Yini Okufanele Icatshangelwe Lapho I-Anesthetizing Cats?

Amakati ahluke ezinjeni ngezindlela eziningi, hhayi nje ngoba awahambi ngenjabulo ehhovisi likadokotela eduze kwamakhosi azo. Kukhona umehluko we-anatomical kanye ne-physiological: uma kuqhathaniswa nezinja, amakati anevolumu encane yamaphaphu kanye nevolumu encane yegazi mayelana nesisindo somzimba. Ingaphezulu lomzimba, ngakolunye uhlangothi, likhulu uma liqhathaniswa, ngakho izinga lokushisa lingehla ngokushesha.

Ngokwezibalo, iziguli zekati ngeshwa zinengozi enkulu yokubulala izinzwa kuneziguli zezinja. Lokhu kuyiqiniso ikakhulukazi kumakati agulayo. Iyiphi indlela engcono yokubhekana nalokhu? Ngakho-ke kufanele yini singazibulalisi iziguli zethu zekati futhi z. B. ukwenza ngaphandle kokukhipha amazinyo abuhlungu? Cha! Kunalokho, kufanele siqaphe ngokukhethekile futhi sihlakaniphe futhi singasebenzisa obunye ubuchwepheshe kule njongo.

Ukuhlukaniswa ngezigaba kwaso sonke isiguli esibulala izinzwa kulokho okubizwa nge-ASA classification (bona i-PDF) kuyingxenye yawo wonke umthetho wokubulala izinzwa.

Emakatini ngokuyinhloko kunezici eziyingozi ezilandelayo - okungukuthi, lezi ziguli zinengozi eyengeziwe yokufa:

• impilo ebuthaka (ukuhlukaniswa kwe-ASA, izifo ezihambisanayo)
• ukwandisa iminyaka (bona i-PDF)
• Isisindo ngokweqile (underweight/overweight)
• ukuphuthuma okuphezulu kanye nezinga eliphezulu lobunzima besilinganiso esenziwe

Izifo ezibaluleke kakhulu ezingapheli emakati mayelana ne-anesthesia nazo zivame kakhulu:

• Isifo se-thyroid (cishe njalo i-hyperthyroidism / i-overactive kumakati)
• umfutho wegazi ophezulu/umfutho wegazi ophezulu
• Isifo sezinso (ukwehluleka kwezinso okungapheli)

Kodwa-ke, izifo zokuphefumula (isib. isifuba somoya wezilwane), izifo zesibindi, izifo zemizwa, izifo zegazi, ukungasebenzi kahle kwe-electrolyte, nezifo ezithathelwanayo nazo zinendima ekubulaweni kwezinzwa.

Okulandelayo kuyasebenza ku yonke iminyaka amaqembu: ukuncishiswa kwengcindezi futhi ukulawula kwezinga lokushisa zibaluleke kakhulu ekunciphiseni ubungozi.

Qoqa ulwazi oluningi ngangokunokwenzeka: Umlando wezokwelapha ubaluleke kakhulu ezigulini zekati. Lezi zici ezilandelayo zobungozi zingabuzwa kafushane ngocingo: iminyaka, uhlanga, izifo ezaziwayo, imithi, izinguquko ekomeni/ekuthandeni ukudla, kanye nokubhekwa okukhethekile. Lokhu akuthathi indawo yengxoxo ye-anamnesis noma ukuhlolwa ngudokotela wezilwane ngesikhathi sokuqokwa kokuqala nangosuku lokuhlinza, kodwa kusiza kakhulu ngokuhlela. Ngaphezu kwalokho, abanikazi sebevele baziswe ngezici ezibalulekile.

