Te whakakotahitanga o te anesthesia epidural tuaiwiKo te (CSE) he tikanga e whakamahia ana i roto i ngā tikanga haumanu hei whakarato i te rongoā whakamoe epidural ki ngā tūroro, te rongoā whakamoe kawe, me te rongoā whakamāmā. Ka whakakotahi i ngā painga o te rongoā whakamoe tuaiwi me ngā tikanga rongoā whakamoe epidural. Ko te pokanga CSE e uru ana ki te whakamahinga o tētahi kete rongoā whakamoe tuaiwi whakakotahi, kei roto ko ngā wāhanga maha pērā i te tohu LOR.weronga, ngira epidural, te katitere epidural, metātari epidural.
Kua āta hangaia te kete epidural tuaiwi whakakotahi hei whakarite i te haumaru, te whai huatanga me te ngāwari o te whakamahi i te wā o te tikanga. He wāhanga nui o te kete te pūwero tohu LOR (Loss of Resistance). Ka āwhina i te tohunga whakamoe ki te tautuhi tika i te wāhi epidural. Ina unuhia te pūwero o te pūwero ki muri, ka kumea te hau ki roto i te oko. I te urunga o te ngira ki te wāhi epidural, ka tūtaki te pūwero ki te ātete nā te pēhanga o te wai cerebrospinal. Ko tēnei ngaronga o te ātete e tohu ana kei te tika te tūranga o te ngira.
He ngira angiangi, he angiangi te ngira epidural, e whakamahia ana hei wero i te kiri ki te hohonutanga e hiahiatia ana i te wā o te pokanga CSE. He mea hanga hei whakaiti i te mamae o te tūroro, hei whakarite hoki i te whakatakotoranga tika o te catheter epidural. Ka honoa te pokapū o te ngira ki tētahi ngira tohu LOR, e āhei ai te tohunga whakamoe ki te aroturuki i te ātete i te wā e werohia ana te ngira.
Kia tae ki te wāhi epidural, ka tukuna te catheter epidural mā te ngira, ka nekehia ki te wāhi e hiahiatia ana. He ngongo ngāwari te catheter e tuku ana i te rongoā whakangote ā-rohe, te rongoā whakamamae rānei ki roto i te wāhi epidural. Ka puritia ki te rīpene hei ārai i te nekehanga tūpono. I runga i ngā hiahia o te tūroro, ka taea te whakamahi i te catheter mō te werohanga tonu, te tukunga bolus rānei i ia wā.
Hei whakarite i te kounga teitei o te whakahaerenga rongoā, he wāhanga nui te tātari epidural o te huinga CSE. Ka āwhina te tātari ki te tango i ngā matūriki, i ngā moroiti rānei kei roto i te rongoā, i te catheter rānei, ā, ka whakaiti i te tūponotanga o te mate me ngā raruraru. Kua hangaia kia pai ai te rere o te rongoā, me te ārai hoki i ngā poke kia kore ai e tae ki te tinana o te tūroro.
He maha ngā painga o te tikanga whakakotahitanga o te tuaiwi me te epidural. Mā tēnei ka taea te tīmatanga pono me te tere o te rongoā whakamoe nā te horopeta tuatahi o te tuaiwi. He tino whai hua tēnei i ngā wā e hiahiatia ana te whakamamae wawe i te mamae, te wawaotanga rānei. Hei tāpiri, ka whakaratohia e ngā catheter epidural he mamae pumau, he mea pai mō ngā tikanga roa ake.
Mā te whakakotahitanga o te anesthesia tuaiwi me te epidural ka taea te whakarite i te horopeta. Mā tēnei ka taea te whakarite i te nui o te rongoā, arā, ka taea e te tohunga whakamoe te whakarerekē i te horopeta i runga i ngā hiahia me ngā urupare a te tūroro. Mā tēnei huarahi whaiaro ka taea te whakahaere i te mamae me te whakaiti i ngā pānga taha pea.
Hei tāpiritanga, he iti ake te mōrearea o ngā raruraru pūnaha e pā ana ki te CSE ki te whakataurite ki te rongoā whakamoe whānui. Tērā pea ka pai ake te tiaki i te mahi a ngā pukahukahu, ka karo i ētahi raruraru e pā ana ki te manawa, ka karo hoki i te hiahia mō te intubation endotracheal. Ko ngā tūroro e whiwhi ana i te CSE he iti ake te mamae i muri i te pokanga me te poto ake o ngā wā whakaora, ka taea ai e rātou te hoki wawe ki ngā mahi noa.
Hei whakamutunga, he tikanga whai hua te whakakotahitanga o te anesthesia neuraxial me te epidural hei whakarato i te anesthesia, te kawe i te anesthesia, me te analgesia ki ngā tūroro i ngā wā o ngā tikanga haumanu. Ko te kete epidural tuaiwi whakakotahi me ōna wāhanga, pērā i te syringe tohu LOR, te ngira epidural, te catheter epidural, me te tātari epidural, he mea nui ki te whakarite i te haumaru, te whai huatanga, me te angitu o te tikanga. Nā ōna painga me ōna whakamahinga, kua noho te CSE hei wāhanga nui o te mahi anesthesia hou, e whakarato ana i te whakahaere mamae pai ake me te whakaora tere ake i ngā tūroro.
Wā tuku: Oketopa-25-2023