Iyiphi i-analgesic engcono kakhulu yokubeletha?

Ngesinye isikhathi, abesifazane babeletha ekhaya nasensimini, cishe ngaphandle kosizo. Namuhla, ngenxa yemithi ehlukahlukene nemithi, odokotela banganciphisa ubuhlungu besifazane ekubelethweni, ukusheshisa ukubukeka kwemvuthuluka ukukhanya nokubhekana nanoma yisiphi isimo sokuzimela. Kodwa izidakamizwa eziningi ziphephile kumama nengane, futhi yimiphi imithi emihle kakhulu yokubeletha?

Imithi engcono kakhulu engingayithathi mina nomntanami, abesifazane abaningi bayabheka. Futhi bonke ochwepheshe bayavumelana nalokhu. Ukuphepha kwakho kanye nempilo yengane esanda kuzalwa yinto enkulu kakhulu odokotela. Yingakho unelungelo lokuthola lonke ulwazi mayelana nemithi ezosetshenziswa ekubelethweni. Udokotela kumele akutshele ukuthi yiziphi izinketho zemithi ezisebenzayo esimweni sakho, ngokusekelwe esimweni sempilo, inkambo yokukhulelwa kanye nenqubo eningi kakhulu. Kusukela kuhlu oluhlongozwayo, ungakhetha noma imuphi umuthi, kanye nendlela owethulwa ngayo. Ungabonisane nawe kuphela lapho kwenzeka ukuthi kukhona usongo langempela ekuphileni kwakho kanye nokuphila kwengane. Kulokhu, umsebenzi wakho oyinhloko ukuthola isazi esihle futhi uyamethemba ngokugcwele. Yiba nokuthula, ngaphandle kwesidingo nobufakazi obubalulekile, akukho ukuqokwa okuzokwenziwa kuwe.


Ngaphandle kobuhlungu

Yiqiniso, unamandla okwanele angaphakathi ukuze uhambe yonke inqubo yokubukeka komntwana. Noma kunjalo, ngisho nowesifazane onesibindi angadinga usizo oluvela ngaphandle. Kunezinhlobo eziningana zemithi yokwelashwa esetshenziselwa ngezigaba ezahlukene zokubeletha. Kufanele ukwazi ukuthi yiliphi i-painkiller engcono kakhulu yokulethwa kwezidingo.


1. Isigaba sokulungiselela

Uma ubeletha okokuqala, lesi sigaba singadonsela amahora amaningi. Ukuhlukaniswa ngalesi sikhathi, njengombuso, akuvamile, kepha kaningi kunzima kakhulu. Uma ingaholeli ekuvuleni komlomo wesibeletho, ungahlinzeka nge-anesthesia ye-intramuscular - iyokuvumela ukuba udilize ekulele ukulala futhi ulale amahora ambalwa okubuhlungu, okuyiwona oyogcina amandla akho ekuzalweni okuzayo. I-anesthesia enjalo iphumelela ngaphakathi kwamahora angu-3-4.


Imiphumela

I-anesthesia ye-intramuscular ingabangela ukugubha kwe-fetus ku-cardiotocogram, ebhalwe ekubelethweni. Kodwa ngemva kokuphela kwesidakamizwa, imiphumela ibuyele emuva evamile.


2. Isigaba esisebenzayo somsebenzi

Phakathi nalesi sikhathi, ungasebenzisa kokubili i-anesthesia ye-intramuscular kanye ne-anesthesia ye-epidural. Esikhathini sokuqala kubalulekile ukwenza umjovo amaminithi angu-30-40 ngaphambi kokuvela komntwana, kungenjalo ingane ingazalwa ilele futhi ivila. Ungakhathazeki, maduzane uzothola umsebenzi wakhe.

Nge-anesthesia ye-epidural, imithi isungulwa esikhaleni se-epidural esifundeni se-lumbar (umzimba ophansi unqatshelwe ukuzwela). Loluhlobo lwe-anesthesia alunayo umphumela onobuthi futhi alufaki igazi lomama noma umntwana. Noma kunjalo, i-anesthesia enjalo ayifanele wonke umuntu. Ukuqhathaniswa nakho ukukhuluphala noma imisebenzi yokuhlinzwa emgodini. Esinye isimo esibalulekile ukusungulwa kwempi ejwayelekile (nge-periodicity imizuzu 2-3). Uma wenza i-anesthesia ngaphambili, ukubeletha kunganciphisa.


