{"id":33626,"date":"2023-05-14T20:34:13","date_gmt":"2023-05-14T13:34:13","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=33626"},"modified":"2023-05-18T10:52:08","modified_gmt":"2023-05-18T03:52:08","slug":"dieu-tri-dau-bang-thuoc","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/14\/dieu-tri-dau-bang-thuoc\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb \u0111au b\u1eb1ng thu\u1ed1c"},"content":{"rendered":"<p><strong>\u00a0\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u1eabn m\u1eafc\u00a0 h\u1ed9i ch\u1ee9ng \u0111au vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c gi\u1ea3m \u0111au c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a b\u00e1c s\u0129 \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 c\u00e1c lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111au th\u00f4ng d\u1ee5ng v\u00e0 c\u00e1ch ch\u00fang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m \u0111au v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n<figure id=\"attachment_33644\" aria-describedby=\"caption-attachment-33644\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-33644 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/OIP-2-300x241.jpg\" alt=\"benh-nhan-dau\" width=\"300\" height=\"241\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/OIP-2-300x241.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/OIP-2.jpg 369w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-33644\" class=\"wp-caption-text\">\u1ea2nh m\u00f4 t\u1ea3 b\u1ec7nh nh\u00e2n b\u1ecb \u0111au l\u01b0ng, ngu\u1ed3n internet<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<h2><strong>1. \u0110\u1ecbnh ngh\u0129a \u0111au<\/strong><\/h2>\n<p><span style=\"font-weight: 400;\">\u0110\u1ecbnh ngh\u0129a m\u1edbi c\u1ee7a Hi\u1ec7p h\u1ed9i Qu\u1ed1c t\u1ebf\u00a0 Nghi\u00ean c\u1ee9u v\u1ec1 \u0111au (IASP) \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1 tr\u00ean t\u1ea1p ch\u00ed\u00a0 \u0111au c\u1ee7a IASP.\u00a0 \u201c\u0110au l\u00e0 m\u1ed9t tr\u1ea3i nghi\u1ec7m c\u1ea3m gi\u00e1c ho\u1eb7c c\u1ea3m x\u00fac kh\u00f3 ch\u1ecbu li\u00ean quan \u0111\u1ebfn, ho\u1eb7c t\u01b0\u01a1ng t\u1ef1 nh\u01b0 li\u00ean quan \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng m\u00f4 th\u1ef1c t\u1ebf ho\u1eb7c ti\u1ec1m \u1ea9n\u201d. \u0110i k\u00e8m v\u1edbi 6 \u0111i\u1ec3m ch\u00ednh \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh r\u00f5 h\u01a1n v\u1ec1 \u0111au.\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0\u0110au lu\u00f4n l\u00e0 m\u1ed9t tr\u1ea3i nghi\u1ec7m c\u00e1 nh\u00e2n b\u1ecb \u1ea3nh h\u01b0\u1edfng \u1edf c\u00e1c m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau b\u1edfi c\u00e1c y\u1ebfu t\u1ed1 sinh h\u1ecdc, t\u00e2m l\u00fd v\u00e0 x\u00e3 h\u1ed9i.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110au v\u00e0 c\u1ea3m th\u1ee5 \u0111au l\u00e0 hai hi\u1ec7n t\u01b0\u1ee3ng kh\u00e1c nhau. \u0110au kh\u00f4ng th\u1ec3 ch\u1ec9 \u0111\u01b0\u1ee3c suy ra t\u1eeb ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh c\u1ea3m gi\u00e1c.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Th\u00f4ng qua kinh nghi\u1ec7m s\u1ed1ng c\u1ee7a m\u00ecnh, c\u00e1c c\u00e1 nh\u00e2n h\u1ecdc \u0111\u01b0\u1ee3c kh\u00e1i ni\u1ec7m \u0111au.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0Ph\u1ea3n h\u1ed3i v\u1ec1 \u0111au c\u1ee7a m\u1ed9t ng\u01b0\u1eddi c\u1ea7n \u0111\u01b0\u1ee3c t\u00f4n tr\u1ecdng.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0M\u1eb7c d\u00f9 c\u01a1n \u0111au th\u01b0\u1eddng c\u00f3 vai tr\u00f2 th\u00edch \u1ee9ng, nh\u01b0ng n\u00f3 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng ti\u00eau c\u1ef1c \u0111\u1ebfn ch\u1ee9c n\u0103ng, s\u1ee9c kh\u1ecfe t\u00e2m l\u00fd v\u00e0 x\u00e3 h\u1ed9i.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0M\u00f4 t\u1ea3 b\u1eb1ng l\u1eddi n\u00f3i ch\u1ec9 l\u00e0 m\u1ed9t trong m\u1ed9t s\u1ed1 h\u00e0nh vi th\u1ec3 hi\u1ec7n n\u1ed7i \u0111au; kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng giao ti\u1ebfp kh\u00f4ng th\u1ec3 ph\u1ee7 nh\u1eadn con ng\u01b0\u1eddi ho\u1eb7c \u0111\u1ed9ng v\u1eadt kh\u00f4ng ph\u1ea3i con ng\u01b0\u1eddi kh\u00f4ng tr\u1ea3i qua \u0111au.