Kushandiswa kweaneshesia muchikamu chechipiri ichi chakakamurwa kuva mativi maviri: general anesthesia, uye munharaunda anesthesia. Kubva kune anesthesia yenharaunda munyika kune yebasa, epidural anesthesia, spinal anesthesia uye kusanganiswa kwepinini epidural anesthesia inoshandiswa.
General anesthesia
Imwe makore gumi apfuura, general anesthesia ndiyo yakakosha yeaneshesia mune chikamu chekusiya. Nyanzvi dzakaona nzvimbo dzakachengetedzeka dzakachengetedzwa kunharaunda yeanesthesia dzakanga dzisina kukwana. Parizvino, aneshehesia yakawanda inoshandiswa muzviitiko zvisingawanzoitiki:
- Muchipo chekupikisa kwechirwere uye chepeminyo anesthesia (kubuda ropa kwakanyanya, coagulopathy, thrombocytopenia, nezvimwewo);
- Mune zvimwe zvipingamupinyi zvinokonzera (kupera kwembambo yembilical, nzvimbo inoputika ye fetus, nezvimwewo);
- Mune zviitiko zvinokurumidzira, kana pasina nguva yekugadzirira nekuitisa nzvimbo yeaneshesia.
Nechitsauko chechiesarea, general anesthhesia inokonzera mamwe matambudziko uye zvakaoma kutakura kudarika imwe nzvimbo. Apo pamuviri unoshanduka patency yenzira yekufema, saka pane zvinetso nehutukuro hwe trachea. Dambudziko rekugadzirisa gastric zviri mumugwagwa wekufema zvakanyanya kuwedzera, zvichiita kuti pneumonia uye kukundikana kukurukufema. Anesthetics, inoshandiswa muna general anesthesia, zvakasimba "kurova" muviri kwete amai chete, asiwo mwana. Mwana achangoberekwa anogona kukanganiswa nekufema, chirwere chendaneti chakanyanyisa. Pane kuora, kurara, kunyanya kunetseka, izvo zvinoita kuti zvive zvakaoma kuvanachiremba kuti vaite mhedziso pamusoro pemamiriro emucheche.
Regional anesthesia
Epidural uye maginal anesthesia muchikamu chekuvharidzira inoonekwa se "yegoridhe" yeanesthesia. Aya maitiro akafanana kune umwe neumwe. Vano "gura" marwadzo ari mune imwe chikamu chemuviri. Panguva imwechete amai vari mupfungwa uye vanogona kuona kuberekwa kwomwana wavo. Regional anesthesia inoshandiswa ne puncturing uye injecting anesthetic kumucheto kumashure - munzvimbo inenge iri pedyo nepamutsipa.
Misiyano ndeyokuti mishonga ine spinal anesthesia inojowa ine nheyo mukati memvura inenge ichigeza mushonga wepinini. Iko ndiko, iyi inowanzojowa. Uye nepidural anesthesia, mishonga inoshandiswa kuburikidza ne catheter inowanikwa, iyo inoramba iri mumuviri kusvikira pakuguma kwebasa. Kuburikidza naro, zviri nyore kutonga mamwe mishonga pasina re-puncturing.
Nespestine anesthesia, anesthesia inowanikwa mumaminitsi gumi nemashanu, uye nepidural chete mushure memaawa 20-30. Neine anesthesia, murwere haanzwi kurwadziwa. Uye pamwe nemunharaunda yeanesthesia, mamiriro acho ezvinhu akasiyana. Hazviwanzoitiki mushure mokunge anesthesia yenharaunda iyo inogara ichiramba ichirwadziwa. Dzimwe nguva chikonzero ndicho chimiro chomunhu. Dzimwe nguva, apo hondo dzinotanga, hurongwa hwemagetsi huri kunyanya kuiswa uye hahudzivirirwa zvachose. Asi dzimwe nguva chikonzero chekushaya kukwana kweanharaunda aneshehesia inokanganisa anesthesiologist.
Kana marwadzo panguva yechiganda ichi chichiripo mushure mekunge aneshehesia yepelinha, vanachiremba vanowanzoenda kune aneshehesia yakawanda. Asi sezvo huwandu hweanesthesia husina kuchengeteka kune mwana achangoberekwa, nemvumo yaamai, basa racho rinogona kupfuurira nekunetseka kwakanyanya. Maitiro akadaro, nhamo, haasi ega. Nokudaro, vakadzi vane pamuviri vari kuronga chirwere che "chinorwadza" chete kuitira kuti varege kuberekwa nekuberekwa, zvakakosha kufungisisa nezvemigumisiro.
Kana kurwadziwa kunonzwika mushure mekuda kwepachiviri aneshesia, zvino mhinduro yacho iri nyore. Chimwe chitsva chekushongedza chinoshandiswa kuburikidza ne catheter. Ichokwadi, inongoshanda chete kana catheter yakanyatsoiswa. Mukuwedzera, mamwe mazamu emishonga inorwadza anogona kuchinja mwana achangoberekwa.
Contraindications: hutachiona mumunda weanesthesia, kusawirirana kwevanhu, ropa coagulability matambudziko, pasi platelets, nezvimwewo.
Migumisiro: mushure mokunge ichinge ichinyanya kuve nemafungiro epidural anesthesia, misoro yakasimba inomuka inoda kuvandudzwa. Mushure me "spinalka" - misoro haisi yakasimba.
Kubatsirwa: kufananidzwa neanesthesia yakawanda yakachengeteka kune amai nevana.