Imiphumela

I-anesthesia ye-intramuscular ayinayo umphumela omubi. Emva kwamahora 3-4, i-anesthetics ihlukana ngokuphelele futhi ayitholakali egazini.

Uma i-anesthesia yomgogodla isetshenziselwa isigaba sokudla, inkhanda kungenzeka. Zisuswa kalula ngokulawulwa okukhethekile. Izilonda ze-Neuralgic kuleli cala azivamile. Isikhala ezingeni lapho umjovo owenziwe khona awuqukethe umsele we-vertebral, cishe akunakwenzeka ukungena ezindlini eziphumayo. Inqubo yokwenza i-anesthesia enjalo iye yasetshenziswa ngokucacile.


Udinga ama-antibiotics?

abesifazane besithwala i-Group B Streptococcus, okwandisa kakhulu ingozi yokuthola lesi sifo enganeni esanda kuzalwa. Ngaphezu kwalokho, i-streptococcus, enomphumela omubi ku-placenta, ingabangela i-hypoxia ye-fetal. Yingakho, ngesonto lama-36 lokukhulelwa, bonke omama abazayo bayanconywa ukuba benze isisu (ezivela ezingxenyeni zangasese zangaphandle) ukucacisa ukuba khona kwe-streptococcus. Uma itholakala, ama-antibiotic (njenge-penicillin) asetshenziselwa ukubeletha. Ngezinye izikhathi imithi elwa namagciwane ishiwo abesifazane abanenhloso yeprophylactic. Isibonelo, uma owesifazane okhulelwe amahora angu-8 edlule eshiye amanzi, futhi umsebenzi wokuzalwa awukaqali.


Engeza ngesivinini

Ngakho-ke, masinya masinyane imvuthuluka. Kodwa uma kungazelelwe kukhona isimo lapho ukuvinjelwa kungathinta isimo somntwana kanye nenhlalakahle yomama, odokotela bangakhuthaza umsebenzi wokusebenza. Isibonelo, uma owesifazane efika ekhaya lokubeletha enezingqinamba ezingavamile, ama-Vedas ashiye amahora angu-5 adlule, noma ezimweni ezinzima kakhulu, uma kubalulekile ukuthi umsebenzi uwele emini.


1. Isigaba sokulungiselela

Esigabeni sokulungiselela abasebenzi, ukulungiselela okhethekile kusetshenziswa ngendlela ye-gel, eyethulwa ngaphakathi kwesifazane. Iqukethe ama-analogues ama-rhodostimators wezemvelo we-prostaglandins, alungiselela umlomo wesibeletho wezokulethwa okuzayo - ukufinyefisa, ukwenza kube nzima, ukuhlinzekela ukuvula.


2. Isigaba esisebenzayo somsebenzi

Esigabeni esisebenzayo somsebenzi, uma iziphazamiso zingenamandla ngokwanele futhi zivame ukuba njalo, umlomo wesibeletho awuvuli noma umsebenzi wezisebenzi owaqala ngokuzumayo ngokuzumayo, usebenzise i-oxytocin, okwandisa imvamisa yezinhlangothi zokubeletha. I-rodovozbuzhdenie enjalo ivame ukuqhutshwa kanye ne-anesthesia. U-Oxytocin ulawulwa ngosizo lwe-dropper kuze kube sekuqalisweni kwezingqinamba ezijwayelekile kanye nokuvulwa komlomo wesibeletho. Isikhathi sokusetshenziswa kwayo singumuntu ngamunye - omunye umuntu amahora angu-7, kumuntu oyedwa 16. Uma emva kwalokhu ukukhushulwa kwakungekho umphumela, kuvinjelwe, futhi umsebenzi uphela ngesigaba sokugcina. Ukwaziswa okwenziwa yi-oxytocin kunciphisa kakhulu imithwalo yegazi futhi yingakho kubangelwa ukwanda kwengcindezi yegazi kumama ozayo kanye nokungabi khona kwe-oksijeni (hypoxia) enganeni akuphelelwe yisikhathi. Umphumela ezitsheni ze-analogues zokwenziwa zaleli hormone yemvelo eyenziwe yi-placenta incishisiwe.


Imiphumela

Kubaluleke kakhulu ukusebenzisa i-oxytocin, ngemuva kokulinda, uma umlomo wesibeletho usubile, uvuthiwe. Ukuphuthuma ngokweqile odokotela abenza lokhu kukhuthazwa esigabeni sokulungiselela (umsebenzi wesibeletho, ubukhulu) ngokuvamile kuholela esigabeni sokugcina.

