He aha ka hui pū ʻana o ka anesthesia epidural spinal?

ʻO ka anesthesia epidural spinal i hui pū ʻia(CSE) kahi ʻenehana i hoʻohana ʻia i nā kaʻina hana lapaʻau e hāʻawi i nā mea maʻi me ka anesthesia epidural, ka anesthesia halihali, a me ka analgesia. Hoʻohui ia i nā pono o ka anesthesia spinal a me nā ʻenehana anesthesia epidural. Pili ka ʻoki ʻana o CSE i ka hoʻohana ʻana i kahi pahu epidural spinal i hui pū ʻia, nona nā ʻāpana like ʻole e like me kahi hōʻailona LOR.syringe, nila epidural, kaʻa epidural, a mekānana epidural.

Ua hoʻolālā pono ʻia ka pahu epidural spinal i hui pū ʻia e hōʻoia i ka palekana, ka pono a me ka maʻalahi o ka hoʻohana ʻana i ka wā o ke kaʻina hana. ʻO ka syringe hōʻailona LOR (Loss of Resistance) kahi ʻāpana koʻikoʻi o ka pahu. Kōkua ia i ka anesthesiologist e ʻike pololei i ka hakahaka epidural. Ke huki ʻia ka plunger o ka syringe i hope, huki ʻia ka ea i loko o ka barela. Ke komo ka nila i ka hakahaka epidural, hālāwai ka plunger me ke kūʻē ma muli o ke kaomi o ka wai cerebrospinal. Hōʻike kēia nalowale o ke kūʻē ua kūpono ke kūlana o ka nila.

He nila hakahaka ka nila epidural, he lahilahi ka paia i hoʻohana ʻia e komo i loko o ka ʻili i ka hohonu i makemake ʻia i ka wā o ke ʻoki ʻana CSE. Ua hoʻolālā ʻia e hōʻemi i ka ʻoluʻolu ʻole o ka mea maʻi a hōʻoia i ke kau pololei ʻana o ka catheter epidural. Hoʻopili ʻia ke kikowaena o ka nila i kahi syringe hōʻike LOR, e ʻae ana i ka anesthesiologist e nānā i ke kū'ē ʻana i ka wā e hoʻokomo ʻia ai ka nila.

Ke komo i loko o ka hakahaka epidural, hoʻokomo ʻia ke catheter epidural ma o ke kui a hoʻoneʻe ʻia i kahi i makemake ʻia. He ʻōmole palupalu ke catheter e hāʻawi ana i ka anesthetic kūloko a i ʻole ka analgesic i loko o ka hakahaka epidural. Hoʻopaʻa ʻia ia me ka lipine e pale aku i ka neʻe ʻana. Ma muli o nā pono o ka mea maʻi, hiki ke hoʻohana ʻia ke catheter no ka hoʻokomo mau ʻana a i ʻole ka hoʻokele bolus intermittent.

I mea e hōʻoia ai i ka lawelawe ʻana i nā lāʻau lapaʻau kiʻekiʻe, he ʻāpana koʻikoʻi ka kānana epidural o ka CSE suite. Kōkua ke kānana i ka wehe ʻana i nā ʻāpana a i ʻole nā ​​​​microorganism e loaʻa paha i loko o ka lāʻau lapaʻau a i ʻole catheter, a laila e hōʻemi ana i ka pilikia o ka maʻi a me nā pilikia. Ua hoʻolālā ʻia e ʻae i ke kahe mālie o ka lāʻau lapaʻau me ka pale ʻana i nā mea haumia mai ka hiki ʻana i ke kino o ka mea maʻi.

He nui nā pono o ke ʻano hana spinal-epidural i hui pū ʻia. Hāʻawi ia i ka hoʻomaka ʻana o ka anesthesia hilinaʻi a wikiwiki hoʻi ma muli o ka mahele mua o ka spinal. He mea pono loa kēia i nā kūlana kahi e pono ai ka hoʻomaha koke ʻana i ka ʻeha a i ʻole ke komo ʻana. Eia kekahi, hāʻawi nā catheters epidural i ka analgesia mau, e kūpono ai no nā kaʻina hana lōʻihi.

Hāʻawi pū ka hui pū ʻana o ka anesthesia spinal-epidural i ka maʻalahi o ka hoʻohana ʻana i ka lāʻau. Hiki iā ia ke hoʻololi ʻia ka lāʻau, ʻo ia hoʻi, hiki i ka anesthesiologist ke hoʻoponopono i ka nui o ka lāʻau ma muli o nā pono a me nā pane o ka mea maʻi. Kōkua kēia ʻano hana pilikino i ka hoʻokō ʻana i ka kaohi ʻeha kūpono me ka hoʻēmi ʻana i nā hopena ʻaoʻao.

Eia kekahi, pili ka CSE me ka haʻahaʻa o ka pilikia o nā pilikia ʻōnaehana i hoʻohālikelike ʻia me ka anesthesia laulā. Hiki iā ia ke mālama maikaʻi i ka hana o ka māmā, pale i kekahi mau pilikia e pili ana i ke alaea, a pale i ka pono no ka intubation endotracheal. ʻO nā mea maʻi e hana ana i ka CSE e ʻike pinepine i ka ʻeha postoperative emi a me nā manawa hoʻōla pōkole, e ʻae ana iā lākou e hoʻi koke i nā hana maʻamau.

I ka hopena, ʻo ka neuraxial a me ka epidural anesthesia i hui pū ʻia he ʻenehana waiwai nui ia no ka hāʻawi ʻana i ka anesthesia, ka anesthesia lawe, a me ka analgesia i nā maʻi i ka wā o nā kaʻina hana lapaʻau. ʻO ka pahu epidural spinal i hui pū ʻia a me kāna mau ʻāpana, e like me ka syringe LOR indicator, ka nila epidural, ka catheter epidural, a me ka kānana epidural, he kuleana koʻikoʻi ia i ka hōʻoia ʻana i ka palekana, ka pono, a me ka holomua o ke kaʻina hana. Me kona mau pono a me nā noi, ua lilo ʻo CSE i ʻāpana koʻikoʻi o ka hana anesthesia hou, e hāʻawi ana i nā maʻi me ka hoʻokele ʻeha maikaʻi a me ka hoʻōla wikiwiki.