Mlengalenga pakatikati pa fupa la fupa la msana ndi mtunda wokhazikika umatchedwa epidural. Kupyolera mu zowonjezera, mitsempha ya rootlets imalowa mkati mwake, ndipo kayendedwe ka kukonzekera anesthesia kumaloko kumatetezera chikoka kuti asadutse mwa iwo. Chifukwa cha ichi, n'zotheka kukwaniritsa kutaya kwa mphamvu ndi magalimoto pamagulu enaake a thupi, ngati mankhwalawa amalowa m'kati mwa msana.
Pofuna kubwezeretsa ana, jekeseni zinthu zomwe zimapangitsa kuti munthu asamvetsetse, komanso pamene gawo loperewera likuchitidwa ndi matenda oopsa, ndiye kuti mankhwala omwe amachititsa kuti ntchito yamagetsi iyambe. Kupyolera mu singano kumalo a epidural, catheter imalowetsedwa, singano imachotsedwa, ndipo kupweteka kwa magazi kumayikidwa nthawi ndi nthawi mu catheter yomwe imayikidwa pamapewa kuyambira kumayambiriro kwa nthawi zonse: lidocaine kapena kukonzekera zamakono.
Kubereka pansi pa matenda oopsa
Atamvetsera nkhani kuchokera kwa abwenzi ponena za kubereka ndi matenda oopsa, amayi ambiri, akuopa kubeleka, ayamba kukhala ndi chidwi ndi njira iyi yothandizira. Zikuwoneka kuti palibe chisonyezero chenichenicho cha njira iyi, kupatula ngati chilakolako chochepetsera kupweteka panthawi yamavuto. Koma epidural anesthesia siimakhudza mwanayo mwachindunji: mankhwala samapititsa chingwe chowongolera. Kuonjezera apo, ndi kubala kwachibadwidwe, epidural anesthesia sichikhudza nthawi ya ntchito: zotsutsana zimachitika, kachilombo ka HIV kamatsegulidwa, koma palibe ululu. Amachepetsa kuthamanga kwa magazi, zomwe zili bwino kwa gestosis ya mimba, ndipo njira iyi ya anesthesia ikhoza kugwiritsidwa ntchito pa msinkhu uliwonse, palibe mavuto ambiri omwe sungapeŵe ndi anesthesia ambiri a ntchito.
Epidural anesthesia pakubereka - cons
Malingaliro abwino omwe sungakhale, epidural anesthesia ndi njira yomwe zimadalira kwambiri kuyenerera kwa anesthesiologist ndi zolakwika zirizonse mu khalidwe lawo zingayambitse zotsatira zoyipa pambuyo pa kubala chifukwa cha matenda oopsa. Zotsatirazi, zowopsya kwambiri ndi paresis ndi kufooka kwa kuwonongeka kwa mitsempha ya mitsempha. Kufooka kotheka kwa ntchito, kuphwanya mtima muzimayi ndi mwana wamwamuna, kuphwanya mafuta (njira imayambitsa kutentha kwa thupi), kusokonezeka kwa chikhodzodzo. Mwina pangakhale chisokonezo pa zoyesayesa, zomwe zingafunike kuchotsa mwanayo (pogwiritsa ntchito forceps).
Zofananitsa ndi zovuta zowopsa pa nthawi yobereka
Epidural anesthesia ndi njira yomwe imatsutsana kwambiri kuposa zizindikiro. Choyamba, izo zimatsutsana pa nthawi ya hypersensitivity kwa anesthetics kumaloko. Contraindications ikuphatikizanso:
- magazi;
- matenda osokoneza magazi;
- chisokonezo ndi chisokonezo;
- khunyu;
- zilonda zapakatikati za mitsempha yamkati;
- matenda a msana wa msana;
- chisokonezo chowonjezeka;
- arrhythmia ndi matenda aakulu mtima;
- matumbo a m'mimba.
Musamachite anesthesia pamaso pa kutupa kwa khungu kapena zojambula pa malo opangira jekeseni. Kusiyanitsa kovomerezeka kungakhale kunenepa kwambiri: kulumikizidwa kwa singano kudzera muzitsulo zakuda zonenepa mafuta n'kovuta kwa madokotala.
Zotsatira za matenda opweteka kwambiri atatha kubala
Amayi ambiri amadandaula kuti patangotha miyezi ingapo atasokonezeka ndi mitu yoyipa atatha kuponyedwa mwangozi, zimakhala zofooka ndi paresis, kusadziletsa kwa mkodzo ndi nyansi zakutchire, ngati vuto linayamba ndi kuchotsedwa kwa mwanayo ndipo izi zinayambitsa mavuto osiyanasiyana mwa mwanayo. Mutu ndi chimodzi mwa zotsatira zosasangalatsa kwambiri za matenda osokoneza bongo, omwe amawonetsa kuti amayi ambiri amabereka ana amasiye.
Koma malingaliro a momwe chidutswacho chinagwiritsidwiritsidwira ntchito, pamene matendawa amagwiritsidwa ntchito, ndi bwino kwambiri kusiyana ndi omwe anapangidwa ndi anesthesia ambiri, chifukwa pali zovuta zochepa kwa mayi ndi mwana kuchokera kwa anesthesia ambiri. Malingana ndi nkhani za amayi ambiri, vuto lalikulu mu ntchito pansi pa "epidural" ndilofunikira kuti iwo azidziŵa, amawopa kuti angapweteke, komanso kuti amalephera kukhumudwa chifukwa cha ziwalo za m'mimba.
Ambiri mwa amai amazindikira ndi zina zosasangalatsa za epidural anesthesia - pamene anesthesia amachoka, chiwopsezo champhamvu chimayamba, chomwe chingathetseke mothandizidwa ndi mankhwala ena.
Ngati thanzi labwino, malingaliro ndi zakuthupi za mayi kuti abereke mwana amatha kubereka - ndibwino kuti musagwiritse ntchito mankhwala osokoneza bongo, popeza kuti njira iliyonse yothandizira zachilengedwe popanda zifukwa zomveka zingakhale ndi zotsatira zosiyana kwambiri.