<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\"><strong>2. Ph\u00e2n lo\u1ea1i h\u1ed9i ch\u1ee9ng \u0111au<\/strong>\u00a0<\/span><\/h2>\n<p><b>B\u1ed1n th\u00e0nh ph\u1ea7n c\u1ee7a \u0111au<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Th\u1ee5 th\u1ec3 \u0111au c\u1ee7a c\u00e1c s\u1ee3i A\u03b4 v\u00e0 s\u1ee3i C ph\u00e1t hi\u1ec7n s\u1ef1 h\u1ee7y ho\u1ea1i m\u00f4 (nociception)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110au (pain): do h\u1ee7y ho\u1ea1i m\u00f4; do ho\u1ea1t \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng c\u1ee7a c\u1ea5u tr\u00fac th\u1ea7n kinh ngo\u1ea1i bi\u00ean hay trung \u01b0\u01a1ng.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0S\u1ef1 \u0111au \u0111\u1edbn (suffering)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0H\u00e0nh vi c\u1ee7a \u0111au (pain behaviors)<\/span><\/li>\n<\/ul>\n<p><b>\u00a0Ph\u00e2n lo\u1ea1i \u0111au theo c\u01a1 ch\u1ebf b\u1ec7nh sinh<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110au do h\u1ee7y ho\u1ea1i m\u00f4 (nociceptive pain): ch\u1ea5n th\u01b0\u01a1ng, vi\u00eam, u x\u00e2m l\u1ea5n, ch\u00e8n \u00e9p, t\u00e1c nh\u00e2n l\u00fd h\u00f3a ( nhi\u1ec7t, h\u00f3a ch\u1ea5t, \u00e1p l\u1ef1c).<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u00a0\u0110au do vi\u00eam (inflammatory pain).<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110au ngu\u1ed3n g\u1ed1c th\u1ea7n kinh (neuropathic pain) x\u1ea3y \u0111\u1ebfn m\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 k\u00edch th\u00edch g\u00e2y h\u1ee7y ho\u1ea1i m\u00f4.<\/span><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u0110au ngu\u1ed3n g\u1ed1c th\u1ea7n kinh l\u00e0 h\u1ec7 qu\u1ea3 c\u1ee7a s\u1ef1 t\u1ed5n th\u01b0\u01a1ng v\u00e0 \/ hay c\u1ee7a s\u1ef1 ho\u1ea1t \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng c\u1ee7a \u0111\u01b0\u1eddng c\u1ea3m gi\u00e1c t\u1ea1i h\u1ec7 th\u1ea7n kinh ngo\u1ea1i bi\u00ean (TKNB) hay t\u1ea1i h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng (TKT\u01af).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u0110au ngu\u1ed3n g\u1ed1c th\u1ea7n kinh th\u01b0\u1eddng g\u1eb7p: b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i bi\u00ean \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng th\u1ec3 \u0111au bu\u1ed1t, <\/span><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/vi-sao-ban-bi-dau-kinh-sau-zona\/\"><span style=\"font-weight: 400;\">\u0111au sau zona<\/span><\/a><span style=\"font-weight: 400;\">, \u0111au trong b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i bi\u00ean do nhi\u1ec5m HIV, \u0111au sau t\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i hay d\u00e2y th\u1ea7n kinh, <\/span><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/dac-diem-dau-day-kinh-so-v\/\"><span style=\"font-weight: 400;\">\u0111au d\u00e2y V v\u00f4 c\u0103n<\/span><\/a><span style=\"font-weight: 400;\">\u2026<\/span><\/p>\n<h2><strong>3. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb \u0111au<\/strong><\/h2>\n<p><span style=\"font-weight: 400;\">\u00a0\u0110au c\u1ea5p t\u00ednh th\u01b0\u1eddng ch\u1ec9 c\u1ea7n \u0111i\u1ec1u tr\u1ecb trong th\u1eddi gian ng\u1eafn. \u0110au m\u1ea1n t\u00ednh \u0111\u00f2i h\u1ecfi ph\u1ea3i qu\u1ea3n l\u00fd theo nguy\u00ean t\u1eafc \u0111a ph\u01b0\u01a1ng th\u1ee9c v\u1edbi m\u1ee5c ti\u00eau: h\u1ea1n ch\u1ebf s\u1eed d\u1ee5ng opioid \u0111\u1ebfn m\u1ee9c t\u1ed1i thi\u1ec3u \u0111\u1ec3 tr\u00e1nh s\u1ef1 l\u1ec7 thu\u1ed9c v\u00e0 t\u0103ng li\u1ec1u opioid v\u1ec1 sau. Vi\u1ec7c s\u1eed d\u1ee5ng Opioid li\u1ec1u cao l\u00e0m t\u0103ng kh\u1ea3 n\u0103ng qu\u00e1 li\u1ec1u nh\u01b0ng kh\u00f4ng gi\u00fap t\u0103ng t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au. N\u1ebfu \u0111au kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa th\u00ec c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 phong b\u1ebf th\u1ea7n kinh, c\u1eaft h\u1ea1ch th\u1ea7n kinh giao c\u1ea3m, li\u1ec7u ph\u00e1p nh\u1eadn th\u1ee9c h\u00e0nh vi\u2026<\/span><\/p>\n<h3><strong>3.1. <a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/su-dung-thuoc-giam-dau-hop-ly\/\">C\u00e1c thu\u1ed1c gi\u1ea3m \u0111au kh\u00f4ng Opioid<\/a><\/strong><\/h3>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/thuoc-acetaminophen-cong-dung-chi-dinh-va-luu-y-khi-dung\/\"><strong>Acetaminophen<\/strong><\/a><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"><em> T\u00e1c d\u1ee5ng:<\/em> gi\u1ea3m \u0111au v\u00e0 h\u1ea1 s\u1ed1t, kh\u00f4ng c\u00f3 ho\u1ea1t t\u00ednh kh\u00e1ng vi\u00eam hay ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><em> Li\u1ec1u:<\/em> 325-1000mg m\u1ed7i 4-6h (li\u1ec1u t\u1ed1i \u0111a 4g\/ng\u00e0y) c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng u\u1ed1ng, truy\u1ec1n t\u0129nh m\u1ea1ch hay \u0111\u1eb7t h\u1eadu m\u00f4n. Li\u1ec1u \u1edf b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd n\u1ec1n \u1edf gan kh\u00f4ng n\u00ean v\u01b0\u1ee3t qu\u00e1 2g\/ng\u00e0y.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><em> T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n<\/em>: \u01b0u \u0111i\u1ec3m ch\u00ednh c\u1ee7a acetaminophen l\u00e0 kh\u00f4ng \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u t\u1edbi d\u1ea1 d\u00e0y. Thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c t\u1ebf b\u00e0o gan. Nghi\u00eam tr\u1ecdng (v\u1edbi li\u1ec1u l\u1edbn 10-15g d\u00f9ng trong m\u1ed9t kho\u1ea3ng th\u1eddi gian ng\u1eafn c\u00f3 th\u1ec3 g\u00e2y ho\u1ea1i t\u1eed t\u1ebf b\u00e0o gan nguy hi\u1ec3m t\u1edbi t\u00ednh m\u1ea1ng).\u00a0<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/nguoi-benh-can-luu-y-gi-khi-dung-aspirin\/\"><strong>Aspirin\u00a0<\/strong><\/a><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"><em> T\u00e1c d\u1ee5ng:<\/em> gi\u1ea3m \u0111au, h\u1ea1 s\u1ed1t, kh\u00e1ng vi\u00eam v\u00e0 ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u. Aspirin n\u00ean \u0111\u01b0\u1ee3c d\u00f9ng th\u1eadn tr\u1ecdng \u1edf b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd n\u1ec1n \u1edf gan, th\u1eadn ho\u1eb7c c\u00f3 c\u00e1c r\u1ed1i lo\u1ea1n \u0111\u00f4ng c\u1ea7m m\u00e1u, ph\u1ee5 n\u1eef c\u00f3 thai, b\u1ec7nh nh\u00e2n \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u00e1ng \u0111\u00f4ng. T\u00e1c d\u1ee5ng ch\u1ed1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u c\u00f3 th\u1ec3 k\u00e9o d\u00e0i l\u00ean \u0111\u1ebfn 1 tu\u1ea7n d\u00f9 ch\u1ec9 s\u1eed d\u1ee5ng m\u1ed9t li\u1ec1u duy nh\u1ea5t.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><em> Li\u1ec1u:<\/em> 325-650 mg m\u1ed7i 4h khi c\u1ea7n (t\u1ed1i \u0111a 4g\/ng\u00e0y) c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c \u0111\u1eb7t h\u1eadu m\u00f4n. D\u1ea1ng thu\u1ed1c c\u00f3 v\u1ecf bao tan trong ru\u1ed9t (t\u1ee9c v\u01b0\u1ee3t qua \u0111\u01b0\u1ee3c d\u1ea1 d\u00e0y \u0111\u1ebfn ru\u1ed9t m\u1edbi tan) gi\u00fap gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 l\u00ean \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><em> T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n:<\/em> C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 ph\u1ee5 thu\u1ed9c li\u1ec1u d\u00f9ng bao g\u1ed3m: \u00f9 tai, ch\u00f3ng m\u1eb7t, gi\u1ea3m th\u00ednh l\u1ef1c. C\u00f3 th\u1ec3 g\u00e2y kh\u00f3 ti\u00eau ho\u1eb7c xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a n\u1eb7ng. C\u00e1c ph\u1ea3n \u1ee9ng qu\u00e1 m\u1eabn nh\u01b0 n\u1ed5i m\u1ec1 \u0111ay, co th\u1eaft ph\u1ebf qu\u1ea3n, ph\u00f9 thanh qu\u1ea3n \u00edt g\u1eb7p, nh\u01b0ng \u1edf b\u1ec7nh nh\u00e2n hen ho\u1eb7c c\u00f3 polyp m\u0169i s\u1ebd t\u0103ng kh\u1ea3 n\u0103ng b\u1ecb h\u01a1n. S\u1eed d\u1ee5ng k\u00e9o d\u00e0i c\u00f3 th\u1ec3 g\u00e2y vi\u00eam th\u1eadn m\u00f4 k\u1ebd v\u00e0 ho\u1ea1i t\u1eed nh\u00fa th\u1eadn.