Njengoko inkqubela phambili yezonyango iqhubeka nokuguqula intsimi ye-anesthesia,i-anesthesia ye-spidural edibeneyo yomgogodlaiye yaba yindlela ethandwayo nesebenzayo yokunciphisa iintlungu ngexesha lotyando kunye nezinye iinkqubo zonyango. Le ndlela ekhethekileyo idibanisa iingenelo ze-spinal and epidural anesthesia ukubonelela izigulane zokulawula iintlungu eziphuculweyo kunye nentuthuzelo efanelekileyo. Namhlanje, siza kujonga nzulu kwizicelo, iintlobo zeenaliti, kunye neempawu ze-spinal-epidural anesthesia ukukunceda ufunde ngakumbi malunga nobu buchwepheshe bezonyango.
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Idityaniswe i-spinal-epidural anesthesia, ebizwa ngokubaI-CSE i-anesthesia, kubandakanya ukutofa iziyobisi ngokuthe ngqo kwi-cerebrospinal fluid (CSF) ejikeleze intambo yomgogodla. Oku kuvumela ukuqala ngokukhawuleza kwesenzo kunye ne-anesthesia enzulu xa kuthelekiswa nezinye iindlela. Amachiza asetyenziswa kwi-CSE anesthesia yindibaniselwano ye-anesthetic yendawo (efana ne-bupivacaine okanye i-lidocaine) kunye ne-opioid (efana ne-fentanyl okanye i-morphine). Ngokudibanisa la mayeza, i-anesthesiologists inokufikelela kwiintlungu ezikhawulezayo kunye nexesha elide.
I-anesthesia ye-lumbar-epidural edibeneyo isetyenziswa ngokubanzi kwaye igubungela uluhlu olubanzi lweenkqubo zotyando. Iqhele ukusetyenziswa kuqhaqho lwesisu esisezantsi, i-pelvic kunye namazantsi otyando kunye nasekubelekeni nasekubelekeni. I-CSE anesthesia inenzuzo ngokukodwa kwi-obstetrics kuba inokuphelisa intlungu ngexesha lokubeleka ngelixa igcina ukukwazi ukutyhala ngexesha lesibini lesigaba sokubeleka. Ukongezelela, i-CSE anesthesia isetyenziswa ngakumbi kwiinkqubo zokugula ngaphandle, kunye nezigulane ezifumana amaxesha amafutshane okubuyisela kunye nokuhlala esibhedlele.
Xa kuziwa kwiindidi zeenaliti ezisetyenziswe kwi-anesthesia ye-spidural epidural edibeneyo, zimbini ziyilo eziphambili: iinaliti zepencil kunye neenaliti zokusika. Iinaliti zepensile, ezikwabizwa ngokuba zii-Whitacre okanye iinaliti ze-Sprotte, zinencam ebhityileyo, enencam ethe kratya ebangela ukwenzakala okuncinci kwezicubu ngexesha lokufakwa. Oku kunokunciphisa iziganeko zeengxaki ezifana nentloko emva kokuhlatywa kwe-dural. Iinaliti ezicholiweyo, kwelinye icala, zineencam ezitsolo, ezineengile ezinokugqobhoza izicubu ezinentsinga ngokulula ngakumbi. Ezi naliti zihlala zisetyenziswa kwizigulane ezinezithuba ezinzima ze-epidural kuba zivumela ukufikelela okusebenzayo.
Indibaniselwano ye-spinal and epidural anesthesia kwi-CSE anesthesia ibonelela ngeempawu ezininzi ezizodwa ezinegalelo ekusebenzeni kwayo. Okokuqala, i-CSE i-anesthesia ivumela i-dosing eyongeziweyo, oku kuthetha ukuba i-arhente ye-anesthetic inokulungelelaniswa kuyo yonke inkqubo, inika i-anesthesiologist ukulawula okukhulu kwinqanaba le-anesthesia. Oku kuluncedo ngakumbi ngexesha leenkqubo ezinde apho isigulane sinokudinga ukwandisa okanye ukuthoba amanqanaba echiza. Ukongezelela, i-CSE anesthesia inokuqala ngokukhawuleza kwesenzo kwaye inokubonelela ngokukhawuleza intlungu kune-epidural yedwa.
Ukongezelela, i-CSE anesthesia inenzuzo yokunciphisa intlungu emva kokuhlinzwa. Emva kokuba amayeza omgogodla aphelile, i-catheter ye-epidural ihlala ikhona, ivumela ukulawulwa okuqhubekayo kwe-analgesics ixesha elide. Oku kunceda ukunciphisa intlungu emva kokuhlinzwa, ukunciphisa imfuno ye-opioids ye-systemic, kunye nokuphucula ukwaneliseka kwesigulane.
I-Shanghai TeamStand Corporation yingcaliumthengisi wesixhobo zonyangokunye nomvelisi oqaphela ukubaluleka kokubonelela ngezixhobo ezikumgangatho ophezulu zotyando oludibeneyo lwe-spinal-epidural anesthesia. Ukuzibophezela kwabo ekugqweseni kubonakala kwiindidi zeenaliti abazinikezelayo, ezenzelwe ukuhlangabezana neemfuno ezizodwa zabasebenzi bezempilo. Ngokuqonda iintlobo zeenaliti ezahlukeneyo kunye neempawu zabo, i-anesthesiologists inokukhetha ukhetho olufanelekileyo kwisigulane ngasinye, ukuqinisekisa inkqubo eyimpumelelo kunye nekhululekile.
Isishwankathelo, i-anesthesia ye-spinal-epidural edibeneyo isisityebi esibalulekileyo kwintsimi ye-anesthesia yokuphucula intlungu kunye nokuphucula induduzo yesigulane ngexesha lotyando. Ukusetyenziswa kwayo kugubungela uluhlu olubanzi lotyando, kubandakanywa utyando olusezantsi lwesisu, i-pelvic kunye namazantsi. Uhlobo lwenaliti esetyenzisiweyo, nokuba i-pencil-point okanye i-Sharp-tipped, ixhomekeke kwiimpawu ezizodwa zesigulane. Iimpawu ze-CSE anesthesia, ezifana nedosi eyongeziweyo kunye nokunciphisa intlungu emva kokuhlinzwa, ngakumbi ukuphucula ukusebenza kwayo. Ngenkxaso yeenkampani ezifana ne-TeamStand Corporation e-Shanghai, abaqeqeshi bezempilo banokuqhubeka nokubonelela izigulane ngokufanelekileyo kolawulo lweentlungu kunye namava alungileyo otyando.
Ixesha lokuposa: Oct-17-2023