I-epidural narcosis: iziphumo, ukuchasana, iingxaki, ukuphononongwa

Yonke imihla ininzi imisebenzi eyenziwa kwiikliniki zezokwelapha. Ukuhlinzwa akunakwenzeka ngaphandle kwe-aneshesia efanelekileyo, oko kukuthi, i-anesthesia iyimfuneko, ngaphandle koko ayiyi kukwazi ukunyamezela intlungu enjalo. Zininzi iintlobo ze-anesthesia. Kwinqaku siza kuqonda ukuba yiyiphi i-anesthesia ye-epidural, kwimeko enokuthi isetyenziswe, ingaba kukho ukuchasene.

Iyintoni i-aneshesia epidural

Olu hlobo lwe-anesthesia lenye yezindlela ze-anesthesia yesithili. I-narcosis ye-epidural ukuqaliswa kwezidakamizwa ngokuthe ngqo kwindawo ye-epidural kwikholam ye-vertebral ngokusebenzisa i-catheter. Kwimeko ye-anesthesia enjalo, kunokwenzeka ukuphumeza ezi ziphumo zilandelayo:

• Ukulahlekelwa kobuhlungu besifo.
• Ubuninzi bobubele buyancipha okanye buyalala.
• Ukuphumla kwezihlunu.

Indlela yokwenza i-anesthesia ye-epidural idibaniswe nelokuba isilwanyana singena kwiindawo zokudibanisa ezisemaphandleni kwisiza esinqununu, ngenxa yendlela yokuphambuka kwemigudu yesibindi ivalwe.

I-Principal ye-epestural anesthesia

Kubantu, ikholomu ye-vertebral kunye nokuphela kwezibilini entanyeni kusekuhlaleni. Ummandla we-epidural ukhona kumbindi kwaye ugijima ngaphantsi komgudu. Amagulane entlangeni yentamo, iingalo kunye namagxa awela kuwo, ukuvuvukala kwabo kubangela intlungu kwiindawo eziphambili.

Iyeza elityalwa kule ndawo lidala ukulahleka kobuzwe kunye nokunyaniseka kwentlungu. Ukudluliselwa kweempembelelo zesibindi kuvalwe, oko kunika umphumo onjalo.

Xa i-anesthesia ye-epidural isetyenziswa

Ngenxa yokuba lolu hlobo lwe-anesthesia lusetyenziswa ngexesha lotyando kwiindawo ezahlukeneyo zomzimba, sinokuthi ingozi yesicelo ingaba mkhulu okanye ngaphantsi. Ngokomzekelo, i-anesthesia ye-epidural ye-breast, ingxinja yendawo, imilenze nesisu zisengozini encane kune-analgesia entanyeni nasezingalweni. Ukusetyenziswa kwe-anesthesia enjalo kwentloko akunakwenzeka, kuba ukungasindiswa kwale nxalenye yomzimba kwenziwa nge-craniocebral system.

I-narcosis epidural isetyenziswa rhoqo:

1. Njenge-anesthetic yendawo apho ukuhlinzwa kungalindelekanga, umzekelo, ngexesha lobasebenzi.
2. Njengoko kuncediswa kwi-anesthesia jikelele, kunokwenzeka ukunciphisa inani le-opioids esetyenzisiweyo.
3. I-epestural anesthesia isoloko isetyenziselwa kwicandelo lokugcina.
4. Kwithuba lokugqibela emva kokususwa kwesifo sesifo.
5. Ukuze unyango lwentlungu. Kule meko, iziyobisi ze-steroid kunye nama-analgesics zijojowe kwingingqi ye-epidural.

Luphi uhlobo lwe-anesthesia lokukhetha ukhetho lwe-anesthesia jikelele okanye i-epidural, ugqirha ugqiba kwimeko nganye.

Izindlela ze-anesthesia ye-epidural

Unyaka ngamnye kwi-arsenal ya magqirha kukho iindlela ezintsha ezongezelelweyo zokuphunyezwa kwale nxalenye ye-anesthesia. Xa oogqirha banokukhetha: i-anesthesia jikelele okanye i-epidural anesthesia, ngoko ke, ukuba kunokwenzeka, ukhethe okugqibela. Ukukhethwa okukhulu kwezilwanyana ukuziphatha kwayo kukuvumela ukuba ukhethe ukhetho olufanelekileyo kakhulu kwisigulane ngasinye.