\u00a0<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/thuoc-chong-viem-khong-steroid-nsaid-nhung-dieu-can-biet\/\"><strong>NSAIDs\u00a0<\/strong><\/a><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"><em> T\u00e1c d\u1ee5ng<\/em>: gi\u1ea3m \u0111au, h\u1ea1 s\u1ed1t, kh\u00e1ng vi\u00eam do c\u01a1 ch\u1ebf \u1ee9c ch\u1ebf enzyme cyclooxygenase (COX). T\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i NSAIDs \u0111\u1ec1u c\u00f3 hi\u1ec7u qu\u1ea3 v\u00e0 \u0111\u1ed9c t\u00ednh t\u01b0\u01a1ng t\u1ef1 nhau, v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u0169ng t\u01b0\u01a1ng t\u1ef1 aspirin. B\u1ec7nh nh\u00e2n b\u1ecb d\u1ecb \u1ee9ng hay c\u00f3 ph\u1ea3n \u1ee9ng co th\u1eaft ph\u1ebf qu\u1ea3n khi d\u00f9ng aspirin th\u00ec kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng NSAIDs.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u00a0<a href=\"https:\/\/www.vinmec.com\/vi\/bai-viet\/luu-y-khi-dung-thuoc-chong-dong-kinh\/\">C\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u1ed9ng kinh<\/a> (bao g\u1ed3m: gabapentin, pregabalin, carbamazepine, oxcarbazepine), thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m 3 v\u00f2ng (amitriptylin) v\u00e0 duloxetine l\u00e0 c\u00e1c ch\u1ebf ph\u1ea9m \u0111\u01b0\u1eddng u\u1ed1ng d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111au do th\u1ea7n kinh.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0Thu\u1ed1c gi\u1ea3m \u0111au d\u1ea1ng b\u00f4i t\u1ea1i ch\u1ed7 (nh\u01b0<a href=\"https:\/\/vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/cong-dung-thuoc-lidocain-hcl\/\"> lidocain<\/a>) c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m \u0111au c\u1ee5c b\u1ed9 (nh\u01b0 trong <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/dieu-tri-dau-do-bi-zona-kinh\/\">\u0111au do th\u1ea7n kinh h\u1eadu Zona).<\/a><\/span><\/p>\n<h3><strong>3.2.<a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/thuoc-giam-dau-co-gay-nghien-khong\/\"> C\u00e1c thu\u1ed1c gi\u1ea3m \u0111au opioid<\/a><\/strong><\/h3>\n<p><span style=\"font-weight: 400;\"><em>T\u00e1c d\u1ee5ng:<\/em> c\u00f3 hi\u1ec7u \u1ee9ng d\u01b0\u1ee3c l\u00fd t\u01b0\u01a1ng t\u1ef1 nh\u01b0 opium hay morphine (nh\u00f3m g\u00e2y nghi\u1ec7n) v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho \u0111au m\u1ee9c \u0111\u1ed9 t\u1eeb v\u1eeba \u0111\u1ebfn n\u1eb7ng, \u0111\u1eb7c bi\u1ec7t khi c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi NSAIDs.<\/span><\/p>\n<p><em>\u00a0Li\u1ec1u:<\/em><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> Li\u1ec1u gi\u1ea3m \u0111au t\u01b0\u01a1ng \u0111\u01b0\u01a1ng c\u1ee7a c\u00e1c lo\u1ea1i thu\u1ed1c \u1edf b\u1ea3ng 1-1\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Trong tr\u01b0\u1eddng h\u1ee3p \u0111au c\u1ea5p t\u00ednh, n\u00ean s\u1eed d\u1ee5ng li\u1ec1u th\u1ea5p nh\u1ea5t c\u00f3 t\u00e1c d\u1ee5ng c\u1ee7a opioid ph\u00f3ng th\u00edch nhanh. Tuy nhi\u00ean, khuy\u1ebfn kh\u00edch \u01b0u ti\u00ean s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c gi\u1ea3m \u0111au kh\u00f4ng opioid ho\u1eb7c c\u00e1c chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb gi\u1ea3m \u0111au kh\u00f4ng d\u00f9ng thu\u1ed1c \u0111\u1ec3 gi\u1ea3m nhu c\u1ea7u s\u1eed d\u1ee5ng opioid.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Khi chuy\u1ec3n sang thu\u1ed1c g\u00e2y nghi\u1ec7n kh\u00e1c c\u00f9ng nh\u00f3m do \u0111\u00e1p \u1ee9ng k\u00e9m ho\u1eb7c do b\u1ec7nh nh\u00e2n kh\u00f4ng dung n\u1ea1p th\u00ec thu\u1ed1c m\u1edbi n\u00ean \u0111\u01b0\u1ee3c kh\u1edfi \u0111\u1ea7u v\u1edbi\u00a0 li\u1ec1u b\u1eb1ng 50% li\u1ec1u gi\u1ea3m \u0111au t\u01b0\u01a1ng \u0111\u01b0\u01a1ng \u0111\u1ec3 b\u00f9 cho s\u1ef1 dung n\u1ea1p ch\u00e9o.