Njengoba intuthuko yezokwelapha iqhubeka nezinguquko emkhakheni wokubulala izinzwa,i-anesthesia ye-spidural ehlanganisiwesekuyisu elidumile nelisebenzayo lokudambisa izinhlungu phakathi nokuhlinzwa nezinye izinqubo zokwelapha. Le ndlela eyingqayizivele ihlanganisa izinzuzo ze-anesthesia yomgogodla kanye ne-epidural ukuze inikeze iziguli ukulawula okuthuthukisiwe kobuhlungu kanye nenduduzo efanele. Namuhla, sizobheka ngokujulile izinhlelo zokusebenza, izinhlobo zezinaliti, nezici ze-anesthesia ye-spinal-epidural ehlangene ukuze sikusize ufunde kabanzi mayelana nalobu buchwepheshe bezokwelapha obuguqukayo.
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I-anesthesia yomgogodla-epidural ehlanganisiwe, ebizwa nangokuthiI-CSE anesthesia, kuhlanganisa ukujova izidakamizwa ngokuqondile ku-cerebrospinal fluid (CSF) ezungeze umgogodla. Lokhu kuvumela ukuqala ngokushesha kwesenzo kanye ne-anesthesia ejulile uma kuqhathaniswa nezinye izindlela. Imithi esetshenziswa ku-CSE anesthesia iyinhlanganisela yesibulali-zinzwa sasendaweni (njenge-bupivacaine noma i-lidocaine) kanye ne-opioid (njenge-fentanyl noma i-morphine). Ngokuhlanganisa le mithi, odokotela ababulala izinzwa bangafinyelela ukukhululeka kobuhlungu obusheshayo nobuhlala isikhathi eside.
I-anesthesia ye-lumbar-epidural ehlanganisiwe isetshenziswa kabanzi futhi ihlanganisa izinqubo eziningi zokuhlinza. Ivamise ukusetshenziswa ekuhlinzeni okuphansi kwesisu, i-pelvic kanye nomkhawulo ophansi kanye nasekubelethweni nasekubelethweni. I-CSE anesthesia inenzuzo ikakhulukazi kwezokubeletha ngoba ingadambisa izinhlungu ngesikhathi sokubeletha kuyilapho igcina ikhono lokuphusha phakathi nesigaba sesibili sokubeletha. Ukwengeza, i-CSE anesthesia iya ngokuya isetshenziswa ezinqubweni zeziguli zangaphandle, neziguli ezithola izikhathi ezimfushane zokululama nokuhlala isikhathi esifushane esibhedlela.
Uma kuziwa ezinhlotsheni zezinaliti ezisetshenziselwa i-anesthesia ye-spidural ehlangene yomgogodla, kunemiklamo emibili eyinhloko: izinaliti zepensela kanye nezinaliti zokusika. Izinaliti zepensela, ezibizwa nangokuthi izinaliti ze-Whitacre noma ze-Sprotte, zinethiphu elibuthuntu, elicijile elidala ukuhlukumezeka okuncane kwezicubu ngesikhathi sokufakwa. Lokhu kunganciphisa izehlakalo zezinkinga ezifana nekhanda elibuhlungu ngemva kokubhoboza kabili. Izinaliti ezikhethiwe, ngakolunye uhlangothi, zinamathiphu abukhali, anama-engeli angakwazi ukubhoboza izicubu ze-fibrous kalula. Lezi zinaliti zivame ukusetshenziswa ezigulini ezinezikhala ezinzima ze-epidural ngoba zivumela ukufinyelela okuphumelelayo.
Inhlanganisela ye-anesthesia yomgogodla kanye ne-epidural ku-CSE anesthesia inikeza izici ezimbalwa eziyingqayizivele ezifaka isandla ekusebenzeni kwayo. Okokuqala, ukubulawa kwezinzwa kwe-CSE kuvumela ukuthakwa okungeziwe, okusho ukuthi i-ejenti yokubulala izinzwa ingalungiswa kuyo yonke inqubo, inikeze udokotela obulala izinzwa amandla amakhulu okulawula izinga lokubulala izinzwa. Lokhu kunenzuzo ikakhulukazi phakathi nezinqubo ezinde lapho isiguli singase sidinge ukwandisa noma sehlise amazinga ezidakamizwa. Ukwengeza, i-CSE anesthesia inesiqalo esisheshayo futhi inganikeza ukukhululeka kobuhlungu ngokushesha kune-epidural yedwa.
Ukwengeza, i-CSE anesthesia inenzuzo yokukhulula ubuhlungu be-postoperative isikhathi eside. Uma imithi yomgogodla isiphelile, i-catheter ye-epidural ihlala isendaweni, okuvumela ukuphathwa okuqhubekayo kwama-analgesics isikhathi eside. Lokhu kusiza ukunciphisa ubuhlungu bangemva kokuhlinzwa, kunciphisa isidingo sama-opioid esistimu, futhi kuthuthukisa ukwaneliseka kwesiguli.
I-Shanghai TeamStand Corporation inguchwephesheumphakeli wensiza yezokwelaphakanye nomkhiqizi oqaphela ukubaluleka kokuhlinzeka ngemishini yekhwalithi ephezulu yokuhlinzwa okuhlangene kwe-spinal-epidural anesthesia. Ukuzibophezela kwabo ekwenzeni okuhle kubonakala ezinhlobonhlobo zezinaliti abazinikezayo, eziklanyelwe ukuhlangabezana nezidingo eziyingqayizivele zabasebenzi bezempilo. Ngokuqonda izinhlobo zezinaliti ezihlukene kanye nezici zazo, odokotela ababulala izinzwa bangakhetha ukhetho olufanele kakhulu lwesiguli ngasinye, baqinisekise inqubo ephumelelayo nenethezekile.
Kafushane, i-anesthesia ye-spinal-epidural ehlanganisiwe iyithuluzi elibalulekile emkhakheni we-anesthesia ukuthuthukisa ukukhululeka kobuhlungu nokuthuthukisa induduzo yesiguli ngesikhathi sokuhlinzwa. Ukusetshenziswa kwayo kuhlanganisa ukuhlinzwa okubanzi, okuhlanganisa ukuhlinzwa kwesisu esingezansi, umlenze kanye nokwangaphansi. Uhlobo lwenaliti esetshenzisiwe, kungakhathaliseki ukuthi iphoyinti-ipensela noma i-tipped-tipped, incike ezicini eziyingqayizivele zesiguli. Izici ze-CSE anesthesia, njengomthamo okhuphukayo kanye nokukhululeka kwezinhlungu zesikhathi eside zangemva kokuhlinzwa, zithuthukisa ukusebenza kwayo kahle. Ngokusekelwa izinkampani ezifana ne-TeamStand Corporation e-Shanghai, ochwepheshe bezokunakekelwa kwempilo bangaqhubeka nokuhlinzeka iziguli ngokulawula kahle ubuhlungu kanye nolwazi oluhle lokuhlinzwa.
Isikhathi sokuthumela: Oct-17-2023