{"id":96,"date":"2023-07-29T19:56:26","date_gmt":"2023-07-29T19:56:26","guid":{"rendered":"https:\/\/painfreebirthing.com\/turk\/agri-giderme-yontemleri\/sistemik-agri-tedavisi\/"},"modified":"2023-07-29T19:56:26","modified_gmt":"2023-07-29T19:56:26","slug":"sistemik-agri-tedavisi","status":"publish","type":"page","link":"https:\/\/painfreebirthing.com\/turk\/agri-giderme-yontemleri\/sistemik-agri-tedavisi\/","title":{"rendered":"Systemic Pain Relief"},"content":{"rendered":"\n\n\n\n\n
A. Sistemik Medikasyon
Kan dola\u015f\u0131m\u0131na enjekte edilen, travay s\u0131ras\u0131nda a\u011fr\u0131y\u0131 azaltan ancak tamamen ortadan kald\u0131rmayan a\u011fr\u0131y\u0131 kontrol eden ila\u00e7lar<\/span>
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Do\u011fum a\u011fr\u0131s\u0131n\u0131 azaltmak i\u00e7in ya intraven\u00f6z, ya da intramusk\u00fcler yolla verilen ila\u00e7lard\u0131r. Bu ila\u00e7lar \u00e7o\u011funlukla obstetrisyen <\/span>tarafindan<\/span> verilir, hem\u015fireler taraf\u0131ndan uygulan\u0131r. Opioidler a\u011fr\u0131y\u0131 kontrol etmede en etkili ila\u00e7lard\u0131r. Obstetride travay ve do\u011fum a\u011fr\u0131s\u0131nda uzun tarihsel kullan\u0131mlar\u0131 vard\u0131r. G\u00fcn\u00fcm\u00fczde \u00e7ok say\u0131da narkotik bulundu\u011fu halde, do\u011fumda sadece birka\u00e7 tanesi kullan\u0131lmaktad\u0131r: meperidin (Demerol), morfin, fentanil, butorfanol (stadol) ve nalbufin ( Nubain). Bu ila\u00e7lar kan dola\u015f\u0131m\u0131na girerek travay ve do\u011fum a\u011fr\u0131s\u0131n\u0131 daha  dayan\u0131labilir hale getirirler. Genellikle normalde tam bir analjezi sa\u011flamazlar. Bu ila\u00e7larla meydana gelen a\u011fr\u0131 kontrol\u00fc de\u011fi\u015fkendir, ancak a\u011fr\u0131y\u0131 k\u00f6relterek travay\u0131n\u0131z\u0131n dayan\u0131l\u0131r hale gelmesini sa\u011flarlar. Do\u011fum i\u00e7in rejyonel anestezi tercih etmeyen kad\u0131nlar\u0131n b\u00fcy\u00fck bir k\u0131sm\u0131 bu ila\u00e7lardan birisini se\u00e7mektedir. Epidural veya spinal anestezi \u00f6ncesi bu ila\u00e7lardan yap\u0131lm\u0131\u015f olmas\u0131n\u0131n herhangi bir sak\u0131ncas\u0131 yoktur.  <\/span><\/font><\/p>\n

Obstetrisyen taraf\u0131ndan verilen ila\u00e7larla a\u011fr\u0131 yeterli miktarda kontrol alt\u0131na al\u0131namazsa, anestezi doktoru bu ila\u00e7lar\u0131 bir intraven\u00f6z inf\u00fczyon pompas\u0131yla uygulayabilir. Bu durumda, a\u011fr\u0131n\u0131z\u0131 kontrol alt\u0131na almak istedi\u011finizde, bast\u0131\u011f\u0131n\u0131zda aktif hale gelen bir d\u00fc\u011fme verilecektir. Pompa, sisteminize belli (ayarlanm\u0131\u015f) miktarda ilac\u0131 vermeye programlanm\u0131\u015ft\u0131r. Bu metoda \u201chasta kontroll\u00fc analjezi\u201d (PCA) denir. Uterus kas\u0131lmalar\u0131na ba\u011fl\u0131 a\u011fr\u0131lar\u0131 ne oranda alg\u0131lad\u0131\u011f\u0131n\u0131za ba\u011fl\u0131 olarak ihtiya\u00e7 duydu\u011funuz ila\u00e7lar \u00fczerinde kontrol\u00fcn\u00fcz olur. Anestezi doktoru ve hem\u015fireniz taraf\u0131n\u0131zdan kullan\u0131lan intraven\u00f6z ila\u00e7lar\u0131 g\u00f6r\u00fcnt\u00fcleyecektir.<\/span><\/font><\/p>\n

