Anesthesia epidural spinal jikọtara ọnụ(CSE) bụ usoro eji eme ihe n'ọgwụgwọ iji nye ndị ọrịa ọgwụ mgbu epidural, ọgwụ mgbu njem, na ọgwụ mgbu. Ọ na-ejikọta uru nke ọgwụ mgbu spinal na usoro ọgwụ mgbu epidural. Ịwa ahụ CSE gụnyere iji ngwa epidural spinal jikọtara ọnụ, nke gụnyere ihe dị iche iche dị ka ihe ngosi LOR.sirinji, agịga epidural, katetọ epidural, naihe nzacha epidural.
E ji nlezianya hazie ngwa epidural spinal jikọtara ọnụ iji hụ na nchekwa, irè na mfe ojiji n'oge usoro ahụ. Syringe LOR (Loss of Resistance) bụ akụkụ dị mkpa nke ngwa ahụ. Ọ na-enyere onye na-agwọ ọrịa anesthesiologist aka ịchọpụta oghere epidural nke ọma. Mgbe a dọtara plunger nke sirinji ahụ azụ, a na-adọta ikuku n'ime gbọmgbọm ahụ. Ka agịga ahụ na-abanye n'ime oghere epidural, plunger ahụ na-enweta iguzogide n'ihi nrụgide nke mmiri cerebrospinal. Mfu nke iguzogide a na-egosi na agịga ahụ nọ n'ọnọdụ ziri ezi.
Agịga epidural bụ agịga dị gịrịgịrị, nke nwere mgbidi dị gịrịgịrị nke a na-eji abanye n'ime akpụkpọ ahụ ruo n'ọkwa achọrọ n'oge ịwa ahụ CSE. Emebere ya iji belata ahụ erughị ala nke onye ọrịa ma hụ na e tinyere catheter epidural n'ọnọdụ ziri ezi. E jikọtara etiti agịga ahụ na sirinji ihe ngosi LOR, nke na-enye onye na-agwọ ọrịa anesthesiologist ohere inyocha iguzogide ya n'oge etinyere agịga.
Ozugbo ọ banyere n'ime oghere epidural, a na-agafe katita epidural site na agịga wee gaa n'ebe achọrọ. Katita ahụ bụ ọkpọkọ na-agbanwe agbanwe nke na-ebuga ọgwụ mgbu ma ọ bụ ihe mgbu mpaghara n'ime oghere epidural. A na-eji teepu ejide ya iji gbochie mgbanwe mberede. Dabere na mkpa onye ọrịa, enwere ike iji katita ahụ maka ntinye na-aga n'ihu ma ọ bụ nchịkwa bolus mgbe ụfọdụ.
Iji hụ na ejiri ọgwụ dị elu nye onye ọrịa, ihe nzacha epidural bụ akụkụ dị mkpa nke CSE suite. Ihe nzacha ahụ na-enyere aka iwepụ ihe ọ bụla dị na ọgwụ ma ọ bụ catheter, si otú a na-ebelata ihe ize ndụ nke ibute ọrịa na nsogbu. Emebere ya ka ọ kwe ka ọgwụ na-aga nke ọma ma na-egbochi ihe ọ bụla na-emerụ ahụ iru ahụ onye ọrịa.
Uru dị na usoro ọgwụgwọ spinal-epidural jikọtara dị ọtụtụ. Ọ na-enye ohere ịmalite ọgwụgwọ a pụrụ ịdabere na ya na ngwa ngwa n'ihi ọgwụ mbụ nke spinal. Nke a bara uru karịsịa n'ọnọdụ ebe achọrọ enyemaka mgbu ozugbo ma ọ bụ ọgwụgwọ. Na mgbakwunye, katita epidural na-enye mgbu na-adịgide adịgide, na-eme ka ha dabara adaba maka usoro ọgwụgwọ ogologo oge.
Ọgwụ mgbu azụ na epidural jikọtara ọnụ na-enyekwa mgbanwe n'otú e si enye ọgwụ ahụ. Ọ na-enye ohere ka e nye ọgwụ ahụ title, nke pụtara na dọkịta na-agwọ ọrịa nwere ike ịgbanwe dose ahụ dabere na mkpa na azịza onye ọrịa. Ụzọ a ahaziri ahazi na-enyere aka nweta njikwa ihe mgbu kacha mma ma na-ebelata mmetụta ndị nwere ike ịkpata.
Ọzọkwa, CSE nwere obere ihe ize ndụ nke nsogbu sistemụ ma e jiri ya tụnyere ọgwụ mgbu izugbe. Ọ nwere ike ịnọgide na-arụ ọrụ akpa ume nke ọma, zere nsogbu ụfọdụ metụtara ikuku, ma zere mkpa maka intubation endotracheal. Ndị ọrịa na-eme CSE na-enwekarị obere ihe mgbu mgbe a wachara ha ahụ na oge mgbake dị mkpụmkpụ, nke na-enye ha ohere ịlaghachi n'ọrụ nkịtị ngwa ngwa.
Na mmechi, anestetiiki akwara na epidural jikọtara ọnụ bụ usoro bara uru maka inye ndị ọrịa anestetiiki, ibuga anestetiiki, na analgesia n'oge usoro ọgwụgwọ. Ngwa epidural spinal jikọtara ọnụ na ihe ndị dị na ya, dị ka sirinji LOR indicator, agịga epidural, epidural catheter, na nzacha epidural, na-arụ ọrụ dị oke mkpa n'ịhụ na usoro ahụ dị mma, irè, na ihe ịga nke ọma. Site na uru na ojiji ya, CSE aghọwo akụkụ dị mkpa nke usoro anestetiiki ọgbara ọhụrụ, na-enye ndị ọrịa njikwa mgbu ka mma na mgbake ngwa ngwa.
Oge ozi: Ọktoba-25-2023