Ukongezelela kwiindidi zamachiza kwi-anesthesia, kukho iindlela ezahlukeneyo ze-aneshesia:

1. Eqhubekayo. Kule meko, i-anesthetic ifakwe kwisithuba se-cerebrospinal ngokusisigxina. Ngale ndlela unokuphumeza ukususwa kwentlungu kwithuba lonke le-operation, kwaye iyeza kufuneka zifuneke ngelixa le nto ingaphantsi.
2. Ulawulo lwexesha elide. Ukufumana isilwanyana kunikwa kuphela xa kukho isidingo esiphuthumayo.
3. Anesthesia ngesicelo somguli. Xa usebenzisa le ndlela, isigulane sinayo iqhosha phantsi kwezandla zakhe. Ukuba kukho isidingo se-anesthesia, xa usicinezela kwindawo yangaphandle, inxalenye yonyango inikwe.

Oogqirha banaloo machiza aphelisa ngokupheleleyo intlungu yesifo, kodwa agcina ukuhamba, kwaye ingqalelo ishiyiwe.

Kwiimeko ziphi na izifo zokubulala izifo

Uninzi lwagqirha lubheka le ndlela ye-anesthesia ukuba iyona nto ifanelekileyo ngexesha lomsebenzi kwimilenze. Akuvumelekanga kuphela ukususa isifo sesifo kunye nokuphucula izihlunu kangangoko kunokwenzeka, kodwa nokunciphisa ukulahleka kwegazi.

Izibonakaliso zokusetyenziswa kwe-anesthesia ye-epidural zingaba zendalo ezahlukeneyo, umzekelo:

1. Le ndlela ikhuselekile ngokupheleleyo kwiintso kunye ne-prostate gland.
2. It isetyenziselwa isitho somzimba nesisu.
3. Eyasetyenziswa kakhulu ngexesha lotyando esiswini, amathumbu.
4. Ingasetyenziselwa izifo zentliziyo kunye nesifo sikashukela.

Kodwa oku akuthethi ukuba i-anesthesia ye-epidural isoloko isetyenziselwa kwi-pathologies. Konke kugqitywa kwimeko nganye ngokwalo.

Ukungqinelana kokusetyenziswa

I-naridosis ye-Epidural ye-contraindication inezinto ezilandelayo: zigaba kunye nezihlobo. Udidi lokuqala luquka:

• Ubukho be-tuberculosis spondylitis okanye iingxaki zayo.
• Inkqubo yokuvuvukala emva.
• Umoya wokutshitshiswa ngenxa yexinzelelo.
• Ekubeni kukho ukuxhomekeka kwamachiza asetyenziswayo.
• I-pathologies yenkqubo yesifo.
• Ukuba umgudu unzima kakhulu.
• Inkqubo ye-clotting yegazi iphukile.
• Kukho izifo ezinzulu zesisu esiswini.
• Isithintelo esiswini.

Ukuchasana okuchaseneyo kuninzi kakhulu, kubandakanya:

• Isisindo esiphezulu.
• Imeko embi yomzimba.
• Izifo ezingapheliyo kwikholamu yomgcini.
• Yobudala abantwana.
• Izifo ze-neurological.
• Ukubhengezwa kwe-hypotension kunye nabanye abaninzi.

Umgangatho we-anesthesia ye-epidural ayixhomekeke kuphela kwi-pathology ekhoyo kunye nesimo sempilo yesigulane, kodwa kunye nokulungiselela okumele kusetyenziswe.

I-epidural aneshesia kwiqendu eliqhelekileyo

Xa kukho zonke izibonakaliso zokuqhuba icandelo lesigxina, ngokuphindaphindiweyo i-epidural isetyenziswe endaweni ye- anesthesia jikelele . Le ndlela ikhethwa kwangaphambili, kuba ifuna ukulungiswa okuthile.

Ukuqaliswa kwesilwanyana kwenziwa kwindawo ethile kwizinga lesikhumba, apho ukuphela kweentambo ezivela emlanjeni womkhuhlane kuphuma. Isilwayo sifakwe kwi-tube-catheter ekhethekileyo, ngexesha lokusebenza nanini na, unokongeza iyeza.

Ngenxa yolu hlobo lwe-anesthesia, ukuqonda kuya kuhlala kucacile, kwaye uvelwano olungaphantsi kwesihlengo luyalala. Ibhinqa liyakubona kwaye live oogqirha, kodwa aluve buhlungu.