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> C\u00f3 th\u1ec3 d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam hay d\u1ea1ng h\u1ea5p thu qua da (v\u00ed d\u1ee5: ch\u1ebf ph\u1ea9m d\u1ea1ng mi\u1ebfng d\u00e1n) trong b\u1ec7nh c\u1ea3nh c\u00f3 nu\u1ed1t kh\u00f3, n\u00f4n \u00f3i, ho\u1eb7c gi\u1ea3m h\u1ea5p thu qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> N\u00ean s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c c\u00f3 th\u1eddi gian b\u00e1n h\u1ee7y ng\u1eafn, nh\u01b0 morphine. \u1ede b\u1ec7nh nh\u00e2n ch\u01b0a t\u1eebng d\u00f9ng thu\u1ed1c thu\u1ed9c nh\u00f3m g\u00e2y nghi\u1ec7n tr\u01b0\u1edbc \u0111\u00f3 n\u00ean \u0111\u01b0\u1ee3c cho li\u1ec1u th\u1ea5p nh\u1ea5t c\u00f3 th\u1ec3, c\u00f2n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n dung n\u1ea1p thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c cho li\u1ec1u cao h\u01a1n.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 b\u1ec7nh nh\u00e2n t\u1ef1 ki\u1ec3m so\u00e1t c\u01a1n \u0111au (patient \u2013 controlled analgesia \u2013 PCA), t\u1ee9c b\u1ec7nh nh\u00e2n t\u1ef1 \u0111i\u1ec1u ch\u1ec9nh l\u01b0\u1ee3ng thu\u1ed1c gi\u1ea3m \u0111au c\u1ee7a m\u00ecnh, th\u01b0\u1eddng d\u00f9ng \u0111\u1ec3 ki\u1ec3m so\u00e1t \u0111au trong h\u1eadu ph\u1eabu hay \u1edf b\u1ec7nh nh\u00e2n \u0111au \u1edf giai \u0111o\u1ea1n cu\u1ed1i \u0111\u1eddi. Tuy nhi\u00ean, n\u1ebfu b\u1ec7nh nh\u00e2n ch\u01b0a t\u1eebng s\u1eed d\u1ee5ng opioid th\u00ec kh\u00f4ng n\u00ean cho truy\u1ec1n thu\u1ed1c li\u00ean t\u1ee5c do nguy c\u01a1 g\u00e2y qu\u00e1 li\u1ec1u.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u1ede b\u1ec7nh nh\u00e2n \u0111ang ph\u1ea3i d\u00f9ng gi\u1ea3m \u0111au li\u00ean t\u1ee5c (v\u1edbi m\u1ed9t li\u1ec1u n\u1ec1n n\u00e0o \u0111\u00f3), th\u00ec khi c\u00f3 c\u01a1n \u0111au c\u00f3 th\u1ec3 ph\u1ea3i d\u00f9ng th\u00eam li\u1ec1u b\u1ed5 sung v\u1edbi n\u1ed3ng \u0111\u1ed9 kho\u1ea3ng 5-15% li\u1ec1u n\u1ec1n. Nh\u01b0ng n\u1ebfu nhu c\u1ea7u ph\u1ea3i s\u1eed d\u1ee5ng li\u1ec1u b\u1ed5 sung th\u01b0\u1eddng xuy\u00ean th\u00ec l\u00fac n\u00e0y li\u1ec1u duy tr\u00ec n\u00ean \u0111\u01b0\u1ee3c n\u00e2ng l\u00ean ho\u1eb7c r\u00fat ng\u1eafn kho\u1ea3ng th\u1eddi gian gi\u1eefa c\u00e1c li\u1ec1u<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> N\u1ebfu \u0111au m\u1ee9c \u0111\u1ed9 n\u1eb7ng m\u00e0 kh\u00f4ng th\u1ec3 ki\u1ec3m so\u00e1t v\u1edbi c\u00e1c thu\u1ed1c opioid li\u1ec1u cao, \u0111\u1eb7c bi\u1ec7t khi \u0111ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p PCA v\u1edbi li\u1ec1u n\u1ec1n, l\u00fac n\u00e0y n\u00ean tham v\u1ea5n b\u00e1c s\u0129 chuy\u00ean khoa.\u00a0<\/span><\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"aligncenter size-full wp-image-33639\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Screenshot-650.png\" alt=\"dieu-tri-dau\" width=\"968\" height=\"507\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Screenshot-650.png 968w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Screenshot-650-300x157.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Screenshot-650-768x402.png 768w\" sizes=\"(max-width: 968px) 100vw, 968px\" \/><\/p>\n<p><strong>C\u00e1c opiate ch\u1ecdn l\u1ecdc<\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"><em><a href=\"https:\/\/vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/thuoc-tramadol-hcl-er-cong-dung-chi-dinh-va-luu-y-khi-dung\/\"> Tramadol<\/a>:<\/em> l\u00e0 thu\u1ed1c \u0111\u1ed3ng v\u1eadn opioid v\u00e0 c\u0169ng c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au kh\u00f4ng opioid l\u00ean trung \u01b0\u01a1ng, t\u00e1c \u0111\u1ed9ng l\u00ean con \u0111\u01b0\u1eddng d\u1eabn truy\u1ec1n c\u1ea3m gi\u00e1c \u0111au. Li\u1ec1u: 50-100 mg, u\u1ed1ng m\u1ed7i 4-6h c\u00f3 th\u1ec3 d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111au c\u1ea5p. V\u1edbi b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i ho\u1eb7c c\u00f3 suy gi\u1ea3m ch\u1ee9c n\u0103ng gan, th\u1eadn th\u00ec n\u00ean \u0111\u01b0\u1ee3c gi\u1ea3m li\u1ec1u. Tramadol kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng chung v\u1edbi c\u00e1c thu\u1ed1c an th\u1ea7n, g\u00e2y nghi\u1ec7n, kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u01b0\u1ee3u khi d\u00f9ng. Thu\u1ed1c c\u0169ng kh\u00f4ng n\u00ean d\u00f9ng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang \u0111i\u1ec1u tr\u1ecb v\u1edbi c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf men monoamine oxidase (MAO), do c\u00f3 th\u1ec3 g\u00e2y h\u1ed9i ch\u1ee9ng serotonin. T\u00e1c d\u1ee5ng ph\u1ee5: n\u00f4n \u00f3i, ch\u00f3ng m\u1eb7t, t\u00e1o b\u00f3n, \u0111au \u0111\u1ea7u.