Local anesthesia

Description:

Local anesthesia – the anesthesia which is reached impact of the anesthetizing substance on nerve terminations and trunks in the place of operation.

Local anesthesia is usually used in out-patient practice at small surgical interventions or diagnostic testings. Local anesthesia is used in the presence of contraindications to the general anesthesia (anesthesia).

Ways of local anesthesia.

Surface anesthesia assumes putting anesthetics on skin or mucous, cooling. Aether chloratus, mestnoanesteziruyushchy substances are for this purpose used (1-5% solutions of cocaine, 10% solution of novocaine, 0,25-3% solutions of Dicainum, 2-5% solutions of lidocaine and Trimecainum and others).

Infiltration anesthesia. The fine needle enters into soft tissues of 0,25-0,5% novocaine solution (or other more modern anesthetics) therefore there is a treatment of fabrics in the field of operation by solution of local anesthetic and conductivity of nervous impulses is blocked. At an infiltration anesthesia not only anesthesia, but also other purpose – hydraulic preparation of fabrics which considerably facilitates manipulations of the surgeon and reduces blood loss is reached.

Regional anesthesia – anesthetic is entered in close proximity to a nervous trunk.

Types of regional anesthesia:
Conduction – anesthetic is entered into bliz of a nerve knot, neuroplex or a trunk of a peripheral nerve (for example, at an exodontia).
Spinal (synonyms: lumbar, subdural anesthesia, subarachnoidal anesthesia) is based on administration of anesthetic in a subarachnoid space of a spinal cord. At the same time sensitivity and function of the bodies receiving an innervation is temporarily lost drug injection sites are lower. Similar anesthesia is used at stomach, intestines, liver operations and bilious ways, a spleen, bodies of a small pelvis, the lower extremities. Contraindications to spinal anesthesia: shock, heavy intoxication, a lowering of arterial pressure, that wishing pathology of internals, inflammatory diseases of skin in the place of an estimated injection of drug, deformation of a backbone, etc.
Epidural – anesthetics (lidocaine, bupivacaine, ропивакаин) are entered into an epidural space of a backbone through a special catheter. Similar anesthesia is almost safely used at an analgesia of a breast, stomach, inguinal area and legs, often applied at childbirth. Advantage of epidural anesthesia is use of very small doses of anesthetics, rare by-effects (nausea, vomiting, a lowering of arterial pressure, etc.)
Intravascular – intravenous anesthesia which is used at extremity operations when anesthetic is entered into an extremity on which the styptic plait is imposed. A kind of intravascular anesthesia is intra bone anesthesia.

Contraindications to local anesthesia:
- intolerance of local anesthetics;
- disturbances of mentality of the patient;
- damage of fabrics (the rough hems, the expressed inflammation interfering performance of an infiltration anesthesia, bleeding).

Local anesthesia begins with premedication (preparatory treatment when to the patient enter 1-2% solution of Promedolum, 0,1% solution of atropine, 0,25% of solution of Droperidolum or tranquilizers.

Complications of local anesthesia are extremely rare. Can be: excitement, dizziness, trembling of hands, allergic reactions, pallor, perspiration, bradycardia, hypotension, lowering of arterial pressure, spasms, etc. The preliminary conversation with the patient (specification of intolerance of drugs), careful observance of a dosage and equipment of anesthesia helps to avoid complications.

Intravenous anesthesia.
Intravenous administration of drugs provides a physiological dream and good anesthesia, eliminates feelings of alarm and fear. Similar anesthesia is used at short, low-traumatic operations for ensuring the maximum comfort of patients. Sometimes intravenous anesthesia is a part of the complex anesthesia (including a mask anesthesia with preservation of independent breath or transfer into artificial ventilation of the lungs).