I-epestural anesthesia ene- caesarean section isetshenziswa njengesisekelo sohlobo lwe-anesthesia. Loluhlobo lwe-anesthesia yesifunda luphumelela kakhulu, lunemiphumela emibi emincane. Cabanga ngalokhu ngokuningiliziwe, ukugqamisa izinkomba, izici zokuziphatha nokuphikisana.
I-Epidural anesthesia - izinkomba
I-epestural anesthesia ene-cearean yenziwa ngesifiso sowesifazane osemsebenzini. Omama abaningi abasha abaqokwe isigaba esihleliwe bakhetha ngokuqondile lolu hlobo lwe-anesthesia. Nge-anesthesia enjalo, lo wesifazane uhlala eqonda, ezwa ukukhala kokuqala komntanakhe, kodwa akazwa lutho. Kukhona nezici lapho kukhona khona i-anesthesia ye-epidural inesibopho sokuqeda. Phakathi kwabo kukhona:
- ubukhona be- preeclampsia ;
- umfutho wegazi ophezulu;
- isifo sobindi nesifo sezinso;
- i-myopia ebizwa;
- isifo sikashukela mellitus;
- ukuphikisana no-anesthesia jikelele;
- umsebenzi omningi ngokweqile;
- izimo ezinzima zesisu.
Isigaba se-cearean sinjani nge-anesthesia ye-epidural?
Abesifazane, abalungiselela ukuhlinzwa, bavame ukuba nesithakazelo odokotela, njengoba kwenza isigaba sokudla nesifo sofuba esine-epidural anesthesia. Ngaphambi kokuqala kokuhlinzwa, owesifazane okhulelwe uhlala phansi embhedeni, noma elele eceleni kwakhe. Indawo yenkomba yomgogodla lapho inaliti efakwe khona iphathwa ngokucophelela nge-antiseptic. Ngemuva kokuqala kwe-anesthesia, odokotela benza ukuchotshozwa esiswini esingaphansi, mhlawumbe ngaphezu kwendawo yokushicilela. Esigunjini sokuhlinzwa, kunwetshwa, ukuvula ukufinyelela kumntwana.
Ngemuva kokuvula kahle kwesikhumba, odokotela baqala ukukhipha izithelo ngaphandle. Ngemuva kokuphothulwa kwalesi sigaba ngempumelelo, umntwana usika intambo yomzimba futhi kusetshenziswe isihluthulelo. Umama unikezwa i-oxytocin, ngenxa yokuhlukaniswa kokuzalwa kokuzalwa. Emva kwalokhu, i-suturing yenziwa. Esikhundleni somswakama ezinyangeni ezimbalwa kamuva kunesibazi, esicishe singabonakali, asibangeli umama.
I-anesthesia ye-epidural yenziwe kanjani esigabeni sokudla?
I-epestural anesthesia engxenyeni ye-cache isetshenziswa ngokujwayelekile endaweni yokuhlala. Kulesi simo, isiguli sinikezwa ukuba sithathe isikhundla: imilenze yokuqothula emadolweni, ukubeka amazinyo embhedeni, ukuguqula emuva, ukuguqula isigaba somlomo wesibeletho. Okunye indawo yowesifazane olele eceleni kwakhe (ngokuvamile kaningi ngakwesokudla). Kodwa-ke, umkhuba wezokwelapha ubonisa ukuthi kulula ukuhlinzeka ukuhlinzekwa kwezifo endaweni yokuhlala kwesiguli.
Ukuhlinzeka ngezinzwa, ngosizo lensiza ekhethekile, kufakwa emkhatsini wodonga lomgogodla womgogodla kanye negobolondo elinzima lomgogodla (isikhala se-epidural). I-tube ekhethekile oyinyumba (i-catheter) ifakwa ngokusebenzisa inaliti, eseleyo ukujola kwe-anesthetic. I-epestural anesthesia, ene-caesarean section, ihilela ukulandelela lesi sidakamizwa: ukwandisa ukuhlushwa noma ukuyeka ukunikezwa kwayo.
Ingabe kubuhlungu ukwenza i-anesthesia ye-epidural nge-cearean?