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/cong-dung-thuoc-travicol-codein\/\"><em> Codein<\/em> <\/a>th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p v\u1edbi aspirin ho\u1eb7c acetaminophen (v\u00ed d\u1ee5: ch\u1ebf ph\u1ea9m ultracet\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><em><a href=\"https:\/\/www.vinmec.com\/en\/thuoc\/oxycodone-78\/\"> Oxycodone<\/a> v\u00e0 hydrocodone<\/em> c\u00f3 d\u1ea1ng ch\u1ebf ph\u1ea9m \u0111\u01b0\u1eddng u\u1ed1ng k\u1ebft h\u1ee3p v\u1edbi acetaminophen; ri\u00eang oxycodone c\u00f3 d\u1ea1ng ch\u1ebf ph\u1ea9m kh\u00f4ng ch\u1ee9a acetaminophen, \u1edf d\u1ea1ng ph\u00f3ng th\u00edch nhanh v\u00e0 ph\u00f3ng th\u00edch k\u00e9o d\u00e0i. N\u00ean ch\u00fa \u00fd nguy c\u01a1 qu\u00e1 li\u1ec1u acetaminophen \u1edf nh\u1eefng d\u1ea1ng thu\u1ed1c n\u00e0y.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.vinmec.com\/vi\/thuoc\/morphine-sulfate-tiem-tuy-song-167\/\"><em> Morphine sulfate<\/em><\/a> bao g\u1ed3m c\u1ea3 d\u1ea1ng ph\u00f3ng th\u00edch nhanh v\u00e0 d\u1ea1ng ph\u00f3ng th\u00edch k\u00e9o d\u00e0i. Thu\u1ed1c c\u00f2n \u0111\u01b0\u1ee3c b\u00e0o ch\u1ebf \u1edf d\u1ea1ng l\u1ecfng, c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng cho nh\u1eefng b\u1ec7nh nh\u00e2n g\u1eb7p kh\u00f3 kh\u0103n trong v\u1ea5n \u0111\u1ec1 nu\u1ed1t. Khi s\u1eed d\u1ee5ng morphin n\u00ean l\u01b0u \u00fd t\u1edbi ch\u1ee9c n\u0103ng th\u1eadn.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/thuoc-methadone-hcl-cong-dung-chi-dinh-va-luu-y-khi-dung\/\"><em> Methadone<\/em><\/a> r\u1ea5t hi\u1ec7u qu\u1ea3 khi s\u1eed d\u1ee5ng \u0111\u01b0\u1eddng u\u1ed1ng v\u00e0 l\u00e0m gi\u1ea3m \u0111i tri\u1ec7u ch\u1ee9ng cai khi ng\u01b0ng c\u00e1c lo\u1ea1i opioid kh\u00e1c do th\u1eddi gian b\u00e1n h\u1ee7y c\u1ee7a thu\u1ed1c k\u00e9o d\u00e0i. M\u1eb7c d\u00f9 th\u1eddi gian \u0111\u00e0o th\u1ea3i k\u00e9o d\u00e0i nh\u01b0ng t\u00e1c d\u1ee5ng gi\u1ea3m \u0111au r\u1ea5t ng\u1eafn.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/hydromorphone-la-gi-va-co-tac-dung-gi\/\"><em> Hydromorphone<\/em><\/a> l\u00e0 ch\u1ea5t d\u1eabn xu\u1ea5t t\u1eeb morphine, m\u1ea1nh h\u01a1n 5-7 l\u1ea7n n\u00ean c\u1ea7n ph\u1ea3i th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/fentanyl-la-thuoc-giam-dau-su-dung-sau-phau-thuat\/\"><em> Fentanyl<\/em><\/a> c\u00f3 ch\u1ebf ph\u1ea9m d\u1ea1ng mi\u1ebfng d\u00e1n ph\u00f3ng th\u00edch xuy\u00ean qua da v\u1edbi th\u1eddi gian ph\u00f3ng th\u00edch k\u00e9o d\u00e0i tr\u00ean 72 gi\u1edd. Kh\u1edfi ph\u00e1t t\u00e1c d\u1ee5ng ch\u1eadm. Nguy c\u01a1 g\u00e2y \u1ee9c ch\u1ebf h\u00f4 h\u1ea5p th\u01b0\u1eddng g\u1eb7p h\u01a1n khi \u0111i\u1ec1u tr\u1ecb v\u1edbi fentanyl.<\/span><\/li>\n<\/ul>\n<h3><strong>3.3. Th\u1eadn tr\u1ecdng<\/strong><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\"> Opioid ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i trong c\u00e1c b\u1ec7nh l\u00fd c\u1ea5p t\u00ednh m\u00e0 ki\u1ec3u \u0111au v\u00e0 m\u1ee9c \u0111\u1ed9 \u0111au l\u00e0 nh\u1eefng d\u1ea5u hi\u1ec7u quan tr\u1ecdng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh (v\u00ed d\u1ee5 nh\u01b0 ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u). Thu\u1ed1c c\u0169ng c\u00f3 th\u1ec3 g\u00e2y t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Opioid n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng m\u1ed9t c\u00e1ch th\u1eadn tr\u1ecdng tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 <a