I-epidural anesthesia: iyini, lapho ikhonjiswa nezingozi ezingaba khona

-Delile

• Uma kukhonjisiwe
• Kwenziwa kanjani
• Izingozi ezingaba khona
• Ukunakekela ngemuva kwe-anesthesia
• Umehluko phakathi kwe-epidural nomgogodla

I-Epidural anesthesia, ebizwa nangokuthi i-epidural anesthesia, uhlobo lwe-anesthesia oluvimba izinhlungu zesifunda esisodwa kuphela somzimba, imvamisa kusuka okhalweni phansi okubandakanya isisu, emuva nasemilenzeni, kodwa umuntu usenokuzwa ukuthintwa nokucindezelwa. Lolu hlobo lwe-anesthesia lwenziwa ukuze umuntu akwazi ukuhlala ephapheme ngesikhathi sokuhlinzwa, ngoba alulithinti izinga lokuqonda, futhi luvame ukusetshenziswa ngesikhathi sezinqubo ezilula zokuhlinza, njengesigaba sokuhlinzwa noma ekuhlinzweni kwabesifazane noma kobuhle.

Ukwenza i-epidural, umuthi wokubulala izinzwa usetshenziswa esikhaleni se-vertebral ukufinyelela emithanjeni yesifunda, enesenzo sesikhashana, esilawulwa ngudokotela. Kwenziwa kunoma yisiphi isibhedlela esinesikhungo sokuhlinza, nge-anesthetist.

Uma kukhonjisiwe

I-Epidural anesthesia ingasetshenziselwa izinqubo zokuhlinzwa ezinjenge:

• EKesariya;
• Ukulungiswa kweHernia;
• Ukuhlinzwa okuvamile esifubeni, esiswini noma esibindini;
• Ukuhlinzwa kwamathambo okhalweni, kwamadolo noma okwephuka okhalweni;
• Ukuhlinzwa kwabesifazane njenge-hysterectomy noma ukuhlinzwa okuncane esitezi se-pelvic;
• Ukuhlinzwa komchamo njengokukhishwa kwendlala yesinye noma yamatshe ezinso;
• Ukuhlinzwa ngemithambo efana nokunqunywa noma ukuvuselelwa kwemithambo yegazi emilenzeni;
• Ukuhlinzwa kwezingane ezifana ne-inguinal hernia noma ukuhlinzwa kwamathambo.

Ngaphezu kwalokho, i-epidural ingenziwa ngesikhathi sokuzalwa okujwayelekile ezimweni lapho owesifazane enamahora amaningi okusebenza noma esezinhlungwini ezinkulu, esebenzisa i-analgesic epidural ukudambisa izinhlungu. Bona ukuthi i-epidural anesthesia yenziwa kanjani ngesikhathi sokubeletha.

I-Epidural anesthesia ithathwa njengephephile futhi ihlotshaniswa nengozi ephansi ye-tachycardia, thrombosis kanye nezinkinga zamaphaphu, noma kunjalo akufanele isetshenziswe kubantu abanezifo ezisebenzayo noma lapho kusetshenziswa khona i-anesthesia, noma kubantu abanezinguquko emgogodleni, ukopha ngaphandle kwesizathu esizwakalayo noma abasebenzisa imishanguzo ye-anticoagulant. Ngaphezu kwalokho, ukusetshenziswa kwale anesthesia nakho akunconywa ezimweni lapho udokotela engakwazi ukuthola isikhala se-epidural.

Kwenziwa kanjani

I-Epidural anesthesia ivame ukusetshenziselwa ukuhlinza okuncane, okuvame kakhulu ngesikhathi sokuhlinzwa noma ngesikhathi sokubeletha okujwayelekile, njengoba kugwema izinhlungu ngesikhathi sokubeletha futhi kungalimazi ingane.

Ngesikhathi se-anesthesia, isiguli sihlala sihleli futhi sincike phambili noma silele ngohlangothi, siguqe ngamadolo futhi siphumule ngasesilevini. Ngemuva kwalokho, isibulala-zinzwa sivula izikhala eziphakathi kwamathambo omgogodla ngesandla, sisebenzisa umuthi wokubulala izinzwa wendawo ukunciphisa ukungaphatheki kahle bese sifaka inaliti nethambo lepulasitiki elincanyana, elibizwa ngokuthi i-catheter, elidlula maphakathi nenaliti.

