Epidural anesthesia ine chikamu chesarasi inoshandiswa sechikonzero chechimiro cheaneshesia. Iyi mhando yenharaunda yeanesthesia inobatsira kwazvo, ine madhara maduku. Chimbofunga izvi zvakanyatsotsanangurwa, kusimbisa zviratidzo, zviitiko zvekufambisa uye zvinopesana.
Epidural anesthesia - zviratidzo
Epidural anesthesia ne cesarean inoitwa nechishuvo chemukadzi ari mubasa. Vanaamai vazhinji vemazuva anouya avo vanorayirwa chikamu chakarongwa vanosarudza zvakananga kune rudzi urwu rweaneshesia. Neine aneshesia yakadaro, mukadzi wacho anoramba achiziva, anonzwa kuchema kwekutanga kwechecheche, asi haanzwi chinhu zvachose. Panewo zvimwe zvinhu muhupo hwechiitiko chinonzi anesthesia chinotarisirwa kuti chirege kuchengetedzwa. Pakati pavo pane:
- kuvapo kwe preeclampsia ;
- high blood pressure;
- chiropa uye chirwere chetsvo;
- pronounced myopia;
- chirwere cheshuga mellitus;
- contraindications kune general anesthesia;
- basa rakawandisa basa;
- mamiriro ezvinhu echirwere chechibereko.
Ko chikamu chekudzivirira chinokonzerwa sei nemafungiro epidural anesthesia?
Vakadzi, vachigadzirira kuvhiyiwa, vanowanzofarirwa navanachiremba, sezvinoitwa chikamu chechiesarea ne epidural anesthesia. Pamberi pokutanga kwekuvhiya, mukadzi ane pamuviri anogara pasi panhovo, kana kuti akarara padivi rake. Nharaunda yemutsara wepelinha umo nenyuchi inowanikwa inochengetedzwa zvakanyatsorariswa neine antiseptic. Mushure mokutanga kweanesthesia, vanachiremba vanoita kuvhara mucheche pasi, zvichida pamusoro pepasicic. Pakuvadzwa kwekuvhiya, kuwedzera kunogadziriswa, kuzarura kugona kumucheche.
Mushure mokuzarura kwakanaka kwechirwere, vanachiremba vanotanga kubvisa michero kunze. Mushure mekubudirira kwekugadzirisa danga iri, mwana anocheka mutsara wembilical uye chirongwa chinoshandiswa. Amai anopiwa oxytocin, nokuda kwekuparadzaniswa kwekuberekwa. Mushure meizvi, suturing inoitwa. Panzvimbo yemutsara kwemwedzi mishomanana gare gare pane chivara, chinenge chakanga chisingaoneki, hachiiti kuti Amai vasava nehanya.
Ndezvipi zvakashata anesthesia zvakaitwa muchikamu chekushaya chirwere?
Epidural anesthesia muchikamu chechikaanese chinowanzotaurwa muhugaro. Muchiitiko ichi, murwere anopiwa kuti atore nzvimbo: makumbo kuti aparadzwe mumabvi, aise mavhiri pamubhedha, afukidze shure, achitsiva chikamu chechibereki. Zvimwe ndezvekuti mukadzi akange avete parutivi rwake (kakawanda kurudyi). Zvisinei, chiito chekurapa chinoratidza kuti zvakajeka kupa mutsauko muhutano hwemurwere.
Anesthetic, nerubatsiro rwetsono inokosha, inopindirwa munzvimbo iyo iri pamadziro emugero wepelinha uye yakaoma shell yepelinical space (epidural space). Chimwe chidimbu, chakaonda sterile tube (catheter) chinosungirirwa kuburikidza nenyuchi, iyo inosara yejairo yeanesthetic. Epidural anesthesia, ine chikamu chekushaya chirwere, inosanganisira kuisa madhiragi ichi: kuwedzera kuvhara kana kuvharwa kwayo.
Zvinorwadza here kuita epidural anesthesia ne cesarean?