href=\"https:\/\/www.vinmec.com\/vi\/benh\/suy-giap-3245\/\">suy gi\u00e1p<\/a>, <a href=\"https:\/\/www.vinmec.com\/vi\/benh\/addison-suy-tuyen-thuong-than-nguyen-phat-4696\/\">b\u1ec7nh Addison<\/a>, <a href=\"https:\/\/www.vinmec.com\/vi\/benh\/suy-tuyen-yen-3046\/\">suy tuy\u1ebfn y\u00ean<\/a>, <a href=\"https:\/\/www.vinmec.com\/vi\/benh\/thieu-mau-3007\/\">thi\u1ebfu m\u00e1u<\/a>, c\u00f3 b\u1ec7nh l\u00fd h\u00f4 h\u1ea5p n\u1ec1n (nh\u01b0 <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/benh-phoi-tac-nghen-man-tinh-copd\/\">COPD<\/a>, <a href=\"https:\/\/www.vinmec.com\/vi\/benh\/hen-phe-quan-2949\/\">hen<\/a>, g\u00f9 v\u1eb9o c\u1ed9t s\u1ed1ng, b\u00e9o ph\u00ec n\u1eb7ng), suy dinh d\u01b0\u1ee1ng n\u1eb7ng, suy nh\u01b0\u1ee3c hay t\u00e2m ph\u1ebf m\u1ea1n.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Li\u1ec1u opioid c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u1edf b\u1ec7nh nh\u00e2n suy gan, suy th\u1eadn.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> C\u00e1c thu\u1ed1c l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a opioid bao g\u1ed3m phenothiazines, thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m, benzodiazepines v\u00e0 r\u01b0\u1ee3u.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Hi\u1ec7n t\u01b0\u1ee3ng dung n\u1ea1p h\u00ecnh th\u00e0nh khi s\u1eed d\u1ee5ng thu\u1ed1c k\u00e9o d\u00e0i v\u00e0 \u0111i k\u00e8m v\u1edbi s\u1ef1 l\u1ec7 thu\u1ed9c v\u1ec1 th\u1ec3 ch\u1ea5t, \u0111\u1eb7c tr\u01b0ng b\u1edfi h\u1ed9i ch\u1ee9ng cai khi ng\u01b0ng thu\u1ed1c \u0111\u1ed9t ng\u1ed9t (lo \u00e2u, k\u00edch \u0111\u1ed9ng, v\u00e3 m\u1ed3 h\u00f4i, tim \u0111\u1eadp nhanh, r\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a v\u00e0 th\u00e2n nhi\u1ec7t kh\u00f4ng \u1ed5n \u0111\u1ecbnh). C\u00f3 th\u1ec3 x\u1ea3y ra ch\u1ec9 ngay sau 2 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> N\u1ebfu s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ed1i v\u1eadn opioid c\u00f3 th\u1ec3 l\u00e0m th\u00fac \u0111\u1ea9y h\u1ed9i ch\u1ee9ng cai ngay sau 3 ng\u00e0y \u0111i\u1ec1u tr\u1ecb. V\u00ec v\u1eady, c\u1ea7n gi\u1ea3m li\u1ec1u t\u1eeb t\u1eeb trong v\u00e0i ng\u00e0y \u0111\u1ec3 l\u00e0m gi\u1ea3m h\u1ed9i ch\u1ee9ng cai.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> K\u00ea \u0111\u01a1n thu\u1ed1c opioid khi xu\u1ea5t vi\u1ec7n v\u1edbi th\u1eddi gian d\u00f9ng kh\u00f4ng n\u00ean v\u01b0\u1ee3t qu\u00e1 th\u1eddi gian k\u00e9o d\u00e0i (d\u1ef1 \u0111o\u00e1n) c\u1ee7a c\u01a1n \u0111au. Th\u01b0\u1eddng k\u00ea trong 3 ng\u00e0y ho\u1eb7c ng\u1eafn h\u01a1n l\u00e0 \u0111\u1ee7. Vi\u1ec7c k\u00ea thu\u1ed1c opioid \u0111\u1ec3 gi\u1ea3m \u0111au sau xu\u1ea5t vi\u1ec7n l\u00ean \u0111\u1ebfn 7 ng\u00e0y l\u00e0 kh\u00f4ng c\u1ea7n thi\u1ebft v\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/span><\/li>\n<\/ul>\n<h2><strong>4. T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n v\u00e0 \u0111\u1ed9c t\u00ednh<\/strong><\/h2>\n<ul>\n<li><span style=\"font-weight: 400;\"> \u1ea2nh h\u01b0\u1edfng \u0111\u1ebfn th\u1ea7n kinh trung \u01b0\u01a1ng bao g\u1ed3m: tr\u1ea1ng th\u00e1i khoan kho\u00e1i, an th\u1ea7n v\u00e0 g\u00e2y co \u0111\u1ed3ng t\u1eed.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u1ee8c ch\u1ebf h\u00f4 h\u1ea5p ph\u1ee5 thu\u1ed9c li\u1ec1u v\u00e0 th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n r\u00f5 sau khi ti\u00eam t\u0129nh m\u1ea1ch.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u00a0T\u00e1c d\u1ee5ng l\u00ean tim m\u1ea1ch: gi\u00e3n m\u1ea1ch ngo\u1ea1i bi\u00ean v\u00e0 t\u1ee5t huy\u1ebft \u00e1p\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> T\u00e1c d\u1ee5ng l\u00ean ti\u00eau h\u00f3a: t\u00e1o b\u00f3n, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n. C\u00e1c thu\u1ed1c l\u00e0m m\u1ec1m ph\u00e2n v\u00e0 nhu\u1eadn tr\u00e0ng n\u00ean \u0111\u01b0\u1ee3c k\u00ea toa d\u00f9ng k\u00e8m theo \u0111\u1ec3 h\u1ea1n ch\u1ebf t\u00ecnh tr\u1ea1ng t\u00e1o b\u00f3n. C\u00e1c thu\u1ed1c opioid c\u00f3 th\u1ec3 g\u00e2y ph\u00ecnh \u0111\u1ea1i tr\u00e0ng nhi\u1ec5m \u0111\u1ed9c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh vi\u00eam ru\u1ed9t.