Bwenzi losatha komanso losagwirizana ndi anesthesia iliyonse ndi opaleshoni. Wodwala wodwala sangadye mwachisawawa pokhapokha atawonetsedwa mtundu wina wa opaleshoni. Choncho, ngati akunena kuti anesthesia yaikulu imakhudza bwanji thupi pamene ali ndi mimba, imatanthawuza zotsatira zosokoneza - zonse zowopsya komanso opaleshoniyo.
Malingana ndi chiwerengero, pafupifupi 3% ya amayi pa nthawi yomwe ali ndi pakati ayenera kuchitidwa opaleshoni ya anesthesia. Kawirikawiri, ntchito imayendetsedwa m'mayendedwe a mano, matenda oopsa komanso opaleshoni (cholecystectomy, appendectomy). Anesthesia pa nthawi yomwe ali ndi mimba imachitidwa kokha ngati pali zizindikiro zofulumira komanso zofunikira, pansi pa mikhalidwe yomwe ikuwopseza moyo wa mayi. Ngati izi ziloleza, ngati opaleshoni yokhayo ndi anesthesia sichifunikanso mwamsanga, ndipo ndi bwino kuyembekezera kubadwa kwa mwanayo. Pambuyo pake, popanda zoopsa zina, mayi akhoza kuchipatala kuti apange chithandizo chochiritsira cha matendawa.
Kodi ndizoopsa zotani za anesthesia ambiri mwa amayi apakati?
Pofufuza kafukufuku wochulukirapo, akatswiri apeza mfundo zotsatirazi:
- Nthenda yaikulu ya anesthesia panthawi yopweteketsa panthawi ya mimba imapereka chiwerengero chochepa cha amayi omwe amamwalira. Ndipotu, ndi ofanana kwambiri ndi chiopsezo cha anesthesia zomwe zimachitidwa opaleshoni mwa amayi omwe alibe amayi.
- Kuopsa kwa kukula kwa msinkhu kumakhala kosabadwa pakati pa ana obadwa kumene pamene panthawi yomwe mayi ali ndi mimba yonyansa komanso yogwiritsidwa ntchito ndi yochepa kwambiri. Zimakhala zofanana ndi nthawi zambiri zomwe zimapangitsa kuti amayi omwe ali ndi mimba asanamwalire ndi opaleshoni.
- Mkwatibwi wopita padera, wowerengeka pa ma trimesters atatu onse a mimba, komanso mwayi wa imfa ya fetus ndi pafupifupi 6 peresenti. Peresenti iyi ndi yapamwamba kwambiri (11%), ngati anesthesia inkachitika m'miyezi itatu yoyamba ya mimba. Nthawi yoopsa kwambiri motere - masabata 8 oyambirira, pamene mwana wakhanda amayikidwa ndikupanga ziwalo zikuluzikulu ndi machitidwe.
- Pangakhale kubadwa msanga, pamene anesthesia yambiri imagwiritsidwa ntchito panthawi ya mimba, imakhalanso 8%.
Kukonzekera kwa anesthesia ambiri
Pofufuza zaka za posachedwapa, chitetezo cha mankhwala chawonetsedwa kuti chikukwanira kwa anesthesia ambiri pa mimba. Mosakayikira, zotsatira zovulaza pa mwana wakhanda monga kukonzekera koopsa monga diazepam ndi nitrous oxide ankaganiziridwa nthawi zonse. Akatswiri atsimikizira kuti pa nthawi yopweteka kwambiri pa nthawi yomwe ali ndi mimba, chofunika kwambiri si mankhwala enieni (mankhwala osokoneza bongo), koma njira yowonongeka. Ntchito yofunika kwambiri siimasewera chifukwa cha kuvomereza kwa mpweya wothamanga wa magazi komanso kuchuluka kwake kwa mpweya wokhala ndi magazi a mayi wapakati pa nthawi ya anesthesia. Palinso mfundo yakuti pa nthawi ya mimba ndi bwino kupeĊµa kugwiritsa ntchito mankhwala osokoneza bongo omwe ali ndi adrenaline. Ngakhale kulumidwa mwangozi kwa anesthetics kotero mu magazi a mchere kungayambitse kuphulika kwakukulu ndi kosalekeza kwa magazi kupita ku mwanayo kudzera mu pulasitiki. Akatswiri amamvetsera kuti mankhwala oterewa amadziwika bwino kwambiri, monga ultracaine kapena articaine ali ndi adrenaline.
Choncho, tingathe kunena kuti anesthesia ndi opaleshoni yomwe imachitika panthawi yomwe ali ndi mimba imakhala yotetezeka ku thanzi la mayi, koma nthawi zina ikhoza kuvulaza mwana wamtsogolo. Nthawizonse yoopsa kwambiri ndi yoyamba itatu ya mimba. Chotsatira chomaliza pa kufunikira kwa opaleshoni ndi anesthesia ambiri pa nthawi ya mimba ziyenera kutengedwa mosamala kwambiri. Ndikofunika kuganizira zoopsa zonse za zotsatira zolakwika za anesthesia ndi ntchito yomweyi pa chitukuko cha mwana wosabadwa. Ngati opaleshoniyo siili yofunikira ndipo pali mwayi wakuyikiritsa kwa kanthawi, ndiye kuti ndibwino kuti muyichite pa nthawi yachitatu ya mimba.