Le nqubo, njenge-anesthesia ye-epidural, ayibuhlungu kakhulu isiguli ngokwayo. Ngaphambi kokugqunywa, odokotela benza i-anesthesia yendawo. Ukukhathazeka okuncane, ubuhlungu obukhulelwe abakhulelwe bangazizwa kuphela ngesikhathi sokubanjwa. Ngakolunye uhlangothi inqubo ayibangeli ubuhlungu, ibekezeleleke ngokuphelele abesifazane besendaweni. Okuhlangenwe nakho komama wesikhathi esizayo, ngokuphathelene nobuhlungu bokuphathwa okunjalo, njenge-anesthesia ye-epidural engxenyeni yokulahla, ayinasisekelo.
Isigaba esingasese sikhona isikhathi esingakanani sokuphefumula kwesifo se-epidural?
Ingxenye yesesare ngaphansi kwe-anesthesia ye-epidural ingapheli isigamu sehora. Ngesikhathi esifanayo, ngokwesilinganiso, kusukela ngesikhathi sokuphatha ukukhishwa kwesisu esiswini kusukela esiswini, kuthatha imizuzu engu-10-15. Isikhathi sonke sichithwa ekusebenziseni isilonda emva kokusebenza. Ngesikhathi esifanayo, owesifazane unikezwa ihomoni yokususwa nokuzalwa kwe-placenta. Ukuze uvimbele ukutheleleka, umama unikezwa izidakamizwa zokulwa nezifo.
I-Caesarea ngaphansi kwe-epestural anesthesia - sensations
Ngokusebenza kahle kwe-anesthesia, owesifazane akazizwa lutho ngesikhathi sokusebenza. Ukucatshangelwa esigabeni sokudla ngaphansi kwe-epidural anesthesia kuhlotshaniswa nokuqala kwesenzo se-anesthetic. Ngemva komjovo, owesifazane okhulelwe uqala ukubona ukufudumala, umuzwa wokucindezeleka emilenzeni yakhe. Ngemva kwesikhashana, umama ozayo ngeke azizwe ngokuphelele engxenyeni engezansi ye-trunk - noma yini engaphansi kwesayithi lomjovo. I-numb numbness iyandalala kuwo wonke umzimba. Lesi simo singahambiswa nokuxubana okuncane, umuzwa we-goosebumps, owanyamalala ngemuva kokuphelelwa yisikhathi kwe-anesthesia.
Zingaki i-anesthesia ye-epidural ngemuva kwe-cearean?
I-epestural anesthesia ene-caesarean cishe amahora amabili. Ngokushesha ngalesi sikhathi, odokotela banqabela owesifazane ukuba avuke ngemuva kokuhlinzwa. Ngaloluhlobo lwe-anesthesia, ukugeleza kwegazi emaphethelweni aphansi kunciphisa. Ngenxa yalokhu, uma uzama ukuvuka, kunobuthakathaka emilenzeni yakho - kunamathuba aphezulu okuwa. Ngaphezu kwalokho, ngokuvamile ngemva kokuhlinzwa kukhona ukukhanda ikhanda, isizungu, okwenza kube ngcono impilo yabantu abasha.
I-epestural anesthesia emkhakheni we-caesarean - imiphumela
Imiphumela emva kokubulawa kwe-epidural anesthesia esigabeni sokuqeda izivame kuvame ukungahambisani nokungahambisani nokuziphatha kwakhe noma ukwephulwa kwe-algorithm ye-anesthesia. Kule nkinga kungenzeka ukuphawula, kokubili kumama nomntwana. Landela imiphumela ye-anesthesia ye-epidural kubantu besifazane abahamba phambili (ngesikhathi sokubeletha):
- ukuhlukunyezwa kwegobolondo elinzima lomthambo womgogodla;
- ukwehla kwenhliziyo;
- ukubonakala kwesicasule nokuhlanza;
- ukusabela okweqile ku-anesthetic.
Ukuphazanyiswa kungathuthuka esikhathini esisha esisha ngemuva kwesikhathi sokuhamba kwesikhathi:
- ubuhlungu ngemuva nangenhloko;
- ukwephulwa kwe- lactation ;
- ukwehlisa ubuzwe bemilenze;
- ukuphazanyiswa kwe-CNS.