Iyi nzira, sepidural anesthesia, inenge isingarwadziri nemurwere pachake. Vasati vasvika, vanachiremba vanoita anesthesia yemunharaunda. Kunetseka kuduku, kurwadziwa kwepamuviri pamuviri anokwanisa kunzwa chete panguva yekuvhara. Mune imwe nzvimbo iyo nzira haina kukonzera marwadzo, inonyatsokurudzirwa nevakadzi vari munzvimbo. Zviitiko zveamai vanguva yemberi, pamusoro pekurwadziwa kwekushandiswa kwakadaro, sepidural anesthesia mune chikamu chekudzivirira, hazvina maturo.
Inguva yakareba sei chikamu chekudzivirirwa chinopedzisira chave chenguva yakawanda?
Chikamu cheCesarea pasi pepidural anesthesia hachina nguva inopfuura hafu yeawa. Panguva imwecheteyo, paavhareji, kubva panguva yekutungamirirwa kusvika kubudiswa kwemucheche kunze kubva pamimba, zvinotora 10-15 maminitsi. Nguva yose yasara inoshandiswa pakugadzirisa ronda re postoperative. Panguva imwecheteyo, mukadzi anopiwa hormone yekubviswa uye kuberekwa kweparcenta. Kuti udzivirire utachiona, amai vanopiwa antibacterial drugs.
Cesarea pasi pepidural anesthesia - sensations
Nekuita kwakakodzera kweanesthesia, mukadzi haanzwi chero chinhu panguva yekushanda. Kufungidzira muchikamu chechiesarea pasi pepidural anesthesia kunobatanidza nekutangira kwechiito chekushaya maitiro. Mushure mokujowa, mukadzi ane pamuviri anotanga kuona kuchema, kunzwa kunetseka mumakumbo ake. Mushure mechinguva, amai vari kumangwana havanzwi zvachose chikamu chezasi chedu - chinhu chipi nechipi pasi pejw.org. Chimwe chinhu chisina simba chinopararira mumuviri wose. Ichi chiitiko chinogona kuenderedzwa nekutinhira kuduku, manzwiro ekubuda kwebasa, izvo zvinonyangarika mushure mokuzadza anesthesia.
Ndedzipi dzakawanda dzinopesana neseshesia mushure mokunge dzisara?
Epidural anesthesia ne caesarean inenge maawa maviri. Pakarepo panguva ino, vanachiremba vanodzivisa mukadzi kuti amuke mushure mekushanda. Nemhando iyi yeanesthesia, ropa rinoyerera mumumucheto uri pasi rinoderera. Nemhaka yeizvi, kana iwe ukaedza kumuka, kune utera mumakumbo ako - kune huwandu hwakanyanya hwekuwira. Mukuwedzera, kazhinji mushure mokuvhiyiwa kune musoro, dutu, izvo zvinowedzera hupenyu hwemutsva.
Epidural anesthesia muchikamu chekasearean - mhinduro
Migumisiro inotevera mushure mekushaya chirwere chepfungwa muchikamu chekudzivirirwa kazhinji chinowanzobatanidzwa nekusateerera kusingapindirani kune zvaanoita kana nekuputsa kwechirongwa cheanesthesia. Munyaya iyi zvinetso zvinogona kutaurwa, zvose kubva kuna amai nevana. Tevera migumisiro yepachirwere anesthesia yevakadzi vepakati (munguva yebasa):
- kushungurudzika kwehombodo yakaoma yemutsipa wepelinha;
- kuderera kwepfungwa yemwoyo;
- kuratidzika kwekunyunyutira uye kurutsa;
- zvinokonzera kugadzikana kusvika kune anesthetic.
Kuvhiringidzika kunogona kukura mune imwe nguva ichangobva kuve mu postpartum period:
- kurwadziwa kumusana nemusoro;
- kukanganisa kwe lactation ;
- kuderera kwekunzwa kwemakumbo;
- kuvhiringidzwa kweCSS.
