Mitundu ya anesthesia yomwe imagwiritsidwa ntchito m'gawo lachisumbu imagawidwa m'madera awiri: anesthhesia ambiri, ndi aesthesia kumadera. A antiesthesia m'madera amdziko chifukwa cha ntchito, epidural anesthesia, anesthesia wam'mimba ndi kuphatikiza kwapinal epestural anesthesia.
Anesthesia
Zaka khumi zapitazo, anesthesia ambiri anali mtundu waukulu wa anesthesia mu gawo losungirako. Akatswiri omwe ankadziwa kuti anesthesia a m'derali ndi otetezeka sankakwanira. Pakalipano, anesthesia wambiri amagwiritsidwa ntchito nthawi zambiri:
- Pamaso pa zotsutsana ndi zochitika zowopsya komanso zamimba zam'mimba (magazi oopsa, coagulopathy, thrombocytopenia, etc.);
- Zomwe zimakhala zovuta kwambiri (kupweteka kwa umbilical cord, malo opatsirana a fetus, ndi zina zotero);
- Pazidzidzidzi, pamene palibe nthawi yokonzekera ndikuyambitsa matenda a anesthesia.
Ndi chigawo cha msuzi, anesthésia yambiri imayambitsa mavuto ambiri ndipo ndi ovuta kupirira kusiyana ndi amodzi. Pamene mimba imasintha patency ya tsamba la kupuma, kotero pali mavuto ndi chidziwitso cha trachea. Kuopsa kwa ingestion ya chapamimba zomwe zili m'magulu opuma ndizowonjezeka kwambiri, zimayambitsa chibayo komanso kulephera kupuma. Anesthetics, yomwe imagwiritsidwa ntchito m'thupi lonse, imamenya "thupi" mwamphamvu osati mayi okha, komanso mwana. Mwana wakhanda angasokonezedwe ndi kupuma, dongosolo la mitsempha lapsinjika. Pali kuchepa, kugona, kuthamanga kwamwano, zomwe zimapangitsa kuti zovuta kuti madotolo azitha kuganiza za momwe mwana wakhanda amachitira.
Anesthesia kumadera
Matenda opatsirana ndi amphongo m'magazi amadzimadzi amatchedwa "standard gold" ya anesthesia. Njira izi ndizofanana. Iwo "amachotsa" ululu wokhawokha mu gawo lina la thupi. Pa nthawi imodzimodziyo mayiyo ali m'maganizo ndipo amatha kuona kubadwa kwa mwana wake. Anesthesia ya m'deralo imapangidwa ndi puncturing ndi jekeseni mankhwala otsekemera m'munsi kumbuyo - kumalo apadera pafupi ndi msana.
Kusiyanitsa ndiko kuti mankhwala omwe ali ndi anesthesia wamtsempha amalowetsedwa ndi singano m'madzi omwe amatsuka chingwe cha msana. Izi ndizo, jekeseni wamba. Ndipo ndi matenda a epidural anesthesia, mankhwalawa amaloledwa kudzera mu kathetti yomwe imayikidwa, yomwe imakhalabe m'thupi mpaka mapeto a opaleshoniyo. Kupyolera mwa izo, ndibwino kupereka mankhwala ena popanda kubwezeretsanso.
Ndi kupweteka kwa msana, kupweteka kwa mitsempha kumachitika maminiti 10-15, ndipo pamakhala mphindi 20-30. Ndi anesthesia wambiri, wodwala samamva ululu. Ndipo ndi aesthesia kumadera, zochitikazo ndi zosiyana. Sizodziwika kwambiri pambuyo pa anesthesia ya m'deralo kuti wokonda kupitirizabe kumva ululu. Nthawi zina chifukwa chake ndi umunthu wa munthu. Nthawi zina, pamene nkhondo zimayambira, dongosolo la mitsempha limakhala lopambanitsa ndipo silikutsekedwa kwathunthu. Koma nthawi zina chifukwa cha zolephera za m'dera la anesthesia ndi cholakwika cha anesthesiologist.
Ngati kupweteka panthawi yamagazi kumakhalabe pambuyo pa kupweteka kwa msana, madokotala amatembenukira ku anesthesia ambiri. Koma popeza kuti anesthesia ambiri sakhala otetezeka kwa mwana wakhanda, ndi chilolezo cha amayi, opaleshoniyo ikhoza kupitirizabe ndi ululu waukulu. Zochitika zotere, mwatsoka, sizodziwika. Choncho, amayi apakati omwe akukonzekera gawo lachisamaliro chopanda phokoso pokhapokha kuti asatengere zowawa za kubadwa, ndibwino kuganizira mosamala za zotsatira zake.
Ngati ululu umamveka pambuyo pa matenda osokoneza bongo, ndiye kuti njirayo ndi yophweka. Mlingo watsopano wokonda kuchepetsa thupi umayambitsidwa kudzera mu catheter. Zoona, zimangogwira ntchito ngati catheter imalowa bwino. Komanso, mankhwala ena opweteka amatha kukhudza mwana wakhanda.
Zotsutsana: matenda opatsirana pogonana, kusagwirizana kwa wina aliyense, vuto la magazi coagulability, mapulateletti otsika, ndi zina zotero.
Zotsatira: Pambuyo pa matendawa amatha kupwetekedwa mtima kwambiri. Pambuyo pa "spinalka" - mutu samakhala wamphamvu kwambiri.
Ubwino: poyerekezera ndi anesthesia wambiri ndi otetezeka kwa mayi ndi mwana.