Ukwenza kabi i-anesthesia ye-epidural nge-caesarean sigaba kungathinta nesimo somntwana:
- ukwehla ngesilinganiso senhliziyo (bradycardia);
- ukwephula inqubo yokuphefumula;
- ukwephulwa kwe-reflex esondayo;
- ukudideka;
- ukukhathazeka.
Ubuhlungu emuva emuva kwe-anesthesia ye-epidural ne-cearean
I-epestural anesthesia ene-Caesarean, imiphumela yayo ebizwa ngenhla, ngokuvamile iphenduka ubuhlungu besifazane ngemuva kokuzalwa kwengane. Kukhona izizathu eziningi zalokhu. I-Dangerous yi-epidurit - inqubo yokuvuvukala esikhaleni se-epidural. Le nkinga ivela ngenxa yendawo ehlala isikhathi eside ye-catheter ngemuva noma lapho ingxenye yayo ihlala khona. Ngaphezu kwalokho, ubuhlungu bungase bubi nakakhulu ngemva kokuhlinzwa ngoba kutholakala umlando wakhe we-vertebral.
Ezinye izimbangela zobuhlungu endaweni yangemuva zihlobene ngokuqondile nokuziphatha okungalungile kwenqubo efana ne-anesthesia ye-epidural engxenyeni ye-cearean, impendulo yomzimba ku-anesthetic. Ngenxa yokungabi nalwazi olunzulu, udokotela angalimaza i -jectject ngegobolondo elinzima, lapho izimpande zemizwa zikhona khona. Ngokuhlukile, kubalulekile ukuhlukanisa ubuhlungu obukhulu, obuhlobene ngokuqondile nesimo sengqondo sesiguli.
Izinsizwa ngemuva kwe-anesthesia ye-epidural ne-cearean
Ukutshela ngemiphumela kanye nezinkinga ze-anesthesia ye-epidural endaweni yesigcawu, kuyadingeka ukuhlukanisa nokukhanda ikhanda ngemuva kokusebenza. Ukubukeka kwabo kuhlotshaniswa nomphumela we-anesthetic ingxenye emzimbeni. Lokhu kusabela kubonakala kuma-50% weziguli ezazithola zi-analgesia ze-epidural. Ubude bezinzwa ezibuhlungu - kusukela emahoreni amaningana kuya emavikini amaningana. Izinwele zingabangelwa ukuguqulwa kwengcindezi yokungasebenzi, ngenxa yokuphuma kwe-cerebrospinal fluid endaweni yesikhala (ngokulimala ebuchosheni bobuchopho).
Izimo ezinjalo zidinga ukunakekelwa kokuhlinzwa. Ukusebenza kufaka ukuphindaphindiwe nokuphuza komthamo ngokusiza idivayisi ekhethekile. Ngemuva kokuxhaphaza, i-puncta yegazi ifakwa kwisayithi lokugaya. Igazi lesiguli esithathwe emthanjeni lijojelwe esakhiweni sokubanjwa. Ngenxa yalokho, ukuphuma kwe-cerebrospinal fluid kuvinjelwe. Ukukhululwa kwesifazane onhlalakahle kubhala kakade ngosuku olulandelayo ngemuva kwenqubo.
I-Epestural anesthesia ene-caesarean section - ukungqinelani
Loluhlobo lwe-anesthesia yesifunda lungase lungasetshenziswa ngaso sonke isikhathi. Futhi noma yikuphi ukuxhaphaza ngokwezokwelapha, ukuvinjelwa ekufezeni futhi kune-anesthesia ye-epidural neKhesariya, ukuphikisana kokusetshenziswa kwalokhu okulandelayo:
- ukwenqaba kwesiguli;
- ukungabikho kwemishini ekhethekile noma ochwepheshe abaqeqeshiwe;
- isifo esibi kakhulu;
- ukuphelelwa amanzi emzimbeni;
- ukuphazamiseka kwesistimu yegazi coagulation;
- i-hypotension;
- ukuthatha ama- anticoagulants ;
- ukulimala komgogodla;
- ukucindezela okuphezulu okungahambi kahle;
- ukusabela okweqile ku-anesthetic;
- ukuphazamiseka kwenhliziyo;
- hypoxia yesisu ;
- ukulimazeka kwe-fetus.