Epidural anesthesia: ndi chiyani, pomwe chiwonetsedwa komanso zoopsa zomwe zingachitike

Zamkati

• Zikawonetsedwa
• Momwe zimachitikira
• Zowopsa zomwe zingachitike
• Kusamalira pambuyo pochita dzanzi
• Kusiyana pakati pa epidural ndi msana

Epidural anesthesia, yomwe imadziwikanso kuti epidural anesthesia, ndi mtundu wa mankhwala oletsa ululu omwe amaletsa kupweteka kwa gawo limodzi lokha la thupi, nthawi zambiri kuyambira m'chiuno kutsika komwe kumaphatikizapo pamimba, kumbuyo ndi miyendo, koma munthuyo amatha kumva kukhudzidwa ndi kukakamizidwa. Mtundu uwu wa dzanzi umachitika kuti munthuyo akhalebe tcheru panthawi yochitidwa opaleshoni, chifukwa sizimakhudza kuchuluka kwa chikumbumtima, ndipo nthawi zambiri umagwiritsidwa ntchito pochita opaleshoni yosavuta, monga gawo la opareshoni kapena maopareshoni azachipatala kapena okongoletsa.

Pochita epidural, mankhwala oletsa ululu amagwiritsidwa ntchito m'malo opindika kuti afike pamitsempha yam'derali, pochita kwakanthawi, motsogozedwa ndi adotolo. Zimachitika mchipatala chilichonse chomwe chili ndi malo opangira opaleshoni, ndi wochita opaleshoni.

Zikawonetsedwa

Epidural anesthesia itha kugwiritsidwa ntchito pochita ma opaleshoni monga:

• Kaisara;
• Kukonzanso kwa Hernia;
• Opaleshoni yayikulu pamabele, m'mimba kapena chiwindi;
• Kuchita maopaleshoni amchiuno, bondo kapena mafupa a chiuno;
• Opaleshoni ya amayi monga hysterectomy kapena opaleshoni yaying'ono pansi;
• Opaleshoni ya m'mitsempha monga kuchotsa prostate kapena miyala ya impso;
• Opaleshoni ya mitsempha monga kudulidwa kapena kukonzanso mitsempha yam'miyendo;
• Opaleshoni ya ana monga inguinal hernia kapena opaleshoni ya mafupa.

Kuphatikizanso apo, matendawa amatha kuchitika nthawi yobereka nthawi yomwe mayi amakhala atagwira ntchito kwa maola ambiri kapena akumva kuwawa kwambiri, pogwiritsa ntchito mankhwala oletsa kupweteka. Onani momwe epidural anesthesia imagwirira ntchito pobereka.

Epidural anesthesia amadziwika kuti ndiotetezeka ndipo amakhala ndi chiopsezo chochepa cha tachycardia, thrombosis ndi zovuta zam'mapapu, komabe siziyenera kugwiritsidwa ntchito kwa anthu omwe ali ndi matenda opatsirana kapena komwe oesthesia amagwiritsidwira ntchito, kapena kwa anthu omwe asintha msana, Kutuluka magazi popanda chifukwa chomveka kapena omwe akugwiritsa ntchito mankhwala oletsa antagagant. Kuphatikiza apo, kugwiritsa ntchito anesthesia sikunalimbikitsidwenso ngati dokotala sangapeze malo am'mimba.

Momwe zimachitikira

Epidural anesthesia imagwiritsidwa ntchito pochita maopaleshoni ang'onoang'ono, omwe amakhala ofala kwambiri panthawi yobereka kapena pakubereka kwabwino, chifukwa amapewa zowawa pakubereka ndipo samamupweteka mwanayo.

Pakati pa anesthesia, wodwalayo amakhala pansi ndikutsamira kutsogolo kapena atagona chammbali, mawondo ake atapindika ndikupumula pachibwano chake. Kenako, wodwalayo amatsegula malo pakati pa mafupa a msana ndi dzanja, ndikugwiritsa ntchito mankhwala oletsa ululu kuti achepetse kusowa ndikulowetsa singano ndi chubu chochepa cha pulasitiki, chotchedwa catheter, chomwe chimadutsa pakatikati pa singano.

