Puas yog Opioids xav tau tiag tiag tom qab C-Section?

Zoo Siab

• Tshuaj xyuas rau

Lub ntiaj teb kev ua haujlwm thiab kev xa khoom tau hloov pauv, nrawm. Tsis yog tsuas yog cov kws tshawb fawb pom txoj hauv kev kom ua haujlwm nrawm dua, tab sis cov poj niam kuj tseem xaiv rau txoj hauv kev yooj yim dua C-section. Thaum C-ntu tseem tsis tau pom zoo los ntawm World Health Organization tshwj tsis yog pom tias tsim nyog kho mob, qee zaum lawv yog tsim nyog. Thiab qhov kev tshawb fawb tshiab dhau los tuaj yeem ua rau txheej txheem rov zoo dua, tsis mob, thiab tsis quav ntsej.

Tau kawg, C-ntu lawv tus kheej tsis quav ntsej, tab sis cov tshuaj feem ntau siv hauv cov txheej txheem rov qab-opioids xws li Percocet lossis Vicodin-yog. Thiab tsab ntawv ceeb toom tshiab los ntawm QuintilesIMS lub koom haum tau pom tias 9 hauv 10 tus neeg phais phais tau txais opioid RXs los tswj kev mob tom qab phais. Lawv tau muab qhov nruab nrab ntawm 85 ntsiav tshuaj txhua-ib tus lej uas yuav siab dhau, raws li daim ntawv tshaj tawm kuj pom tias kev siv tshuaj opioids ntau dhau tom qab kev phais ua rau 3.3 billion cov tshuaj tsis siv hauv 2016 ib leeg.

Txoj kev tshawb fawb tshiab luam tawm hauv Obstetrics & Gynecology rov qab rau cov poj niam rov qab los ntawm C-section. Tom qab tshuaj xyuas 179 tus neeg mob, lawv pom tias thaum 83 feem pua ​​siv cov tshuaj opioids rau qhov nruab nrab yim hnub tom qab tso tawm, 75 feem pua ​​tseem tsis tau siv cov tshuaj. Qhov ntawd yog qhov txaus ntshai tshwj xeeb rau cov poj niam, raws li QuintilesIMS tsab ntawv ceeb toom pom tias poj niam muaj 40 feem pua ​​feem ntau yuav dhau los ua cov neeg siv opioid tsis tu ncua tom qab kis tau.

Yog li, yog tias cov poj niam feem ntau yuav muaj kev quav tshuaj opioids, ib lo lus nug tshwm sim: Puas muaj txoj hauv kev kom tsis txhob tso siab rau lawv thaum rov qab los ntawm C-section? Ib tug kws kho mob-Richard Chudacoff, MD, ob-gyn nyob rau hauv Dumas, TX-xav tias cov lus teb yog ib tug reounding yog.

Dr. Chudacoff hais tias nws tau siv lwm txoj cai tswj kev mob rau ob peb lub xyoo dhau los, raws li nws tau pom cov neeg mob qis qis tuaj yeem pom lawv tus kheej thaum noj tshuaj opioids. "Nws yog amazing snowball nyhuv lawv muaj peev xwm," nws piav qhia. "Opioids tsis tshem qhov mob, lawv tsuas yog ua rau koj tsis mob siab tias qhov mob nyob ntawd, uas txhais tau tias koj tsis quav ntsej txog txhua yam ntxiv." Tab sis yog tias koj tshem tawm cov tshuaj opioids los ntawm qhov sib npaug, Dr. Chudacoff hais tias cov neeg mob hnov ​​​​zoo dua lub hlwb tom qab yug me nyuam.

Nyob rau sab saum toj ntawm qhov ntawd, Dr. Chudacoff kwv yees tias feem ntau ntawm cov neeg uas muaj tshuaj opioid lossis tus heroin tau pib nrog kev noj tshuaj mob, zoo li tom qab phais zoo li C-section, vim nws feem ntau yog ib tus neeg thawj zaug raug rau lawv. "Koj mus tsev nrog lub raj mis ntawm cov tshuaj no thiab nws yooj yim siv lawv los pab koj tsaug zog, txav mus los, thiab ua rau koj zoo siab yog tias koj muaj kev nyuaj siab me ntsis." (Kev nyuaj siab tom qab yug me nyuam muaj ntau dua li qhov koj xav.)

Tseem, C-sections yog a heev phais loj thiab koj yuav xav kho qhov mob yog tias koj xav tau. (Nyeem ntxiv ntawm Parents.com: Cov kws tshaj lij ntsuas qhov zoo thiab qhov tsis zoo ntawm Kev Noj Tshuaj Opioids Tom Qab C-Section) Thiab kom muaj kev ncaj ncees, ntau tus poj niam noj cov tshuaj tua kab mob rau lub sijhawm luv luv yam tsis muaj teeb meem. Kev siv mus ntev yog qhov uas koj pib muaj teeb meem-tab sis cov teeb meem no yog qhov loj. Lub Chaw Tiv Thaiv thiab Tiv Thaiv Kab Mob (CDC) pom tias kev noj tshuaj ntau dhau los ntawm cov tshuaj opioids tau nce plaub npaug txij li xyoo 1999, suav txog kwv yees li 15,000 tus neeg tuag hauv 2015.