Kuita zvisina kunaka epidural anesthesia nechikamu chekudya chinogona kukanganisawo mwana wemamiriro ezvinhu:
- kuderera kwenhamba yemwoyo (bradycardia);
- kuputsa kwekufema;
- kutyora kweanotora reflex;
- disorientation;
- encephalopathy.
Kurwadziwa shure shure kwepachirwere anesthesia ne cesarean
Epidural anesthesia ane caesarean, mhedzisiro yaro inonzi zita iri pamusoro, kazhinji inoshandura kurwadziwa kwemukadzi mushure mokuberekwa kwomwana. Panogona kuva nezvikonzero zvakawanda zveizvi. Dangerous epidurit - chirwere chekuvhiringidza munzvimbo yepidural. Ichi chinetso chinowedzera nekuda kwenzvimbo refu kwenguva iyo catheter kumashure kana kana chikamu chayo chiripo. Mukuwedzera, kurwadziwa kunogona kuwedzera kukura mushure mekuvhiyiwa nekuda kwehutachiona hwechirwere.
Zvimwe zvinokonzera marwadzo kumashure kunobatanidzwa zvakananga nemufambiro wakaipa wehutano hwakadai sepidural anesthesia mune chikamu chekudzivirira, mitezo yemuviri kune anesthetic. Nokuda kwekushaiwa ruzivo rwakawanda, chiremba angakuvadza injector nehombodo yakaoma, uko maitiro emidzi aripo. Zvakasiyana, zvakakosha kusiyanisa kurwadziwa kwepantom, iyo inobatana zvakananga nemamiriro ekufunga kwemu murwere.
Musoro wepfungwa mushure mepachirwere anesthesia ne cesarean
Kutaura pamusoro pemigumisiro uye zvinetso zvepidural anesthesia muchikamu chekudzivirira, zvakakosha kusiyanisa nekugara misoro mushure mekushanda. Kuonekwa kwavo kunobatanidza nemigumisiro yeanesthetic chikamu pamuviri. Izvi zvinowanikwa mu50% yevarwere avo vakawana epidural analgesia. Nguva yekutorwa kunorwadza - kubva maawa akawanda kusvika kumavhiki mashomanana. Musoro unogona kukonzerwa nekushandurwa kwekusagadzikana kwepfungwa, nekuda kwekubuda kweperesipinal fluid muchikamu chepidural (pamwe nekukuvadza kamuviri kuropi).
Mamiriro ezvinhu akadaro anoda kupindira kwekupirisa. Basa racho rinosanganisira kudzokorora kutsva uye kunwa kwechirwere nemubatsiro wezvinhu zvakakosha. Mushure mekunyengedza, chirongo cheropa chinowanikwa panzvimbo yekunyura. Ropa revarwere rinotorwa kubva mumhino rinopindwa mujecha rekuvhara. Somugumisiro, kuputika kwechirebrospinal fluid yakavharwa. Ruregerero rwehupenyu hwehupenyu hunotaura kare kare zuva rakatevera mushure mekuita.
Epidural anesthesia ine chikamu cheshesa - zvinopesana
Iyi mhando yenharaunda yeanesthesia inogona kunge isingashandisi nguva dzose. Uye chero kurapwa kupi zvoutano, zvinorambidzwa kuita uye ine epidural anesthesia neKesariya, zvinopesana nekushandiswa kweizvi zvinotevera:
- kuramba kwekutsungirira;
- kusabatwa kwemichina yakakosha kana nyanzvi yepamusoro;
- kuora muviri kwakanyanya;
- kuora muviri kwemuviri;
- kuvhiringidzwa kweropa coagulation system;
- hypotension;
- kutora anticoagulants ;
- kugunzva kwepamuviri;
- kukwirira kusina simba;
- zvinokonzera kugadzikana kusvika kune anesthetic;
- moyo rhythm kuvhiringidzika;
- fetal hypoxia ;
- kusagadzikana kwe fetus.