Ndi catheter yoyikidwa, adokotala amalowetsa mankhwala ochepetsa ululu kudzera mu chubu ndipo, ngakhale sichimapweteka, ndizotheka kumverera pang'onong'ono komanso pang'ono pofikira singano, kutsatiridwa ndi kukakamizidwa komanso kutentha kwa mankhwala kuyikidwa. Nthawi zambiri, zotsatira za epidural anesthesia zimayamba mphindi 10 mpaka 20 mutagwiritsa ntchito.

Mu mtundu uwu wa mankhwala oletsa ululu, adotolo amatha kuwongolera kuchuluka kwa mankhwala oletsa kupweteka komanso nthawi, ndipo nthawi zina, ndizotheka kuphatikiza epidural ndi msana kuti zitheke msanga kapena kuchita epidural anesthesia ndi sedation momwe aliri. kuyambitsa kugona kumagwiritsidwa ntchito pamitsempha.

Zowopsa zomwe zingachitike

Zowopsa za epidural anesthesia ndizosowa kwambiri, komabe, pakhoza kukhala kutsika kwa magazi, kuzizira, kunjenjemera, nseru, kusanza, malungo, matenda, kuwonongeka kwa mitsempha pafupi ndi tsambalo kapena kutuluka magazi.

Kuphatikizanso apo, zimakhala zachilendo kumva mutu pambuyo pa epidural anesthesia, yomwe imatha kuchitika chifukwa cha kutuluka kwa cerebrospinal fluid, yomwe ndi madzi ozungulira msana, chifukwa cha kuboola kopangidwa ndi singano.

Kusamalira pambuyo pochita dzanzi

Matendawa akasokonezedwa, nthawi zambiri pamakhala dzanzi lomwe limatenga maola ochepa zotsatira za mankhwala ochititsa dzanzi zisanathe, kotero ndikofunikira kunama kapena kukhala pansi mpaka kutengeka kwa miyendo yanu kubwerera mwakale.

Ngati mukumva kupweteka kulikonse, muyenera kulankhulana ndi adotolo ndi namwino kuti athe kulandira mankhwala opha ululu.

Pambuyo pa matenda, simukuyenera kuyendetsa galimoto kapena kumwa mowa, osachepera maola 24 mutatha opaleshoni. Dziwani kuti ndi ziti zomwe muyenera kusamala nazo kuti muchiritse mwachangu mukatha opaleshoni.

Kusiyana pakati pa epidural ndi msana

Epidural anesthesia ndiyosiyana ndi dzanzi lam'mimba, chifukwa amagwiritsidwa ntchito m'malo osiyanasiyana:

• Epidural: singano siyikuboola timitsempha tonse, tomwe timakhungu tomwe timazungulira msana, ndipo mankhwala oletsa ululu amaikidwa mozungulira ngalande ya msana, mochulukira komanso kudzera mu catheter yomwe ili kumbuyo, ndipo imangothandiza kuthetsa ululu ndikunyamuka dera la dzanzi, komabe, munthuyo amatha kumverera kukhudzidwa ndi kukakamizidwa;
• Msana: singano imaboola timamimba tonse ndipo mankhwala oletsa ululu amagwiritsidwa ntchito mkati mwa khola la msana, mumadzimadzi a cerebrospinal, omwe ndi madzi omwe amazungulira msana, ndipo amapangidwa nthawi imodzi komanso pang'ono, ndipo amatanthawuza kuti deralo lifa dzanzi komanso lofa ziwalo.

Matendawa amagwiritsidwa ntchito pobereka, chifukwa amalola kuti azigwiritsa ntchito masana tsiku lonse, pomwe msana umagwiritsidwa ntchito pochita maopaleshoni, ndi mankhwala amodzi okha a mankhwala oletsa ululu omwe akugwiritsidwa ntchito.

Pakufunika opaleshoni yozama kwambiri, zimawonetsera dzanzi. Dziwani momwe mankhwala ochititsa dzanzi amagwirira ntchito komanso kuopsa kwake.