Infiltration anesthesia

Description:

Allocate direct infiltration anesthesia when anesthetic is entered directly into fabrics of a surgery field, and indirect (anesthesia of a tooth texture), at the same time the anesthetizing solution from the created depot diffuses in more deeply the located fabrics which are exposed to an operational injury. The infiltration anesthesia can be executed by an injection under skin, a mucous membrane, under a periosteum.

At an operative measure on soft tissues of the person, an alveolar shoot and other areas use direct infiltration anesthesia, at an exodontia and carrying out bone operations on an alveolar shoot - an indirect infiltration anesthesia.

Clinical performance of an indirect infiltration anesthesia on an alveolar shoot upper and a mandible is not identical that it is connected with features of their anatomic structure. On a mandible the compact plate of an alveolar part is slightly thicker and more dense, quantity of openings in it much less. They meet preferential in the field of cutters, canines, is more rare - small molars. An alveolar part is also thicker, than on an upper jaw, especially in small and big molars. The low performance of an infiltration anesthesia is explained a mandible by it.

The mucous membrane of an alveolar shoot has no the expressed submucosal layer and is densely soldered to a periosteum. Administration of anesthetic directly under a mucous membrane is complicated and is followed by the expressed pain reaction owing to its flaking from a periosteum.

At infiltrative anesthesia it is necessary to enter the anesthetizing solution into a transitional fold of a threshold of an oral cavity where there is a submucosal layer: on an upper jaw - projections of tops of teeth, on lower - are slightly higher than it slightly below.

The lateral surface of an alveolar shoot of an upper jaw thin is also formed by a porous bone tissue, anesthetic solutions rather easily get through it. Effective blockade of alveolar nerves of any tooth on an upper jaw can be reached by creation of depot of anesthetic at a tooth top.

Anesthesia over a periosteum belongs to infiltration type of local anesthesia and is provided due to diffusion of mestnoanesteziruyushchy solution through soft and bone tissues to the blocked nerves. Administration of anesthetic under a periosteum is painful because of its flaking from a bone. Besides, it is not possible to enter enough anesthetic. Subperiostal administration of local anesthetic is shown at intervention on a tooth pulp when the infiltration anesthesia is insufficiently effective. It is better to do subperiostal anesthesia short (about 3 cm) by a fine needle. Slow administration of anesthetic does this anesthesia of less painful.

Equipment of an infiltration anesthesia.

To Eagle stick in a transitional fold between the anesthetized tooth and the tooth located medialny and advance to the place located tops of the anesthetized tooth where slowly, warning swelling of a mucous membrane, enter 0,5 ml of solution are slightly higher. For carrying out anesthesia over a periosteum it is necessary to use a fine needle with a diameter of 0,3-0,4 mm and 16-25 mm long. The needle tip at introduction should be oriented a cut to a bone for the direction of the entered solution in bone tissues. It is not necessary to aim to enter a needle under a periosteum as its rich innervation will lead to sharp increase in morbidity not only in needle Coca, but also administrations of solution under a periosteum, and also to post-injection complications. Thanks to high diffusion capacity of modern anesthetics administration of solution under a periosteum will not create considerable advantages in comparison with its deposition under a mucous membrane.

Anesthesia of the first upper painter who is located at the basis of a skuloalveolyarny crest has the following features. As in this place the lateral surface of a bone plate has the big thickness interfering solution diffusion, the injection is carried out on removal from this place on both sides from a skuloalveolyarny crest. Administration of mestnoanesteziruyushchy solution at a top of the second premolar tooth allows to reach effective blockade of nerves of a medial buccal root of the first painter. For anesthesia of a distal buccal root it is necessary to enter a little bigger amount of anesthetic (to 1 ml) directly behind a skuloalveolyarny crest at its top.

As root length at canines big, a projection of their top to the front surface of an upper jaw is located near an infraorbital foramen. Therefore the entered solution can get in the infraorbital channel that will lead to blockade of front upper alveolar nerves which innervate cutters and fabrics of a front surface of an upper jaw.

Anesthesia zone.

Infiltration anesthesia comes in an injection site of local anesthetic, blocking nerve terminations in the place of performance of surgical dental intervention.

Complication.

Flaking of a mucous membrane together with a periosteum, up to a necrosis of fabrics at disturbance of the technology of carrying out an infiltration anesthesia.

At inefficiency of infiltration anesthesia owing to anatomic features or the nature of pathological process in the field of a surgery field it is necessary to do conduction anesthesia.