Nge-catheter efakiwe, udokotela ufaka umuthi wokubulala izinzwa ngepayipi futhi, yize ungalimazi, kuyenzeka uzwe ukubhoboza okuncane nokuncane lapho inaliti ibekwa, kulandele ingcindezi nomuzwa wokufudumala lapho umuthi kusetshenzisiwe. Ngokuvamile, umphumela we-epidural anesthesia uqala imizuzu eyi-10 kuye kwengu-20 ngemuva kokufakwa kwesicelo.

Kulolu hlobo lwe-anesthesia, udokotela angalawula inani le-anesthetic nesikhathi, futhi kwesinye isikhathi, kungenzeka ukuhlanganisa i-epidural nomgogodla ukuthola umphumela osheshayo noma ukwenza i-epidural anesthesia ne-sedation okuyo. yenza ukulala kusetshenziswe emthanjeni.

Izingozi ezingaba khona

Izingozi ze-epidural anesthesia azivamile kakhulu, kepha-ke, kungahle kube khona ukwehla kwengcindezi yegazi, ukugodola, ukundindizela, isicanucanu, ukuhlanza, umkhuhlane, ukutheleleka, ukulimala kwemizwa eduze kwesayithi noma ukuphuma kwegazi.

Ngaphezu kwalokho, kujwayelekile ukuzwa ikhanda ngemuva kwe-epidural anesthesia, engenzeka ngenxa yokuchitheka kwe-cerebrospinal fluid, okuwuketshezi oluzungeze intambo yomgogodla, okudalwa ukubhoboza okwenziwe yinaliti.

Ukunakekela ngemuva kwe-anesthesia

Lapho i-epidural iphazanyiswa, imvamisa kuba nobuthakathaka obuhlala amahora ambalwa ngaphambi kokuba imiphumela ye-anesthesia iqale ukunyamalala, ngakho-ke kubalulekile ukulala noma ukuhlala kuze kube yilapho umuzwa emilenzeni yakho ubuyela kokujwayelekile.

Uma uzwa ubuhlungu, kufanele uxhumane nodokotela nomhlengikazi ukuze welashwe ngamaphilisi ezinhlungu.

Ngemuva kwe-epidural, akufanele ushayele noma uphuze utshwala, okungenani kungakapheli amahora angama-24 ngemuva kwe-anesthesia. Thola ukuthi iziphi izixwayiso ezinkulu ozidingayo ukuze ululame ngokushesha ngemuva kokuhlinzwa.

Umehluko phakathi kwe-epidural nomgogodla

I-Epidural anesthesia ihlukile kune-spinal anesthesia, ngoba isetshenziswa ezifundeni ezahlukahlukene:

• I-Epidural: inaliti ayibhobozi wonke ama-mening, okuyizimbungulu ezizungeze umgogodla, futhi i-anesthetic ibekwe ezungeze umsele womgogodla, ngobuningi obukhulu nange-catheter esemuva, futhi isebenza kuphela ukuqeda ubuhlungu nokushiya indawo ebandayo, noma kunjalo, umuntu usengakuzwa ukuthintwa nokucindezelwa;
• Umgogodla: inaliti ihlaba wonke ama-mening kanye ne-anesthetic isetshenziswa ngaphakathi kwekholomu lomgogodla, ku-cerebrospinal fluid, okuwuketshezi oluzungeze umgogodla, futhi lwenziwa ngasikhathi sinye nangobuningi obuncane, futhi lusebenzela ukwenza indawo ibe ndikindiki futhi ikhubazeke.

I-epidural ivame ukusetshenziselwa ukubeletha, ngoba ivumela imithamo eminingi ukuthi isetshenziswe usuku lonke, kuyilapho umgogodla usetshenziselwa kakhulu ukuhlinza, kusetshenziswa umthamo owodwa kuphela wemithi yokubulala izinzwa.

Lapho kudingeka i-anesthesia ejulile, i-anesthesia ejwayelekile iyakhonjiswa. Thola ukuthi i-anesthesia ejwayelekile isebenza kanjani nezingozi zayo.