguka.

Pamusoro pazvo, Dr. Chudacoff anofungidzira kuti vazhinji veavo vane opioid kana heroin kupindwa muropa vakatanga nekutora mapiritsi emarwadzo, zvichida mushure mekuvhiyiwa seC-section, nokuti kazhinji kacho munhu anotanga kutarisana navo. "Iwe enda kumba nebhodhoro remapiritsi uye zviri nyore kuashandisa kuti akubatsire kurara, kufamba, uye kuita kuti unzwe zviri nani kana iwe wakaora mwoyo zvishoma." (Kuora mwoyo kwePostpartum kwakajairika kupfuura iwe unofunga.)

Zvakadaro, C-zvikamu a zvikuru kuvhiyiwa kukuru uye iwe uchazoda zororo rekurwadziwa kana iwe uchida imwe. (Verenga zvakawanda paParents.com: Nyanzvi Dzinoyera Zvakanakira Nezvakaipira Kutora Opioid Mushure meC-Chikamu) Uye kutaura zvakanaka, vakadzi vazhinji vanotora marwadzo ekurwadziwa kwenguva pfupi pasina nyaya. Kushandisa kusingaperi ndiko kwaunotanga kupinda mumatambudziko-asi matambudziko aya akakura. ICentre for Disease Control and Prevention (CDC) yakawana kuti kudarika kwakawanda kubva kunyorero opioid kwakapetwa katatu kubva 1999, kuverengerwa kufa kwevanhu vanosvika zviuru gumi neshanu muna2015.

Chinokosha ndechekuongorora zvaunogona kusarudza nachiremba wako pamberi. Seimwe nzira, Dr. Chudacoff anga achishandisa Exparel, jekiseni risingaite opioid iro rinoitiswa panguva yekuvhiyiwa uye zvishoma nezvishoma rinobvisa marwadzo pamusoro pemaawa makumi manomwe nemaviri. Akadzidza nezve iyo anesthetic apo shamwari yake yepedyo, maneja maneja wenzvimbo yekuvhiya, akamuudza nezvayo ichishandiswa nevarairidzi vane mavara machena vaibata varwere vehemorrhoid, pamwe navanachiremba vachivhiya mabvi. Varwere vairondedzera kusava nemarwadzo kwemazuva anopfuura mana, saka Dr. Chudacoff akaita tsvakurudzo yakawedzerwa kuti aone kana inogona kushanda muC-sections uye hysterectomy.

Pakupedzisira, akaita yake yekutanga opioid-yemahara C-chikamu uye anoti murwere haana kumbobvira ada mushonga wepashure. Zvakafanana zvinoenda kune yega yega yaakaitwa kubvira. "Handina kunyora zvirevo zveopioid postoperative mumwedzi mitatu," anodaro, achitsanangura kuti maitiro ake ekuchengeta anotsiva acetaminophen (Tylenol) kana ibuprofen (Motrin) kuita "pre-kurapa kurwadziwa nenzira isiri-opioid; kubvisa njodzi yekupindwa muropa. "

Pamusoro pazvo, Dr. Chudacoff anoti varwere vake veExparel, paavhareji, vabuda pamubhedha uye vachifamba mukati memaawa matatu ekuvhiyiwa, uye "99 muzana vakafamba, kuita weti, uye kudya mukati memaawa matanhatu. 1.2 mazuva." Sangano reAmerican Congress of Obstetricians and Gynecologists (ACOG) rinoti avhareji yekugara muchipatara kweC-chikamu mazuva maviri kusvika mana, saka iwo musiyano mukuru.

Kunyangwe izvi zvichinzwika semhinduro kumunamato wese wemukadzi unoshanda unorwadza, mushonga hauuye usina mapako. Kutanga, inodhura. Dr. Chudacoff vanoti chipatara chaanoshandira parizvino chinobhadharira mutengo wemushonga wevarwere, asi handizvo zvinoenderana neprotocol, uye mutengo wakazara wemakumi maviri-mL guchu reExparel angangoita mazana maviri nemakumi maviri nemashanu emadhora. "Izvi ndezvechangobva kuitika zvemushonga, zvirinani kuC-zvikamu, zvekuti vazhinji vema-gyns havatozvizive," anodaro. Izvo zvakare hazvina kuvharwa neinishuwarenzi, anowedzera, ndosaka achikurudzira kutarisa nechipatara chekwako nezve mamwe mari dzekurapa dzaungave nehanya nazvo usati wasaina pamutsetse une doti.

Mutengo hausi iwo wega unetseke, zvakadaro. Zvidzidzo zviviri zvakawana kuti mushonga uyu wakanga usisashande mukubvisa marwadzo ekuvhiyiwa kwebvi pane bupivacaine, jekiseni remuzongoza rave riri mwero wekutarisira kuvhiyiwa kwakasiyana-siyana, kusanganisira C-sections. Asi hazvireve kuti hazvishande mukuderedza kushandiswa kweopioid. Vatsvakurudzi pavakapa Exparel kumabvi kuvhiya varwere-panzvimbo yeiyo bupivacaine-yakazara opioid yekushandisa yakaderera ne78 muzana mumaawa 72 ekutanga mushure mekuvhiyiwa, iine gumi muzana yasara opioid-isina, sekureva kwakaburitswa Zvinyorwa zveArthroplasty. Izvo zvine musoro kufunga kuti Exparel inotora angangoita maawa makumi matanhatu.

“Uku ndiko kutanga kwebudiriro huru,” anodaro. "Kana iwe uchifunga kuti C-zvikamu ndeimwe yemaitiro akajairika muUnited States, pamamirioni 1,2 pagore, zvinoreva kuti unogona kudonhedza huwandu hwezvinyorwa zveopioid neinopfuura miriyoni gore rega, izvo zvingave zvakakura pakurwisa denda ratiri parizvino. "

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