I-anesthesia yomgogodla ehlanganisiwe(CSE) kuyindlela esetshenziswa ezinqubweni zezokwelapha ukunikeza iziguli i-anesthesia ye-epidural, i-anesthesia yokuthutha, kanye ne-analgesia. Ihlanganisa izinzuzo ze-anesthesia yomgogodla kanye namasu e-anesthesia ye-epidural. Ukuhlinzwa kwe-CSE kuhilela ukusetshenziswa kwekhithi ye-spinal epidural ehlanganisiwe, ehlanganisa izingxenye ezahlukahlukene ezifana ne-LOR indicatorisirinji, inaliti ye-epidural, i-catheter ye-epidural, futhiisihlungi se-epidural.
Ikhithi ye-spinal epidural ehlanganisiwe yakhelwe ngokucophelela ukuqinisekisa ukuphepha, ukusebenza kahle kanye nokulula kokusetshenziswa ngesikhathi senqubo. Isirinji ye-LOR (Loss of Resistance) iyingxenye ebalulekile yekhithi. Isiza udokotela wezinzwa ukuhlonza ngokunembile isikhala se-epidural. Lapho i-plunger yesirinji idonswa emuva, umoya udonswa ungene emgqonyeni. Njengoba inalithi ingena esikhaleni se-epidural, i-plunger ihlangabezana nokumelana ngenxa yokucindezela koketshezi lwe-cerebrospinal. Lokhu kulahlekelwa ukumelana kubonisa ukuthi inalithi isendaweni efanele.
Inaliti ye-epidural iyinaliti engenalutho, enodonga oluncane esetshenziselwa ukungena esikhumbeni iye ekujuleni okufunwayo ngesikhathi sokuhlinzwa kwe-CSE. Yenzelwe ukunciphisa ukungakhululeki kwesiguli nokuqinisekisa ukufakwa okunembile kwe-catheter ye-epidural. Ihabhu yenaliti ixhunywe kwisirinji yenkomba ye-LOR, okuvumela udokotela we-anesthesiologist ukuthi aqaphe ukumelana ngesikhathi sokufakwa kwenaliti.
Uma isisesikhaleni se-epidural, i-catheter ye-epidural idlula ngenaliti bese ithuthukiswa iye endaweni oyifunayo. I-catheter iyithubhu eguquguqukayo ehambisa i-anesthetic yendawo noma i-analgesic esikhaleni se-epidural. Ibanjwa endaweni yayo ngetheyiphu ukuvimbela ukuguquka ngengozi. Kuye ngezidingo zesiguli, i-catheter ingasetshenziswa ekufakweni okuqhubekayo noma ekuphathweni kwe-bolus ngezikhathi ezithile.
Ukuqinisekisa ukuphathwa kwemithi esezingeni eliphezulu, isihlungi se-epidural siyingxenye ebalulekile ye-CSE suite. Isihlungi sisiza ukususa noma yiziphi izinhlayiya noma amagciwane angaba khona emuthini noma ku-catheter, ngaleyo ndlela sinciphise ingozi yokutheleleka kanye nezinkinga. Senzelwe ukuvumela ukuhamba kahle kwemithi ngenkathi kuvimbela noma yikuphi ukungcola ukuthi kufinyelele emzimbeni wesiguli.
Izinzuzo zobuchwepheshe obuhlanganisiwe bomgogodla-epidural ziningi. Ivumela ukuqala okuthembekile nokusheshayo kwe-anesthesia ngenxa yomthamo wokuqala womgogodla. Lokhu kuzuzisa kakhulu ezimweni lapho kudingeka khona ukuqeda ubuhlungu ngokushesha noma ukungenelela. Ngaphezu kwalokho, ama-catheter e-epidural ahlinzeka nge-analgesia eqhubekayo, okwenza afanelekele izinqubo ezithatha isikhathi eside.
I-anesthesia ehlanganisiwe yomgogodla ne-epidural iphinde inikeze ukuguquguquka komthamo. Ivumela umuthi ukuthi ulinganiswe, okusho ukuthi udokotela wezinzwa angalungisa umthamo ngokusekelwe ezidingweni zesiguli kanye nezimpendulo. Le ndlela eyenzelwe wena uqobo isiza ekufinyeleleni ukulawula ubuhlungu okuhle kakhulu ngenkathi kunciphisa imiphumela emibi engaba khona.
Ngaphezu kwalokho, i-CSE ihlotshaniswa nengozi ephansi yezinkinga zomzimba uma kuqhathaniswa ne-anesthesia ejwayelekile. Kungalondoloza kangcono ukusebenza kwamaphaphu, kugweme izinkinga ezithile ezihlobene nomgudu womoya, futhi kugweme isidingo sokufakwa kwe-endotracheal intubation. Iziguli ezenza i-CSE zivame ukuzwa ubuhlungu obuncane ngemva kokuhlinzwa kanye nezikhathi ezimfushane zokululama, okuzivumela ukuthi zibuyele emisebenzini evamile ngokushesha.
Ekuphetheni, i-anesthesia ehlanganisiwe ye-neuralaxial kanye ne-epidural iyindlela ewusizo yokuhlinzeka nge-anesthesia, i-anesthesia yokuthutha, kanye ne-analgesia ezigulini ngesikhathi sezinqubo zomtholampilo. Ikhithi ye-epidural yomgogodla ehlanganisiwe kanye nezingxenye zayo, njengesirinji yesibonakaliso se-LOR, inaliti ye-epidural, i-catheter ye-epidural, kanye nesihlungi se-epidural, idlala indima ebalulekile ekuqinisekiseni ukuphepha, ukusebenza kahle, kanye nempumelelo yenqubo. Ngezinzuzo zayo kanye nokusetshenziswa kwayo, i-CSE isibe yingxenye ebalulekile yomkhuba wesimanje we-anesthesia, inikeza iziguli ukuphathwa okungcono kobuhlungu kanye nokululama okusheshayo.
Isikhathi sokuthunyelwe: Okthoba-25-2023