Anesthesia yemusana wepidural yakasanganiswa(CSE) inzira inoshandiswa mukurapa kupa varwere anesthesia ye epidural, anesthesia yekutakura, uye analgesia. Inosanganisa zvakanakira spinal anesthesia uye epidural anesthesia. Kuvhiyiwa kweCSE kunosanganisira kushandisa spinal epidural kit yakabatana, inosanganisira zvikamu zvakasiyana-siyana zvakaita seLOR indicatorsirinji, tsono ye epidural, katheta yemudumbuuyesefa re epidural.
Kiti yemusana inosanganisa tsinga dzemusana yakagadzirwa nokungwarira kuti ive nechokwadi chekuti yakachengeteka, inoshanda uye iri nyore kushandisa panguva yekuvhiyiwa. Sirinji yeLOR (Loss of Resistance) chinhu chakakosha pakiti. Inobatsira chiremba weanorapisa kuziva nzvimbo yetsinga dzemusana nemazvo. Kana tsinga yesirinji yadhonzwa kumashure, mweya unodhonzwa mubhare. Tsinga painopinda munzvimbo yetsinga dzemusana, tsinga inosangana nekusagona kupindira nekuda kwekumanikidzwa kwemvura yemusana. Kurasikirwa uku kwekusagona kupindira kunoratidza kuti tsono iri panzvimbo chaiyo.
Tsono ye epidural itsono ine madziro matete, ine buri, inoshandiswa kupinda muganda kusvika pakadzika panodiwa panguva yekuvhiyiwa kweCSE. Yakagadzirirwa kuderedza kusagadzikana kwemurwere uye kuona kuti catheter ye epidural inoiswa zvakanaka. Hub yetsono yakabatana nesirinji yeLOR indicator, zvichibvumira anesthesiologist kutarisa kuramba kwemushonga panguva yekuiswa kwetsono.
Kana yangosvika panzvimbo ye epidural, catheter ye epidural inopfuudzwa nepatsono yoendeswa kunzvimbo yaunoda. Catheter iyi ichubhu inochinjika inoendesa mushonga wekurwadziwa kana marwadzo munzvimbo ye epidural. Inobatwa panzvimbo netepi kudzivirira kuchinja netsaona. Zvichienderana nezvinodiwa nemurwere, catheter inogona kushandiswa pakupinza mushonga nguva dzose kana kuisirwa bolus nguva nenguva.
Kuti pave nechokwadi chekuti mushonga wepamusoro unopihwa, epidural filter chinhu chakakosha muCSE suite. Filter iyi inobatsira kubvisa chero tupukanana kana tupukanana tungave turi mumushonga kana catheter, nokudaro ichideredza njodzi yehutachiona nematambudziko. Yakagadzirwa kuti ibvumidze kufamba zvakanaka kwemushonga uku ichidzivirira chero tsvina kuti isasvike mumuviri wemurwere.
Zvakanakira zvekushandisa nzira yekubatanidza spinal-epidural ndezvakawanda. Izvi zvinoita kuti mushonga weanesthesia utange nekukurumidza uye nenzira yakavimbika nekuda kwemushonga wekutanga wemusana. Izvi zvinobatsira zvikuru mumamiriro ezvinhu apo marwadzo anodiwa kana kupindira kuripo nekukurumidza. Pamusoro pezvo, macatheter epidural anopa mushonga wekurwadziwa kwenguva refu, zvichiita kuti akwanise kurapwa kwenguva refu.
Kushandisa mushonga weanesthesia wemusana neepidural kunoitawo kuti mushonga wacho ugone kuchinjika. Izvi zvinoita kuti mushonga wacho upihwe mwero, zvichireva kuti chiremba weanesthesia anogona kugadzirisa mwero zvichienderana nezvinodiwa nemurwere uye mhinduro dzake. Nzira iyi inobatsira kudzora marwadzo zvakanaka ukuwo ichideredza migumisiro yakaipa.
Uyezve, CSE ine chekuita nenjodzi shoma yematambudziko emuviri kana ichienzaniswa neanesthesia. Inogona kuchengetedza mashandiro emapapu zviri nani, kudzivirira mamwe matambudziko ane chekuita nemhepo, uye kudzivirira kudiwa kwekuiswa muchubhu. Varwere vanoitwa CSE vanowanzo nzwa kurwadziwa kushoma mushure mekuvhiyiwa uye nguva pfupi yekupora, zvichivabvumira kudzokera kumabasa avo enguva dzose nekukurumidza.
Mukupedzisa, mushonga weanesthesia we "neuraxial" ne "epidural anesthesia" inzira inokosha yekupa anesthesia, kutakura anesthesia, uye analgesia kuvarwere panguva yekuvhiyiwa kwekiriniki. Kit ye "combined spinal epidural kit" pamwe chete nezvikamu zvayo, zvakaita se "LOR indicator syringe", "epidural needle", "epidural catheter", uye "epidural filter", inoita basa rakakosha mukuona kuchengetedzeka, kushanda, uye kubudirira kwemuitiro uyu. Nezvakanakira uye mashandisirwo awo, CSE yave chikamu chakakosha chemuitiro wemazuva ano weanesthesia, ichipa varwere nzira iri nani yekugadzirisa marwadzo uye kupora nekukurumidza.
Nguva yekutumira: Gumiguru-25-2023