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> T\u00e1c d\u1ee5ng l\u00ean h\u1ec7 ti\u1ebft ni\u1ec7u: c\u00f3 th\u1ec3 g\u00e2y b\u00ed ti\u1ec3u.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Ng\u1ee9a r\u1ea5t hay g\u1eb7p khi d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam v\u00e0o c\u1ed9t s\u1ed1ng.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Qu\u00e1 li\u1ec1u opioid <\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u00a0Naloxone, thu\u1ed1c \u0111\u1ed1i v\u1eadn opioid, lu\u00f4n chu\u1ea9n b\u1ecb s\u1eb5n \u0111\u1ec3 d\u1ef1 ph\u00f2ng trong tr\u01b0\u1eddng h\u1ee3p qu\u00e1 li\u1ec1u.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">B\u1ed9 kit c\u1ea5p c\u1ee9u naloxone t\u1ea1i nh\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh gi\u00fap gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong do qu\u00e1 li\u1ec1u opioid. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c cho xu\u1ea5t vi\u1ec7n \u0111i\u1ec1u tr\u1ecb gi\u1ea3m \u0111au ngo\u1ea1i tr\u00fa, v\u1edbi li\u1ec1u t\u01b0\u01a1ng \u0111\u01b0\u01a1ng &gt; 50 mg morphine\/ng\u00e0y c\u00f3 nguy c\u01a1 qu\u00e1 li\u1ec1u cao h\u01a1n v\u00e0 v\u00ec th\u1ebf n\u00ean k\u00ea toa k\u00e8m v\u1edbi naloxone d\u00f9ng \u0111\u01b0\u1eddng m\u0169i c\u00f3 th\u1ec3 gi\u00fap \u00edch cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao n\u00e0y.<\/span><\/li>\n<\/ul>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong> Chapter 1: Inpatient Care in Internal Medicine, The<br \/>\nWashington Manual of Medical Therapeutics 36th).<\/p>\n<p><strong>Xem th\u00eam: <\/strong><\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/giam-dau-man-tinh-phuong-phap-dieu-tri-moi\/\">\u0110i\u1ec1u tr\u1ecb \u0111au m\u00e3n t\u00ednh | Vinmec<\/a><\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/cac-loai-dau-dau-va-cach-dieu-tri\/\">C\u00e1c lo\u1ea1i \u0111au \u0111\u1ea7u v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb | Vinmec<\/a><\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/tong-quan-ve-dau-va-dieu-tri-dau\/\">T\u1ed5ng quan v\u1ec1 \u0111au v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111au | Vinmec<\/a><\/p>\n<p>Video \u0111\u1ec1 xu\u1ea5t:<\/p>\n<p><iframe loading=\"lazy\" title=\"B\u00e0i t\u1eadp 10 ph\u00fat h\u1ebft ngay \u0111au l\u01b0ng\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/-2P9olGUajg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe><\/p>\n<p>B\u00e0i t\u1eadp 10 ph\u00fat h\u1ebft ngay \u0111au l\u01b0ng<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00a0\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u1eabn m\u1eafc\u00a0 h\u1ed9i ch\u1ee9ng \u0111au vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c gi\u1ea3m \u0111au c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng d\u01b0\u1edbi s\u1ef1 gi\u00e1m s\u00e1t c\u1ee7a b\u00e1c s\u0129 \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3. Trong b\u00e0i vi\u1ebft n\u00e0y, ch\u00fang ta s\u1ebd t\u00ecm hi\u1ec3u v\u1ec1 c\u00e1c lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111au th\u00f4ng d\u1ee5ng v\u00e0 c\u00e1ch ch\u00fang [&hellip;]<\/p>\n","protected":false},"author":17,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[97,99,94,100,95,96,98],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>\u0110i\u1ec1u tr\u1ecb \u0111au b\u1eb1ng thu\u1ed1c - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u00ecm hi\u1ec3u v\u1ec1 c\u00e1c lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb \u0111au th\u00f4ng d\u1ee5ng v\u00e0 c\u00e1ch ch\u00fang \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m \u0111au v\u00e0 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u0110i\u1ec1u tr\u1ecb \u0111au b\u1eb1ng thu\u1ed1c - 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