Nzvimbo iri pakati pepakati penzvimbo yemapfupa emakona emusana uye nguva yakasimba inonzi epidural. Kuburikidza nekugara kwenguva refu, nerve rootlets inopinda mairi, uye kushandiswa kwegadziriro yeanesthesia yemo kunodzivirira kusanganisa kudarika kuburikidza navo. Pamusana peizvi, zvinokwanisika kubudirira kurasikirwa kwekunzwisisika uye motokari inoshanda mune chimwe chikamu chemuviri, kana chirwere chinoputika chinoputirwa munzvimbo yepadural yemumwe musana.
Kuti urambe uchinge uchinge wakaberekwa, injoa zvinhu zvinopa kurasikirwa kwenyasha, uye apo chikamu chekudzivirira chiri kuitwa pasi pepidural anesthesia, zvino zvinodhaka zvinodzivisa mhepo yekuita zvinowedzerwa. Kuburikidza nesingano kupinda mune epidural space, catheter inowedzerwa, nheyo inobviswa, uye inogadzirwa nesimbi inoshandiswa nguva nenguva mu catheter yakagadzirirwa pafudzi kubva pakutanga kwezvinyorwa zvekare: lidocaine kana mamwe magadzirirwo emanhasi.
Kuberekwa pasi pepidural anesthesia
Mushure mokuteerera nyaya kubva kune shamwari pamusoro pekusununguka kwepachirwere aneshehesia, vakadzi vakawanda, vachitya kutya kubereka, vanotanga kufarira nzira iyi yeanesthesia. Ikoko kunoratidzika kusina chaicho chinonyatsoratidza iyo nzira, kunze kwekuti chido chekudzikisa marwadzo munguva yebasa. Asi epidural anesthesia haina kukanganisa fetus zvakananga: mishonga haifaniri kupfurikidza nechigadziro chinopfurikidza. Mukuwedzera, nekuberekwa kwekuzvarwa kwepanyama, epidural anesthesia haibatsiri nguva yezvenguva yekushanda: zvipembenene zvinoitika, chibereko chechivharo chinosvinudzwa, asi hapana marwadzo. Inoderedza kuwedzera kweropa, izvo zvakanaka kune gestosis yekuzvitakura, uye iyi nzira yeanesthesia inogona kushandiswa chero ipi zvayo, hapana maitiro akawanda asingagoni kudzivirirwa neaneshehesia yakawanda yebasa.
Epidural anesthesia mukubereka - cons
Izvo zvakakosha zvingave zvisina kuitika, epidural anesthesia ndiyo nzira iyo inonyanya kuenderana nekodzero ye anesthesiologist uye chero zvikanganiso mukuita kwayo zvinogona kukonzera migumisiro yakaipisisa mushure mekusununguka nekuda kwepachirwere anesthesia. Pamigumisiro iyi, yakaoma zvikuru paresis uye kuora mitezo nekukuvara kumagumo ekupedzisira. Kukanganisa kunogona kuitika kwebasa, kukanganisa kwemwoyo mutambo mumadzimai ose uye fetus, kutyora kwe thermoregulation (iyo nzira inokonzera kuwedzera kwekushisa kwemuviri), kukanganiswa kwechidzitiro. Ikoko kunogonawo kuva nekuvhiringidza mukuedza, izvo zvingaita kuti kubudiswa kwe fetus (kuburikidza nekushandiswa kwe forceps).
Kupindirana kwezvirwere zvepachirwere anesthesia panguva yekuberekwa
Epidural anesthesia ndiyo nzira ine zvimwe zvinopesana nezviratidzo. Chokutanga pane zvose, zvinopesana mumatambudziko e hypersensitivity kune anesthetics yekunzvimbo. Contraindications inosanganisirawo:
- kubuda ropa;
- kuvhara ropa kweropa;
- kunyengera uye kushungurudzika;
- kuora mwoyo;
- zvipembenene zvehupenyu zvepakati yenheyo;
- zvirwere zvepelinha;
- kuwedzera kusagadzikana kwechisimba;
- arrhythmia uye kusuruvara kwesimba;
- chibereko chemukati.
Usaita anesthesia pamberi peganda rinoputika kana mavara panzvimbo yejojo. Chimwe chirevo chinopesana chinogona kunge chiri kunyanyisa: kuiswa kwetsono kuburikidza nehutema pasi pekunanisa mafuta yakatsetseka kunonetsa kuvanachiremba.
Migumisiro yepidural anesthesia mushure mekusununguka
Vakadzi vazhinji vanong'un'una kuti mwedzi mishomanana mushure mekugadzirisa kwavakaita mushure mekukuvara kwemazuva ekupedzisira, pakanga pane kuora muviri uye paresis, kusavhiringidza kwemuti uye nyuchi, kana matambudziko akamuka pamwe nekubudiswa kwemucheche uye izvi zvakaunza matambudziko akasiyana mumwana. Musoro wemusoro ndeimwe yemigumisiro inonyanya kushamisa yepidural anesthesia, iyo inoratidzika inoratidza huwandu hwevakadzi vanozvara anesthesia yakadaro.
Asi mhinduro yekuti chikamu chekudzivirira chakanga chashandiswa sei, apo chirwere chinonzi anesthesia chakashandiswa, chiri nani zvikuru kupfuura avo vakaitwa pasi peaneshesia rose, sezvo pane zvichemo zvishoma mumamai nemwana kubva kune aneshehesia yakawanda. Maererano nenhau dzevakadzi vazhinji, kushungurudza kukuru mukushanda pasi pe "epidural" kwaiva chido chekuti vazive, vachitya kuti zvinokuvadza, uyewo kusagadzikana kwepfungwa kubva kune kuora muviri kwemuviri.
Ruzhinji rwevakadzi vanocherechedza uye chimwe chimwe chisingafadzi chepidural anesthesia - apo anesthesia inoparadzana, yakasimba zvikuru inotanga, iyo inogona kutarisirwa chete nekubatsirwa kwemishonga inowedzera.
Kana hutano, hupfungwa uye hugadziro rwemukadzi pakuberekwa kunobvumira - zviri nani kuti usashandise anesthesia, sezvo chero kupindira mune zvisikwa pasina zvikonzero zvakakodzera kunogona kuva nemigumisiro yakaipa kwazvo.