Bu iv ila\u00e7lar\u0131n en \u00f6nemli dezavantajlar\u0131 sersemlik ve uyku hali yaratmas\u0131d\u0131r. Ayr\u0131ca bulant\u0131, kusma, solunumda azalma, ka\u015f\u0131nt\u0131, kab\u0131zl\u0131k ve idrar retansiyonu gibi yan etkiler de g\u00f6r\u00fclebilir. Anne s\u00fct\u00fc vermeyi planl\u0131yorsan\u0131z, ba\u015flang\u0131\u00e7taki \u00e7abalar\u0131n\u0131z zorla\u015fabilir.<\/span><\/font><\/p>\n

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Bebe\u011fe etkisi<\/span><\/b><\/font><\/p>\n

Narkotiklerin bir di\u011fer yan etkisi de hepsinin plasentay\u0131 ge\u00e7ip bebe\u011fin dola\u015f\u0131m\u0131na kat\u0131lmas\u0131d\u0131r. Bunun sonucu olarak bebekte de baz\u0131 etkiler g\u00f6r\u00fclebilir. Uterus i\u00e7inde bebe\u011fin kalp k\u0131z\u0131 hafif de\u011fi\u015febilir. Bu kalp h\u0131z\u0131ndaki de\u011fi\u015fikli\u011fe ba\u011fl\u0131 bilinen ciddi bir etki yoktur.<\/span><\/font><\/p>\n

Bebe\u011fin anneden yava\u015f olmakla beraber bu ila\u00e7lar\u0131 y\u0131kma kabiliyeti vard\u0131r. Bebek do\u011fduktan sonra hafif uykulu olabilir. Tekrar belirtelim, anneye verilen d\u00fc\u015f\u00fck miktardaki ila\u00e7lar\u0131n bebe\u011fi olumsuz etkilemesi beklenmez, ancak bu ila\u00e7lar\u0131n bebe\u011fe ge\u00e7ti\u011fini bilmek \u00f6nemlidir. Bebekte anneye verilen ila\u00e7lar\u0131n etkisini g\u00f6rme \u015fans\u0131, do\u011fum zaman\u0131na g\u00f6re ila\u00e7lar\u0131n verilmesine ba\u011fl\u0131 olabilir.  Bebe\u011fin ila\u00e7lar\u0131 y\u0131kmak i\u00e7in yeterli zaman\u0131 varsa \u00e7ok az etki g\u00f6r\u00fcl\u00fcr. Pek \u00e7ok doktor anneye a\u011fr\u0131 i\u00e7in verilen narkotik ila\u00e7lar\u0131n bebek a\u00e7\u0131s\u0131ndan g\u00fcvenli oldu\u011funu d\u00fc\u015f\u00fcnmektedir.<\/span><\/font><\/p>\n

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Next: Nitrous oxide<\/span><\/a><\/span><\/font><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

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A. Sistemik MedikasyonKan dola\u015f\u0131m\u0131na enjekte edilen, travay s\u0131ras\u0131nda a\u011fr\u0131y\u0131 azaltan ancak tamamen ortadan kald\u0131rmayan a\u011fr\u0131y\u0131 kontrol eden ila\u00e7lar Do\u011fum a\u011fr\u0131s\u0131n\u0131 azaltmak i\u00e7in ya intraven\u00f6z, ya da intramusk\u00fcler yolla verilen ila\u00e7lard\u0131r. Bu ila\u00e7lar \u00e7o\u011funlukla obstetrisyen tarafindan verilir, hem\u015fireler taraf\u0131ndan uygulan\u0131r. Opioidler a\u011fr\u0131y\u0131 kontrol etmede en etkili ila\u00e7lard\u0131r. Obstetride travay ve do\u011fum a\u011fr\u0131s\u0131nda uzun tarihsel kullan\u0131mlar\u0131 vard\u0131r. G\u00fcn\u00fcm\u00fczde \u00e7ok…<\/p>\n

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