Iqiniso

Ukusetshenziswa kwezinyosi kanye ne-papaverine emisebenzini isayensi engalungile. Ngokuvamile lezi zidakamizwa zibekiwe ukuze ziphumule umlomo wesibeletho futhi ziphuthumise inqubo yekhodi. Kodwa-ke, bangakwazi ukususa isipiliyoni semisipha kuphela, kanti umlomo wesibeletho ungumcubu ohlangene. Kulesi simo, ukusetshenziswa kwabo akusizi ngalutho.


Dive ejulile

Emazweni aphesheya, i-anesthesia jikelele ayifuni ukusetshenziswa kakhulu ekubelethweni. Isibonelo, e-US, kuphela ama-5-7% wezingxenye ze-cearean. Nakuba ezweni lethu ukuvame ukusetshenziswa kwalo kufinyelele ku-70%! Ekuqaleni, umjovo ongenamaphilisi unikezwa umama, lona wesifazane ubhapathizwa ebuthongweni, emva kwalokho amavaysi amacici asetshenziswa nge-tube ekhethekile, ayisekele kulo mhlaba kulo lonke umsebenzi.

Ukusabela okweqile kumuthi wezinambuzane kwenzeka kumfazi oyedwa kuphela ngesigidi. Izingozi eziyinhloko zomama nengane zihlobene nokuhlangenwe nakho kanye nokusebenzisana kwethimba labodokotela. Ukuze izidakamizwa ezisetshenzisiwe zingene egazini lomntwana ngesilinganiso esincane, udinga ukususa esibelethweni ngokushesha ngangokunokwenzeka.

Ngaphezu kwalokho, kubaluleke kakhulu ukuthi ingane yawela ngokushesha ezandleni ze-neonatologist. Angabhekana nokugubha nokuqina komzimba wokuphefumula. Uma le-crust ikhipha ama-amniotic fluid, kubalulekile ukuthi othile amsize ahlanze umphimbo wakhe. Isazi sihlola isimo somntwana. Uma engabonakali izimpawu ze-hypoxia (ukungabi khona kwe-oksijeni), uzoba nezinye izingane, kuphela ngaphansi kokuqondisa okusondelene. Uma kunoma yikuphi, ukufakwa ngokufakelwa kokusebenzisa i-mask oksijini kungadingeka. Kunoma yikuphi, yonke imiphumela yokusebenzisa i-anesthesia ejwayelekile yengane iyasuswa ezinsukwini zokuqala zokuphila kwakhe.


Abesifazane abaphikisana ngokuphelele nokusetshenziswa kwanoma yimiphi imithi bangasayina idokhumenti ekhethekile ngaphambi kokubeletha. Kubonisa ukuthi nganoma yimuphi umphumela wenqubo ejwayelekile, bathatha yonke imithwalo yemfanelo.

Kwezinye izimo, uma owesifazane enezinhlungu ezinzima kakhulu ezingakhombisi ekuvuleleni umlomo wesibeletho, kwanele ukugcwalisa izimpahla zomzimba zomzimba. Kulokhu, imisipha ebusayo yesikhumba iyakhipha, futhi ukuhlukana kuyasebenza

I-anesthesia yokuqala ekusebenziseni ngesikhathi se-cearean isetshenziswa ngo-1847 yi-obstetrician J. Simpson. Kwakuyi-chloroform.


Ukuqapha okunengqondo

Ezibhedlela eziningi zokubeletha bonke omama abazayo ngaphandle kokufaka i-dropper nge-saline. Kungani? Ukuze ukwazi ukuphendula masinyane kunoma iziphi izimo eziphuthumayo futhi ngokushesha uziqede. Ukubeletha kuyilindelwe, kodwa inqubo engalindelekile kakhulu. Yingakho kudingeka sibe nokufinyelela okuphakade emthonjeni, ukuze ezimweni eziphuthumayo ngokusebenzisa umkhotha ungakwazi ukufaka imithi ngokushesha. Ngezinye izikhathi omama abazayo bazobekwa i-drop of saline nge-glucose. Lokhu kubaluleke kakhulu kulabo abangazange badle ngaphambi kokubeletha. Kulesi simo, i-glucose iyoba umthombo omuhle kakhulu wamandla, okungabazeki ukuthi uyoba usizo kumama ekubelethweni futhi emva kwabo, lapho eqala ukucindezela ingane yakhe elinde isikhathi eside. I-saline yemvelo ne-glucose iphephile ngokuphelele kokubili umama nengane.