Xa kukho ukhetho - i-anesthesia okanye i- anesthesia jikelele kunye necesarean section - kuyafaneleka ukuqwalasela izibonakaliso kunye nokuchasene kwe-anesthesia.

Iinkcazo ze-aneshesia

Ngokuqhelekileyo, i-anesthesia ye-epidural isetyenziswa:

1. Ukuba umsebenzi wabasebenzi waqala phambili kwexesha, umzekelo, nge-36-37 ngeveki. I-anesthesia enjalo ibuye ibuye ihlasele imisipha ye-pelvic, kunye neentloko zentsana zithwala ubunzima obukhulu xa kuhamba ngedaka lokuzalwa.
2. Ingcinezelo enkulu.
3. Ukungahambelani kwemisebenzi yabasebenzi, xa iinxalenye ezihlukeneyo zekhontrakthi yesibeleko zinamandla . I-epidural anesthesia inokunciphisa ubunzima bokuqhekeza.
4. Ngomsebenzi osisigxina, xa kungekho ukuphumla okupheleleyo ixesha elide. Oku kunokukhokelela ekungaqhelekanga kwezabasebenzi, ngoko sebenzisa i-anesthesia ye-epidural ukuze loo mfazi athole amandla.

Ukungqinelana

Ukongezelela kwimiqondiso, kwimeko yecandelo le-caesarean kukho kwakhona ukuchasana kweso si-anesthesia, ziquka:

• Ubukho beprogram yokuvuvukala kwindawo yokuqhawula.
• Izifo ezithintekayo.
• Ukujongana nokugula kumachiza.
• Ukuba kukho inqatha kwisibeleko.
• Ukuba umntwana uhlala ngapha nangapha okanye uhlala kwindawo e-oblique.
• Inkcenkcesho encinci yowesifazane ekubelethweni.
• Ubunzima obukhulu bebhokhwe.
• Ukuba le ntokazi ayifuni lolu hlobo lwe-anesthesia, ngoko oogqirha abanakuyisebenzisa ngokumelene nentando yakhe.

Ngaphambi kokusebenzisa i-anesthesia ye-epidural, imiphumo, ukungonakali kunye neenzuzo kufuneka kuthathelwe ingqalelo.

Iinzuzo ze-anesthesia ye-epidural kwinqanaba elithintekayo

Izinzuzo zolu hlobo lwe-aneshesia ziquka:

1. Ibhinqa iyayiqonda kuyo yonke into, akukho mngcipheko we-intubation okanye iinjongo.
2. Akukho ncumo yecandelo lokuphefumula eliphezulu, njenge-anesthesia jikelele, ekhethwa ngokukhethekileyo kwizigulane ze-asthma.
3. I-cardiovascular system isebenza ngokucacileyo, ekubeni isilwanyana senza kancane kancane.
4. Ubuchule obuhambelana nokwenza ukunyakaza kugcinwa.
5. Ngalolu hlobo lwe-anesthetic, unokwandisa ixesha le-anesthesia, kuba i-anesthetic ifakwe kwi-catheter nanini na.
6. Emva kokusebenza, ama-opioid amalungiselelo anokulawulwa ukuze anciphise i-syndrome yesifo.

Ukongeza kwi-pluses, kubalulekile ukuphawula ukungaphumeleli kwe-aneshesia.

Iingxaki ze-anesthesia ye-epidural

Naliphi na indlela yokungenelela ngoncedo, kunye ne-anesthesia, inokungaphumeleli kwayo. Iingxaki ze-analgesia ye-epidural ziquka:

1. Impazamo ye-anesthesiologist xa ilawula iziyobisi, xa igqirha lingena ngaphakathi. Oku kunokukhokelela ekuthinjeni, ukuhla kwehla kwegazi.
2. Kukho ingozi ye-injection subarachnoidal, ngenxa yesigxina se-spinal block.
3. Ukuze usebenzise i-anesthesia enjalo kufuneka ube nekhono elifanelekileyo, njengoko le anesthesia inzima kakhulu.
4. Isiza siqala ukusebenza emva kwemizuzu eyi-15-20, ngoko utyando alukwazi ukuqala ngokukhawuleza.
5. Kukho umngcipheko we-anesthesia enganeleyo, xa iziphelo zentsholongwane zingagqitywanga ngokupheleleyo, kwaye ukungazinzi kuhleli ngexesha lo msebenzi.
6. Kubalulekile ukuba ukhethe ngokucophelela amalungiselelo enjenge-aneshesia ngexesha lecesarean section, kuba abanye bangena ngaphakathi kwi-placenta kwaye bangela ukuphazamiseka kokuphefumula nentliziyo yesisu.
7. Emva kokusebenza, intlungu emva, intloko ingabonakala.