Ukuhlolwa kokuqala nokubonisana: Lezi zibalulekile ekuhlolweni okuphelele kwesimo sezempilo. Ngaphezu kokuhlolwa okuphelele komtholampilo, ukukala umfutho wegazi kanye nokuhlolwa kwegazi kuvame ukuboniswa. Ihlela ngokufanele isibulali-zinzwa, ukuhlolwa kokuqala (isb. ngaphambi kokubuyiselwa kwamazinyo) kufanele kwenzeke ngesikhathi esimisiwe esihlukile kusenesikhathi. Lokhu kunenzuzo kumnikazi ukuthi imibuzo ingaxoxwa ngokuthula. Ngokuvamile kudinga ukuncengwa okuthile, kodwa ngezimpikiswano ezingenhla, kungenzeka ukukholisa iningi labanikazi ukuthi ukuvakasha kokuqala kunengqondo. Izinyathelo zokuzijwayeza ezilungele ikati zibe sezithuthukisa ulwazi lomnikazi nekati.

Thatha ukucindezeleka nokukhathazeka ngokungathi sína: Ukucindezeleka nokukhathazeka kuphazamisa isimiso senhliziyo nemithambo yegazi, imiphumela yemithi yokubulala izinzwa, namasosha omzimba. Ukukhathazeka nokucindezeleka kungabangela ukwanda okukhulu komfutho wegazi. Lokhu kusho ukuthi ngisho nesiguli esiphile saka singaba nomfutho wegazi ophakeme ngokuzumayo. Ngakho-ke umgomo wethu kufanele ube yikati elikhululekile ngangokunokwenzeka. Indlela engcono kakhulu yokufeza lokhu isendaweni ezolile, engenaso ukucindezeleka kanye nezindlela zokusebenza zokuphatha kahle ikati.

Izinqubo zokuphumula nezokuvamile nazo zibalulekile ekusetshenzisweni kwangaphambili, ukufakwa kwe-anesthesia, nokulungiselela ukuhlinzwa kanye nokugcinwa kwe-anesthesia.

Izinkomba ezibaluleke kakhulu zakho kokubili ukujula kwe-anesthesia kanye nobuqotho beziguli zethu yizo imingcele ebalulekile: ukuphefumula (izinga lokuphefumula nokugcwala komoyampilo), imithambo yenhliziyo (izinga lenhliziyo, izinga lokushaya kwenhliziyo, umfutho wegazi), izinga lokushisa kanye nokukhalipha kwengqondo.

Ama-reflexes awusizo ngokuyinhloko ekuhloleni ukujula kwe-anesthesia, kuyilapho amanye amapharamitha abalulekile ekuqaphelweni kokubulala izinzwa. Ukuze sikwazi ukwenza ukuqapha okuphrofeshinali, kufanele sobabili sazi kahle amathuluzi ethu futhi sifake amanani ajwayelekile ngaphakathi: lokho okubizwa ngokuthi imingcele eqondiwe.

Izinkinga zingenzeka ngaphambi (ngaphambi kokuhlinzwa), ngesikhathi (i-perioperative) nangemuva (ngemuva kokuhlinzwa). Ungabhekana kanjani nalokhu?

Ingcindezi nokwesaba: ngokuvamile kuvame ukuholela esikhathini eside sokungeniswa futhi ngaleyo ndlela esikhathini eside sokubulala izinzwa.

Ukuphalaza: Kumelwe sikugweme ukuhlanza ngaphambi nangesikhathi sokulashwa izinzwa kanye nalokho okubizwa ngokuthi i-oesophageal reflux (ijusi lesisu lingena emphinjeni futhi lishise ulwelwesi lwamafinyila) phakathi nangemuva komuthi obulala izinzwa.

Idatha yezikhathi ezilungile zokuzila zamakati isashoda. Ubude besikhathi sokuzila buncike kakhulu ekuhlinzweni noma ekwelashweni kanye nempilo yesiguli. Amahora ayishumi nambili nangaphezulu kufanele abhekwe ngokuqinile ekuhlolweni kwegazi okuthile kanye nasekuhlinzweni komgudu wamathumbu. Kwezinye izinyathelo, izikhawu ezimfushane (amahora angu-3-4 ngemva kokudla okulula, okumanzi) zingase zanele. Ukuhlola komuntu ngamunye kufanele kwenziwe lapha. Endabeni yezilwane ezincane noma ezinesifo sikashukela, ukuphathwa kokuzila ukudla kufanele kuxoxwe nethimba.

