Sezvo kufambira mberi mune zvekurapa kuri kuramba kuchivandudza munda weanesthesia,yakasanganiswa spinal epidural anesthesiayave nzira yakakurumbira uye inoshanda yekunyaradza marwadzo panguva yekuvhiyiwa uye mamwe maitiro ekurapa. Iyi nzira yakasiyana-siyana inobatanidza zvakanakira musana uye epidural anesthesia kupa varwere vane marwadzo ekugadzirisa marwadzo uye kunyaradza kwakakwana. Nhasi, tichatarisa zvakadzama mashandisirwo, mhando dzetsono, uye hunhu hwakasanganiswa spinal-epidural anesthesia kuti ikubatsire kudzidza zvakawanda nezve iyi shanduko yekurapa tekinoroji.
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Yakasanganiswa spinal-epidural anesthesia, inonziwoCSE anesthesia, zvinosanganisira kupinza zvinodhaka zvakananga mucerebrospinal fluid (CSF) yakakomberedza rwonzi rwomuzongoza. Izvi zvinobvumira kukurumidza kutanga kwechiito uye yakadzika anesthesia kana ichienzaniswa nedzimwe nzira. Mishonga inoshandiswa muCSE anesthesia isanganiswa yeanesthetic yemunharaunda (yakadai sebupivacaine kana lidocaine) uye opioid (yakadai sefentanyl kana morphine). Nokubatanidza mishonga iyi, anesthesiologists vanogona kuwana kukurumidza uye kwenguva refu marwadzo ekurwadziwa.
Yakasanganiswa lumbar-epidural anesthesia inoshandiswa zvakanyanya uye inovhara maitiro akawanda ekuvhiya. Inowanzoshandiswa mukuvhiyiwa kwepazasi peguvhu, pelvic uye kuzasi kwekupedzisira pamwe nekushanda nekuzvara. CSE anesthesia inonyanya kubatsira mukuzvara nekuti inogona kubvisa marwadzo panguva yekuzvara ichichengetedza kugona kusunda pachikamu chechipiri chekuzvara. Pamusoro pezvo, CSE anesthesia iri kuwedzera kushandiswa mukurapa kwekunze, nevarwere vari kuwana nguva pfupi yekupora uye kupfupika kwekugara muchipatara.
Kana zvasvika kune marudzi etsono anoshandiswa mukubatanidza spinal epidural anesthesia, kune maviri makuru magadzirirwo: penzura-point tsono uye yekucheka-inopinza tsono. Tsono dzepenzura, dzinodaidzwawo kuti Whitacre kana Sprotte tsono, dzine muromo wakagomara, wakatepa unokonzera kushomeka kwematishu panguva yekuiswa. Izvi zvinogona kuderedza kuitika kwematambudziko akadai sekutemwa nemusoro mushure mekuputika kwemukati. Tsono dzakanhongwa, kune rumwe rutivi, dzine matipi akapinza, ane makona anogona kubaya matishu ane fibrous zviri nyore. Idzi tsono dzinowanzoshandiswa kune varwere vane nzvimbo dzakaoma dzepidural nokuti dzinobvumira kuwana zvakanyanya.
Iko kusanganiswa kwemusana uye epidural anesthesia muCSE anesthesia inopa akati wandei akasiyana maficha anobatsira mukubudirira kwayo. Chekutanga, CSE anesthesia inobvumira kuwedzera dosing, zvichireva kuti mumiriri weanesthetic anogona kugadziridzwa mukati memaitiro ese, zvichipa anesthesiologist kutonga kukuru pamusoro pedanho reanesthesia. Izvi zvinonyanya kubatsira panguva refu maitiro apo murwere angangoda kuwedzera kana kuderedza mazinga ezvinodhaka. Uyezve, CSE anesthesia ine kukurumidza kutanga kwechiito uye inogona kupa kukurumidza kusununguka kwemarwadzo kupfuura epidural chete.
Pamusoro pezvo, CSE anesthesia ine mukana wekurebesa marwadzo epashure. Kamwe mishonga yemuzongoza inopera, epidural catheter inoramba iripo, ichibvumira kuenderera mberi kweanalgesics kwenguva yakareba. Izvi zvinobatsira kuderedza kurwadziwa kwepashure, kuderedza kudiwa kwe systemic opioid, uye kunovandudza kugutsikana kwevarwere.
Shanghai TeamStand Corporation inyanzvimupi wemidziyo yekurapauye mugadziri anoziva kukosha kwekupa michina yemhando yepamusoro yekuvhiyiwa kwepinal-epidural anesthesia. Kuzvipira kwavo kune kugona kunoratidzwa mumhando dzakasiyana dzetsono dzavanopa, dzakagadzirirwa kusangana nezvinodiwa zvakasiyana zvevashandi vehutano. Nekunzwisisa mhando dzetsono dzakasiyana uye hunhu hwadzo, anesthesiologists vanogona kusarudza yakanyanya kunaka sarudzo kumurwere wega wega, kuve nechokwadi chekubudirira uye kugadzikana maitiro.
Mukupfupisa, kusanganiswa kwepinal-epidural anesthesia chinhu chakakosha mumunda weanesthesia kusimbisa marwadzo uye kuvandudza kunyaradza kwevarwere panguva yekuvhiyiwa. Zvishandiso zvaro zvinofukidza kwakasiyana-siyana kwekuvhiya, kusanganisira kuvhiyiwa kwezasi kwedumbu, pelvic uye kuzasi. Mhando yetsono inoshandiswa, ingave penzura-inopinza kana yakapinza-inopinza, zvinoenderana neakasarudzika maitiro emurwere. Zvimiro zveCSE anesthesia, senge incremental dosing uye kurebesa marwadzo mushure mekuvhiyiwa, zvinowedzera kuwedzera kushanda kwayo. Nerutsigiro rwemakambani akaita seTeamStand Corporation muShanghai, vashandi vezvehutano vanogona kuramba vachipa varwere zvakanyanya kudzora marwadzo uye chiitiko chakanaka chekuvhiya.
Nguva yekutumira: Oct-17-2023