Ukwenza ukhetho olufanelekileyo, ukuba unesigqeba esinqumlekileyo, i- epidural okanye i-anesthesia jikelele, kufuneka uqikelele zonke iingxaki kunye neengxaki. Cingisisa iinkcazo ezikhoyo kwaye ukhethe uhlobo olufanelekileyo kakhulu lwe-anesthesia.

Iingxaki ze-epestural anesthesia

I-narcosis ye-epidural iyancipha kunokuba yinto encinci, nangona iimeko ezinjalo zenzeka. Uninzi u qaphela:

1. Kwizigulane ezi-1 kwezi-20, le mveliso ayisebenzi kude kube sekupheleni, kwaye iziphelo zentsholongwane zivalwe ngokupheleleyo, oko kuthetha ukuba i-anesthesia ayiyi kusebenza.
2. Ukuba kukho i-coagulopathy, kukho umngcipheko wokwakheka kwe-hematoma.
3. Umonakalo obangelwa ngengozi ngexesha lokugqitywa kwexesha elide lingakhokelela ekuphumeni kwe-cerebrospinal fluid endaweni yangaphaya. Oku kufakwe intloko emva kokuhlinzwa.
4. Inani elikhulu lemithi yeentlungu lingaba yingozi, eliya kubangela ukungabikho okukhuselekileyo.
5. Kukho iziphumo ezibi ngenxa yokusetyenziswa kwamachiza athile entlungu.

Kuzo zonke ezi ngasentla, sinokugqiba ukuba iimpembelelo ze- epidural anesthesia zinzima kwimpilo kwiimeko ezinqabileyo kakhulu.

Uphononongo malunga nokusetyenziswa kwe-analgesia ye-epidural

Ngokwemvelo, ngamnye umntu, ngoko ke, ukuba ezinye zixhomekeke kakuhle yi-anesthesia jikelele, ngoko kwabanye, i-anesthesia ye-epidural ikhethwayo. Ukuphononongwa kwakhe kukuhle.

Uninzi lwezigulane lubona umgangatho omhle we-anesthesia, abafazi ngexesha lexesha le-caesarean banokubona zonke izenzo zogqirha baze bakuve ukukhala kwabo umntwana emva kokuzalwa kwakhe. Kukhona ithuba elihle lokunciphisa kakhulu intlungu yesifo emva kokuhlinzwa.

Abaninzi abasetyhini baxela ukuba phambi koxinzelelo lwegazi oluphezulu, ukusebenzisa i-anesthesia ye-epidural yenza kube lula ukugcina izibonakaliso ngaphakathi kwemida yesiqhelo, echaphazelekayo kuphela ekuchaphazela umsebenzi wabasebenzi.

Kodwa ngaphandle kwengxelo engalunganga nayo ayiyenzi. Ezinye izigulane emva kokuba i-anesthesia enjalo ivakale intloko, inhlungu emva. Kukho kwakhona apho izilwanyana azizange zisebenze, kwaye ukuvinjelwa kweziphetho zesibindi akuzange kwenzeke.

Ukujonga kuzo zonke iirhafu, unokwenza isigqibo esisodwa: naluphi na uhlobo lwe-anesthesia ludinga indlela efanelekileyo kwiingcali. Nangona uphatha kakubi kwi-anesthesia elula, ungabaleli umyinge weyeza, unokufumana imiphumo engathandekiyo, ngamanye amaxesha unobunzima kakhulu, kunye nento ongayithetha ngayo nge-epidural.

Yonke imibuzo kufuneka ixoxwe kunye nogqirha kwangaphambili, ukwenzela ukuba emva koko akuyi kuba nembonakalo engathandekiyo.

Ewe, kuya kuba yinto efanelekileyo ukuba akukho mntu wayedinga ukuhlinzwa, oko kuthetha ukuba i-anesthesia yayingeke ibe yimfuneko. Kodwa izinto zethu ezibalulekileyo ziyenzeka ukuba ngamanye amaxesha imisebenzi ayikwazi ukunqandwa ukuze kugcinwe ubomi kunye nempilo. Zizinyame kwaye uphile.