๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Hemostasis
Hemostasis
The presence of any implanted cardiac pacemakers and defibrillators should be noted, and an appropriate method of electrosurgery selected (see Chapter 16). For patients with pacemakers and implantable cardioverter defibrillators (ICDs), it may be safest to utilize electrocoagulation with bipolar forceps or a hand-held heat cautery device.15,16 When using standard monopolar electrosurgical devices, frequently practiced precautions include applying short bursts of energy (<5 seconds), using minimal power, and avoiding use of electrosurgery around the implanted device.17 Epinephrine, which is commonly added to local anesthetics, should be avoided in epinephrine-sensitive patients.