Anesthesia in stomatology

Description:

Local anesthesia belongs to a local analgesia more, but in modern dental practice the term "chalk cash anesthesia" is used.
The drugs used for the local, anesthesia (L,A) carry out blockade of carrying out afferent, nervous impulses.
Allocate the following types of local anesthesia:
- application anesthesia
- infiltration anesthesia
- regional blockade
- intraligamentarny anesthesia
- conduction anesthesia

Local anesthetics are the medicines which are the most widely used in dental practice. They provide disturbance of transfer of afferent nervous impulses, in particular to the impulsation connected with irritation of pain receptors and also in a little smaller degree tactile, thermal and receptors of pressure. In general, they are very reliable, and is admissible, for performance of the majority of dental procedures, to do use of local anesthetics without use of resources of the general anesthesia.
It is possible to mark out the following advantages of local anesthetics:
- convenience of use, it is possible to enter them into operative measure time;
- preservation of clear consciousness of the patient and the advantages connected with it;
- reduction of bleeding during surgical interventions on periodontal fabrics and in an oral cavity (a contribution of a vazokonstruktorny component);
- decrease in risk of development of arrhythmia (the risk increases when carrying out surgical intervention under the general anesthesia);
- reduction of depth of the general anesthesia at simultaneous use of local anesthetic during operations because of reduction of an afferent impulsation in TsNS;
- immediate effect of local anesthesia when using as postoperative anesthesia and the reduction of indications connected with it to purpose of opiates — stopping of chronic front pain (for example, epileptiform neuralgias); for this purpose use local anesthetics of long action.

Infiltration anesthesia.
At an infiltration anesthesia solution is deposited with tooth top projections, gets by means of diffusion through a bone and influences periapical nerve terminations, nerve terminations of a periodoktalny sheaf, bone and soft tissues. For a possibility of implementation of such diffusion the bone has to be porous in this connection, this type of MA cannot be adequate at manipulations in the field of premolar tooths and painters of a mandible. Usually for carrying out this type of anesthesia the needle is entered into a transitional fold, advanced to a root top projection point (proceeding from knowledge of average length of a root of this tooth), rest a needle against a bone so that the cut of a needle was developed to a bone, and enter 1 — 2 ml of solution (about about a half of a cartridge of 2,2 ml). It is not necessary to try to obtain administration of anesthetic under a periosteum.

Conduction anesthesia.
Conduction anesthesia - MA-solution is deposited around a nervous trunk, and the fabrics innervated by it are anesthetized. In dental practice several types of conduction anesthesia are used. The choice of a type of blockade depends on the ipea area. the believed intervention.
- Blockade of a nizhnealveolyarny nerve — all mandible.
- Blockade of a mental nerve — from the central cutter to the first premolar tooth of a mandible.
- Blockade of a nizhneglaznichny nerve — from the central cutter to the second premolar tooth of an upper jaw.
- Blockade of a nasopalatine nerve — a mucous membrane and a periosteum of a hard palate from a front cutter to a canine of an upper jaw.
- Blockade of a big palatal nerve — a mucous membrane and a periosteum of a hard palate from premolar tooths to painters.
- Blockade of upper back branches of the II branch of a trifacial — upper painters. Seldom gives any effect in addition to simple infiltration.
Blockade of a nizhnealveolyarny nerve is most often used. In addition to fabrics, innetviruyemy this nerve, when carrying out this type of anesthesia usually anesthetizes also the fabrics innervated by a lingual nerve.