Njengoko inkqubela phambili kwezonyango iqhubeka nokuguqula icandelo le-anesthesia,i-anesthesia yomgogodla edibeneyoiye yaba yindlela edumileyo nesebenzayo yokuphelisa iintlungu ngexesha lotyando kunye nezinye iinkqubo zonyango. Le ndlela ikhethekileyo idibanisa iingenelo ze-spinal and epidural anesthesia ukubonelela izigulana ngolawulo oluphuculweyo lweentlungu kunye nentuthuzelo efanelekileyo. Namhlanje, siza kujonga ngokunzulu ukusetyenziswa, iintlobo zeenaliti, kunye neempawu ze-anesthesia edibeneyo ye-spinal-epidural ukukunceda ufunde ngakumbi ngale teknoloji yezonyango eguqukayo.
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I-anesthesia edibeneyo yomgogodla-epidural, ekwabizwa ngokuba yi-combined spinal-epidural anesthesia,I-CSE anesthesia, kubandakanya ukufaka amayeza ngqo kwi-cerebrospinal fluid (CSF) ejikeleze umqolo. Oku kuvumela ukuqala ngokukhawuleza kokusebenza kunye ne-anesthesia enzulu xa kuthelekiswa nezinye iindlela. Amayeza asetyenziswa kwi-anesthesia ye-CSE yindibaniselwano ye-anesthetic yendawo (efana ne-bupivacaine okanye i-lidocaine) kunye ne-opioid (efana ne-fentanyl okanye i-morphine). Ngokudibanisa la mayeza, iingcali ze-anesthesia zinokufumana isiqabu sentlungu ngokukhawuleza nangokuhlala ixesha elide.
I-anesthesia edibeneyo ye-lumbar-epidural isetyenziswa kakhulu kwaye igubungela uluhlu olubanzi lweenkqubo zotyando. Isetyenziswa kakhulu kutyando olusezantsi kwesisu, i-pelvic kunye nemilenze esezantsi kunye nokubeleka. I-anesthesia ye-CSE iluncedo kakhulu kunyango lokubeleka kuba inokunciphisa iintlungu ngexesha lokubeleka ngelixa igcina amandla okutyhala kwinqanaba lesibini lokubeleka. Ukongeza, i-anesthesia ye-CSE isetyenziswa ngakumbi kwiinkqubo zokulaliswa ngaphandle, apho izigulane zifumana amaxesha amafutshane okuchacha kunye nokuhlala ixesha elifutshane esibhedlele.
Xa kufikwa kwiintlobo zeenaliti ezisetyenziswa kwi-anesthesia edibeneyo ye-spinal epidural, kukho uyilo oluphambili olubini: iinaliti zepensile kunye neenaliti ze-cutting-point. Iinaliti zepensile, ezikwabizwa ngokuba ziinaliti zeWhitacre okanye zeSprotte, zinencam ethe tyaba nencinci ebangela ukwenzakala okuncinci kwezicubu ngexesha lokufakwa. Oku kunokunciphisa ukwanda kweengxaki ezifana neentloko ezibuhlungu emva kokubhobozwa kwe-dural. Kwelinye icala, iinaliti ezikhethiweyo zinencam ebukhali, egobileyo enokugqobhoza izicubu ezine-fibrous ngokulula. Ezi naliti zihlala zisetyenziswa kwizigulane ezineendawo ezinzima ze-epidural kuba zivumela ukufikelela okusebenzayo ngakumbi.
Ukudityaniswa kwe-anesthesia yomqolo kunye ne-epidural kwi-anesthesia ye-CSE kubonelela ngeempawu ezahlukeneyo ezinegalelo ekusebenzeni kwayo. Okokuqala, i-anesthesia ye-CSE ivumela ukuthathwa kwedosi kancinci, oko kuthetha ukuba i-anesthetic agent inokulungiswa kuyo yonke inkqubo, nto leyo enika i-anesthesiologist ulawulo olukhulu kwinqanaba le-anesthesia. Oku kuluncedo ngakumbi ngexesha leenkqubo ezinde apho isigulane sinokufuna ukwandisa okanye ukunciphisa amanqanaba eziyobisi. Ukongeza, i-anesthesia ye-CSE iqala ngokukhawuleza ukusebenza kwaye inokubonelela ngokunciphisa iintlungu ngokukhawuleza kune-epidural yodwa.
Ukongeza, i-CSE anesthesia inenzuzo yokuphelisa iintlungu emva kotyando ixesha elide. Xa amayeza omqolo ephelile, i-epidural catheter ihlala isebenza, ivumela ukunikezelwa rhoqo kwe-analgesics ixesha elide. Oku kunceda ukunciphisa iintlungu emva kotyando, kunciphisa isidingo se-opioids yenkqubo yomzimba, kwaye kuphucula ulwaneliseko lwesigulana.
I-Shanghai TeamStand Corporation yingcaliumboneleli wezixhobo zonyangokunye nomenzi oqonda ukubaluleka kokubonelela ngezixhobo ezikumgangatho ophezulu zotyando lwe-anesthesia yomgogodla kunye ne-epidural. Ukuzinikela kwabo ekugqweseni kubonakala kwiindidi zeenaliti abazinikezelayo, ezenzelwe ukuhlangabezana neemfuno ezizodwa zeengcali zempilo. Ngokuqonda iintlobo ezahlukeneyo zeenaliti kunye neempawu zazo, iingcali ze-anesthesia zinokukhetha ukhetho olufanelekileyo kwisigulana ngasinye, ukuqinisekisa inkqubo ephumelelayo nekhululekileyo.
Ngamafutshane, i-anesthesia edibeneyo yomgogodla kunye ne-epidural sisixhobo esibalulekileyo kwicandelo le-anesthesia ukuphucula ukukhululeka kwentlungu kunye nokuphucula intuthuzelo yesigulana ngexesha lotyando. Ukusetyenziswa kwayo kugubungela uluhlu olubanzi lotyando, kubandakanya utyando olusezantsi kwesisu, i-pelvic kunye notyando olusezantsi. Uhlobo lwenaliti esetyenzisiweyo, nokuba lunepensile okanye lunencam ebukhali, luxhomekeke kwiimpawu ezikhethekileyo zesigulana. Iimpawu ze-anesthesia ye-CSE, ezinje ngomthamo ongezelelweyo kunye nokunciphisa intlungu emva kotyando ixesha elide, ziyayiphucula ngakumbi ukusebenza kwayo. Ngenkxaso yeenkampani ezifana neTeamStand Corporation eShanghai, iingcali zezempilo zinokuqhubeka nokubonelela izigulana ngolawulo olufanelekileyo lwentlungu kunye namava otyando alungileyo.
Ixesha leposi: Oktobha-17-2023