1. Ukugcwala komoyampilo

• Hlola ukushaya kwenhliziyo, okunye ukushaya kwenhliziyo noma isignali ye-Doppler
• uma ingekho: ukuvuselelwa kwe-cardiopulmonary
• ngenisa umoya ngesandla ukuze uhlole ukugeleza komoya (imigudu yomoya evimbekile, ukwakheka kwamafinyila, ukuklayeka/ukuklayeka, ...?) - uma kubonakala, lungisa imbangela
• Hlola ukutholakala komoyampilo esigulini (ukuhlola ukuvuza)
• Hlola isihlalo senzwa

2. Ukwehla kwezinga lokushisa (hypothermia)

• Khulisa izinga lokushisa legumbi, qinisekisa ukutholakala kokushisa okusebenzayo nokuqondile kusukela ekuqaleni, kanye nezinyathelo ezengeziwe zokungenzi lutho (ingubo yokulala, amasokisi)
• Gcina isiguli somile, somile
• Ukunikezwa kwesisombululo sokumnika esifudumele
• I-Hypothermia ingase iholele ku-hyperthermia phakathi nesigaba sokuvuka, ngakho qhubeka uhlola izinga lokushisa ngemva kokuba selijwayelekile!

3. Izinga lokushaya kwenhliziyo lehla kakhulu:

• Hlola imithi (i-narcosis/premedication), kungaba umphumela omubi?
• Hlola umfutho wegazi - uma uphansi kakhulu, ukumnika/umuthi uma kunesidingo (ngokubonisana)
• I-ECG - uma ihlukile, imithi ingadingeka (ngokubonisana)
• Hlola ukujula kwe-anesthesia - yehlise uma kunesidingo
• Hlola izinga lokushisa - lifudumele

4. Umfutho wegazi uyehla (hypotension)

• Hlola ukujula kokubulala izinzwa, uma kungenzeka yehlisa izinzwa (nciphisa igesi lapho uhogela, phikisa kancane lapho ujova)
• Vumelana nodokotela ohlinzayo ukuthi ukumnika noma umuthi uyadingeka yini ukuze uzinze uhlelo lokujikeleza kwegazi.

5. Izinga lokushaya kwenhliziyo likhuphuka kakhulu: HR > 180 bpm (tachycardia)

• Hlola ukujula kwe-anesthesia
• Hlola ukulingana kweshubhu noma ukungena kwe-venous
• i-hypoxemia.
• i-hypotension
• hypovolemia/ukwethuka
• hyperthermia

6. Ukwenyuka kwezinga lokushisa lomzimba (hyperthermia)

• Ukususwa kwayo yonke imithombo yokushisa
• uphole ngenkuthalo ngamathawula amanzi, abalandeli, njll.
• kungenzeka kuvuselelwe i-sedation

1. Ukuvuka isikhathi eside/ukubambezeleka ukuvuka

• Ingabe sekudlule imizuzu engu-15-30 ngemva kokululama?
• Ingabe izinga lokushisa livamile noma lincishisiwe? (bona ngenhla)
• Ingabe yonke imithi yanikezwa
  baphikiswa? (bona i-anesthesia protocol)
• ukuphefumula

2. Ukuvuswa kwenkanuko okweqile (dysphoria)

• Ingabe ikati liyasabela futhi liyalawuleka?
• Ingabe ikati lizwa ubuhlungu?
• Ingabe ikhona i-hypoxia? (Kuyini ukugcwaliswa kwe-oxygen?)
• Yimiphi imithi eyasetshenziswa, futhi yimiphi imiphumela emibi okufanele ilindelwe?

Iziguli zethu zamakati kufanele zihlaliswe endaweni ethule, emnyama futhi nethuba lokuhlehla phakathi nesigaba sokululama kanye nokuqapha okwengeziwe. Kufanele baqhubeke nokugadwa lapho, okungenani kuze kube yilapho wonke amanani alinganisiwe esejwayelekile, okungenani amahora amathathu kuya kwamane.