Qhov tseem ceeb yog tshuaj xyuas koj cov kev xaiv nrog koj tus kws kho mob ua ntej. Raws li lwm txoj hauv kev, Dr. Chudacoff tau siv Exparel, txhaj tshuaj tsis yog opioid uas tau siv thaum phais thiab maj mam txo qhov mob dhau 72 teev. Nws tau kawm txog cov tshuaj loog thaum nws tus phooj ywg ze, tus thawj coj ntawm lub chaw phais mob, qhia nws txog nws siv los ntawm cov kws phais neeg mob plab uas tau cuam tshuam nrog cov neeg mob hemorrhoid, nrog rau cov kws kho mob ua kev phais hauv caug. Cov neeg mob tau tshaj tawm tias tsis muaj qhov mob siab tshaj plaub hnub, yog li Dr. Chudacoff tau tshawb fawb ntxiv los saib seb nws puas tuaj yeem ua haujlwm hauv C-sections thiab hysterectomies.

Thaum kawg, nws tau ua nws thawj qhov tsis muaj opioid C-section thiab hais tias tus neeg mob tsis xav tau daim ntawv xaj phais. Tib yam mus rau txhua tus nws tau ua txij li. "Kuv tsis tau sau daim ntawv yuav tshuaj tom qab phais mob opioids hauv peb lub hlis," nws sau tseg, piav qhia tias nws tus qauv kev saib xyuas hloov pauv ntawm acetaminophen (Tylenol) lossis ibuprofen (Motrin) rau "kho mob ua ntej uas tsis yog opioid zam; tshem tawm txoj kev pheej hmoo rau kev quav yeeb quav tshuaj. "

Nyob rau sab saum toj ntawm qhov ntawd, Dr. Chudacoff hais tias nws cov neeg mob Exparel yog, qhov nruab nrab, tawm ntawm txaj thiab taug kev hauv peb teev ntawm kev phais, thiab "99 feem pua ​​​​tau taug kev, peed, thiab noj nyob rau hauv 6 teev. 1.2 hnub." American Congress of Obstetricians and Gynecologists (ACOG) hais tias qhov nruab nrab tsev kho mob nyob rau C-ntu yog ob mus rau plaub hnub, yog li ntawd qhov sib txawv tseem ceeb.

Thaum lub suab no zoo li cov lus teb rau txhua tus poj niam ua haujlwm nyuaj thov Vajtswv, cov tshuaj tsis tuaj yam tsis muaj kev ceeb toom. Ua ntej, nws kim. Dr. Chudacoff hais tias lub tsev kho mob tam sim no nws ua haujlwm ntawm tus nqi ntawm cov tshuaj rau cov neeg mob, tab sis qhov ntawd tsis yog tus qauv raws tu qauv, thiab tus nqi lag luam wholesale rau 20-mL vial ntawm Exparel yog txog $ 285. "Qhov no tsis ntev los no ntawm cov tshuaj, tsawg kawg rau C-sections, uas feem ntau ntawm ob-gyns tseem tsis paub txog nws," nws hais. Nws kuj tseem tsis tau them los ntawm kev pov hwm, nws ntxiv, uas yog vim li cas nws pom zoo tshuaj xyuas nrog koj lub tsev kho mob hauv nroog txog cov nqi kho mob ntxiv uas koj yuav tsum tau ua lub luag haujlwm ua ntej kos npe rau ntawm kab kab.

Nqe tsis yog kev txhawj xeeb nkaus xwb, txawm hais tias. Ob txoj kev tshawb nrhiav pom cov tshuaj tsis muaj txiaj ntsig zoo dua hauv kev kho mob lub hauv caug mob dua li bupivacaine, tshuaj txhaj tshuaj txha caj qaum uas tau ua tus txheej txheem saib xyuas rau ntau yam kev phais, suav nrog C-ntu. Tab sis qhov ntawd tsis txhais tau tias nws tsis muaj txiaj ntsig hauv kev txo kev siv opioid. Thaum cov kws tshawb fawb tau tswj hwm Exparel rau cov neeg mob phais hauv lub hauv caug-hloov tus qauv bupivacaine-tag nrho opioid noj tau txo los ntawm 78 feem pua ​​​​hauv thawj 72 teev tom qab kev phais, nrog 10 feem pua ​​​​ntawm cov opioid-dawb, raws li kev tshawb fawb luam tawm Phau ntawv Journal of Arthroplasty. Qhov ntawd ua rau pom kev txiav txim siab tias Exparel siv sijhawm kwv yees li 60 teev ntev dua.

Nws hais tias "Qhov no yog qhov pib ntawm qhov muaj peev xwm loj," nws hais. "Yog tias koj txiav txim siab tias C-ntu yog ib qho ntawm cov txheej txheem feem ntau nyob hauv Tebchaws Meskas, ntawm 1.2 lab ib xyoos, uas txhais tau tias koj tuaj yeem tso cov tshuaj opioid ntau dua ib lab txhua xyoo, uas yuav loj heev rau kev sib ntaus kab mob sib kis peb nyob tam sim no. "

Tshuaj xyuas rau