Njengoba intuthuko yezokwelapha iqhubeka nokuguqula insimu yokubulala izinzwa,i-anesthesia yomgogodla ehlanganisiwesekuyindlela ethandwayo nephumelelayo yokuqeda ubuhlungu ngesikhathi sokuhlinzwa nezinye izinqubo zezokwelapha. Le ndlela eyingqayizivele ihlanganisa izinzuzo ze-spinal and epidural anesthesia ukuze inikeze iziguli ukulawula ubuhlungu okuthuthukisiwe kanye nenduduzo ephelele. Namuhla, sizobheka ngokujulile ukusetshenziswa, izinhlobo zezinaliti, kanye nezici ze-spinal-epidural anesthesia ehlanganisiwe ukuze sikusize ufunde kabanzi ngalobu buchwepheshe bezokwelapha obushintshashintshayo.
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I-anesthesia ehlanganisiwe yomgogodla-epidural, ebizwa nangokuthiI-CSE anesthesia, kuhilela ukufaka imithi ngqo ku-cerebrospinal fluid (CSF) ezungeze umgogodla. Lokhu kuvumela ukuqala okusheshayo kokusebenza kanye ne-anesthesia ejulile uma kuqhathaniswa nezinye izindlela. Imithi esetshenziswa ku-anesthesia ye-CSE iyinhlanganisela ye-anesthesia yendawo (njenge-bupivacaine noma i-lidocaine) kanye ne-opioid (njenge-fentanyl noma i-morphine). Ngokuhlanganisa le mithi, odokotela be-anesthesia bangathola ukukhululeka kobuhlungu okusheshayo nokuhlala isikhathi eside.
I-anesthesia ehlanganisiwe ye-lumbar-epidural isetshenziswa kabanzi futhi ihlanganisa izinhlobo eziningi zezinqubo zokuhlinzwa. Ivame ukusetshenziswa ekuhlinzeni kwesisu esingezansi, i-pelvic kanye nemilenze engezansi kanye nasekuhlinzweni nasekubelethweni. I-anesthesia ye-CSE iwusizo kakhulu ekubelethweni ngoba ingadambisa ubuhlungu ngesikhathi sokubeletha ngenkathi igcina ikhono lokucindezela esigabeni sesibili sokubeletha. Ngaphezu kwalokho, i-anesthesia ye-CSE isetshenziswa kakhulu ezinqubweni zokulaliswa esibhedlela, lapho iziguli zibhekana nezikhathi zokululama ezimfushane kanye nokuhlala esibhedlela okufushane.
Uma kukhulunywa ngezinhlobo zezinaliti ezisetshenziswa ku-anesthesia ehlanganisiwe ye-spinal epidural, kunezinhlobo ezimbili eziyinhloko: izinaliti zepensela kanye nezinaliti ze-cutting-point. Izinaliti zepensela, ezibizwa nangokuthi izinaliti ze-Whitacre noma ze-Sprotte, zinesihloko esibuthuntu, esinciphile esibangela ukulimala okuncane kwezicubu ngesikhathi sokufakwa. Lokhu kunganciphisa ukwanda kwezinkinga ezifana nekhanda elibuhlungu ngemva kokubhoboza i-dural. Izinaliti ezikhethiwe, ngakolunye uhlangothi, zinezihloko ezibukhali, ezigobile ezingabhoboza izicubu ezine-fibrous kalula. Lezi zinaliti zivame ukusetshenziswa ezigulini ezinezikhala ezinzima ze-epidural ngoba zivumela ukufinyelela okusebenzayo.
Ukuhlanganiswa kwe-anesthesia yomgogodla kanye ne-epidural ku-anesthesia ye-CSE kunikeza izici eziningana ezihlukile ezifaka isandla ekusebenzeni kwayo. Okokuqala, i-anesthesia ye-CSE ivumela ukunqunywa okwengeziwe, okusho ukuthi i-anesthetic ingalungiswa kuyo yonke inqubo, okunikeza udokotela we-anesthesia ukulawula okukhulu ezingeni le-anesthesia. Lokhu kuzuzisa kakhulu phakathi nezinqubo ezinde lapho isiguli singadinga ukwandisa noma ukunciphisa amazinga emithi. Ngaphezu kwalokho, i-anesthesia ye-CSE iqala ukusebenza ngokushesha futhi inganikeza ukukhululeka kobuhlungu ngokushesha kune-epidural yodwa.
Ngaphezu kwalokho, i-CSE anesthesia inenzuzo yokuqeda ubuhlungu isikhathi eside ngemva kokuhlinzwa. Uma imithi yomgogodla isiphelile, i-epidural catheter ihlala isebenza, okuvumela ukuphathwa okuqhubekayo kwemithi yokunciphisa ubuhlungu isikhathi eside. Lokhu kusiza ukunciphisa ubuhlungu ngemva kokuhlinzwa, kunciphisa isidingo se-opioids yomzimba, futhi kuthuthukise ukwaneliseka kwesiguli.
I-Shanghai TeamStand Corporation inguchwephesheumhlinzeki wedivayisi yezokwelaphakanye nomkhiqizi oqaphela ukubaluleka kokuhlinzeka ngemishini esezingeni eliphezulu yokuhlinzwa okuhlanganisiwe kwe-spinal-epidural anesthesia. Ukuzibophezela kwabo ekwenzeni kahle kubonakala ezinhlobonhlobo zezinaliti abazinikezayo, ezenzelwe ukuhlangabezana nezidingo ezihlukile zochwepheshe bezempilo. Ngokuqonda izinhlobo ezahlukene zezinaliti kanye nezici zazo, odokotela be-anesthesiologists bangakhetha inketho efanele kakhulu yesiguli ngasinye, ukuqinisekisa inqubo ephumelelayo nekhululekile.
Ngamafuphi, i-anesthesia ehlanganisiwe yomgogodla ne-epidural iyithuluzi eliwusizo emkhakheni we-anesthesia yokuthuthukisa ukukhululeka kobuhlungu nokuthuthukisa induduzo yesiguli ngesikhathi sokuhlinzwa. Ukusetshenziswa kwayo kuhlanganisa ukuhlinzwa okubanzi, okuhlanganisa ukuhlinzwa kwesisu esingezansi, kwe-pelvic kanye nemilenze engezansi. Uhlobo lwenaliti olusetshenziswayo, kungaba olunepensela noma oluneziqongo ezibukhali, luncike ezicini ezihlukile zesiguli. Izici ze-anesthesia ye-CSE, njengomthamo oqhubekayo kanye nokukhululeka kobuhlungu ngemva kokuhlinzwa isikhathi eside, zithuthukisa ukusebenza kwayo. Ngokusekelwa yizinkampani ezifana ne-TeamStand Corporation eShanghai, ochwepheshe bezempilo bangaqhubeka nokuhlinzeka iziguli ngokulawula ubuhlungu okuhle kanye nokuhlangenwe nakho okuhle kokuhlinzwa.
Isikhathi sokuthunyelwe: Okthoba-17-2023