I-anesthesia ye-spidural ehlanganisiwe yomgogodla(CSE) indlela esetshenziswa ezinqubweni zomtholampilo ukunikeza iziguli izinzwa ze-epidural, i-anesthesia yokuthutha, kanye ne-analgesia. Ihlanganisa izinzuzo ze-anesthesia yomgogodla kanye namasu e-epidural anesthesia. Ukuhlinzwa kwe-CSE kuhilela ukusetshenziswa kwekhithi ye-spidural epidural ehlanganisiwe, ehlanganisa izingxenye ezihlukahlukene ezifana nenkomba ye-LOR.umjovo, inaliti ye-epidural, i-epidural catheter, futhiisihlungi se-epidural.
Ikhithi ye-spidural epidural ehlanganisiwe iklanywe ngokucophelela ukuze kuqinisekiswe ukuphepha, ukusebenza kahle nokulula ukusetshenziswa ngesikhathi senqubo. Isirinji yenkomba ye-LOR (Ukulahlekelwa Ukumelana) iyingxenye ebalulekile yekhithi. Isiza udokotela obulala izinzwa ukuthi abone ngokunembile indawo ye-epidural. Lapho i-plunger yesirinji idonselwa emuva, umoya udonselwa emgqonyeni. Njengoba inaliti ingena endaweni ye-epidural, i-plunger ihlangabezana nokuphikiswa ngenxa yokucindezela koketshezi lwe-cerebrospinal. Lokhu kulahlekelwa kokumelana kubonisa ukuthi inaliti isendaweni efanele.
Inalithi ye-epidural iyinaliti engenalutho, enezindonga ezincane esetshenziselwa ukungena esikhumbeni iye ekujuleni okufunayo phakathi nokuhlinzwa kwe-CSE. Yenzelwe ukunciphisa ukungakhululeki kwesiguli kanye nokuqinisekisa ukubekwa okunembile kwe-epidural catheter. Ihabhu yenaliti ixhunywe kusirinji yenkomba ye-LOR, okuvumela udokotela obulala izinzwa ukuthi aqaphe ukumelana ngesikhathi sokufakwa yenaliti.
Uma ususendaweni ye-epidural, i-catheter ye-epidural idluliswa ngenaliti futhi iqhubekele endaweni oyifunayo. I-catheter iyishubhu eliguquguqukayo eliletha i-anesthetic yendawo noma i-analgesic endaweni ye-epidural. Ibanjwe endaweni ngetheyiphu ukuvimbela ukuguquka ngengozi. Kuye ngezidingo zesiguli, i-catheter ingasetshenziselwa ukumnika okuqhubekayo noma ukuphathwa kwe-bolus ngezikhathi ezithile.
Ukuqinisekisa ukuphathwa kwezidakamizwa kwekhwalithi ephezulu, isihlungi se-epidural siyingxenye ebalulekile ye-CSE suite. Isihlungi sisiza ukususa noma yiziphi izinhlayiya noma ama-microorganisms okungenzeka akhona emuthini noma ku-catheter, ngaleyo ndlela sinciphise ingozi yokutheleleka kanye nezinkinga. Iklanyelwe ukuvumela ukugeleza kahle kwemithi kuyilapho ivimbela noma yikuphi ukungcola ekufinyeleleni emzimbeni wesiguli.
Izinzuzo zendlela ehlanganisiwe yomgogodla-epidural ziningi. Ivumela ukuqala okuthembekile nokusheshayo kwe-anesthesia ngenxa yomthamo wokuqala womgogodla. Lokhu kunenzuzo ikakhulukazi ezimweni lapho kudingeka khona ukukhulula ubuhlungu ngokushesha noma ukungenelela. Ukwengeza, ama-catheter e-epidural ahlinzeka nge-analgesia eqhubekayo, okuwenza afanelekele izinqubo ezithatha isikhathi eside.
I-anesthesia ye-spinal-epidural ehlanganisiwe ihlinzeka ngokuguquguquka kwe-dosing. Ivumela umuthi ukuthi ufakwe titrated, okusho ukuthi udokotela obulala izinzwa angakwazi ukulungisa umthamo ngokuya ngezidingo nezimpendulo zesiguli. Le ndlela yomuntu siqu isiza ukufeza ukulawulwa kobuhlungu okulungile ngenkathi inciphisa imiphumela emibi engaba khona.
Ngaphezu kwalokho, i-CSE ihlotshaniswa nengozi ephansi yezinkinga zesistimu uma kuqhathaniswa ne-anesthesia ejwayelekile. Ingase ilondoloze kangcono ukusebenza kwamaphaphu, igweme izinkinga ezithile ezihlobene nendlela yomoya, futhi igweme isidingo sokusebenzisa i-endotracheal intubation. Iziguli ezibhekana ne-CSE ngokuvamile zithola ubuhlungu obuncane ngemva kokuhlinzwa kanye nezikhathi zokululama ezimfushane, ezizivumela ukuba zibuyele emisebenzini evamile ngokushesha okukhulu.
Ekuphetheni, i-neuraxial ne-epidural anesthesia ehlangene iyindlela ebalulekile yokuhlinzeka nge-anesthesia, i-anesthesia yokuthutha, ne-analgesia ezigulini phakathi nezinqubo zomtholampilo. Ikhithi ye-spidural epidural ehlanganisiwe kanye nezingxenye zayo, njengesirinji yenkomba ye-LOR, inaliti ye-epidural, i-epidural catheter, nesihlungi se-epidural, idlala indima ebalulekile ekuqinisekiseni ukuphepha, ukusebenza kahle, kanye nempumelelo yenqubo. Ngezinzuzo zayo kanye nezicelo, i-CSE isibe yingxenye ebalulekile yomkhuba wesimanje wokubulala izinzwa, ukuhlinzeka iziguli ngokuphathwa okungcono kobuhlungu nokululama ngokushesha.
Isikhathi sokuthumela: Oct-25-2023