Ukuthola amaphuzu obuhlungu okuvamile nakho kubaluleke kakhulu. Lokhu kufanele kwenziwe njalo ngemizuzu engama-30 bese, uma kunesidingo, kulungiswe inkomba yobuhlungu.

Izinyathelo zokuzijwayeza ezilungele ikati zithuthukisa ukuthobela komnikazi wekati. Lokhu kubonakala ikakhulukazi eqinisweni lokuthi ikati nomnikazi abacindezelekile kangako ngoba abangani abanemilenze emine bazizwa besongelwa kancane futhi abangani abanemilenze emibili bazizwa bethathwa ngokungathi sína. Inhlolovo yabanikazi ibonise ukuthi babona kahle lapho amakati abo ezizwa ekhululekile futhi ekhululekile ekusebenzeni. Lokhu kwenza umnikazi azimisele ukuletha ikati ukuze liyohlolwa kaningi futhi njalo.

Konke ukuvakasha kwezilwane kufanele kube kufushane futhi kungabi nengcindezi ngangokunokwenzeka. Lokhu vele kuqala ekhaya. Umnikazi uthola amacebiso abalulekile okuthutha okungenakucindezeleka kusenesikhathi (ngocingo noma ngesikhathi esimisiwe), aqale ngokungena ebhokisini, kuhlanganise nokuqeqeshwa kwesibhakela uma kudingekile, kuze kube yilapho efika kulowo mkhuba.

Ukuqokwa kuhlelwa ngendlela yokuthi zingabibikho izikhathi zokulinda iziguli futhi umkhuba uthule. Ngokwenza, ikati lilethwa ngqo endaweni ethule. Ama-pheromone akhethekile (ingxenye yekati ebhekene ne-pheromone F3), izindawo zokupaka eziphakanyisiwe, ukufiphala ngokuvala ibhokisi lezokuthutha, noma ukukhanya okufiphele kungasiza. Ngaphezu kwalokho, umsebenzi kufanele wenziwe ngomoya ophansi, ngesineke, futhi ngaphandle kobudlova ngaso sonke isikhathi. Umnikazi ubuye alethe nezingubo zokulala ezithokomele eziletha iphunga lalabo abangaziwa endaweni engaziwa. Ukuphatha ukudla kungathuthukisa ukwamukelwa kokudla ngemva kokubulala izinzwa futhi kusize ukucupha umgudu wamathumbu.

• Ukuphefumula: 8-20 ukuphefumula/ngomzuzu

Bala ngendlela ye-adspectorally - okungukuthi ukuphefumula okubonakalayo - futhi njalo ukuhlole kanye nokugcwala komoyampilo (ungabeki isandla sakho esifubeni sakho, lokhu kwenza ukuphefumula kube nzima!).

• Ukugcwala komoyampilo: 100%

Endabeni yokuphefumula okuzenzakalelayo, ukuguquguquka okuphezulu ebangeni lama-90-100% kufanele kubekezelelwe. Ukuqapha nge-pulse oximeter noma i-capnograph kungcono kakhulu (qiniseka ukuthi kunendawo efile encane!).

• Izinga lokushaya kwenhliziyo nekhwalithi: eqinile, evamile

Lokhu kufanele kuhlolwe ngeminwe noma ngesignali ye-Doppler.

• Umfutho wegazi (systolic)> 90 mmHG kanye

Idivayisi yokulinganisa i-Doppler ifaneleka kangcono, njengoba ikala ngokunembile futhi imvamisa yokushaya kwenhliziyo nekhwalithi nakho kungahlolwa.

• Izinga lokushisa (ububanzi obujwayelekile): 38-39 °C; ezilwaneni ezincane kufika ku-39.5 °C

Isilinganiso senziwa nge-thermometer ye-rectal noma i-temperature probe.