I-Tubal anesthesia kwiamazinyo: ubuchule, amalungiselelo

I-Tubal anesthesia yingozi kakhulu, ngokweengxaki, izixhobo zokusebenza. Okwangoku, le nkqubo isetyenziswe ngokungaqhelekanga. Yenziwa yinkqubo yokulawula kunye nokulawulwa kwezilwanyana. I-Anesthesia isetyenziselwa ukunyusa i-anesthetize kummandla wee-molars eziphezulu, ngokukodwa ukukhutshwa kweentsholongwane zenyanga.

Iimpawu zenkqubo

Iimpawu zobunzima bobunzima bommandla wolawulo lweziyobisi zandisa ingozi yeengxaki kunye nokunciphisa ukusebenza kwe-anesthesia. Makhe sicinge ngamanye amaxesha.

Esikhatsini se-temporo-pterygoid ngasentla kwintlambo ephezulu i-plexus ephazamisayo. Ihlala kuloo ndawo ukusuka kwi-incision engezantsi ukuya emhlathini osezantsi. Ukugqitywa ngokukhawuleza kwodonga olunobumba kubangela ukubunjwa kwe-hematoma enkulu, enzima ukukhusela.

Isingeniso senaliti kwinqanaba elaneleyo likhokelela ekubeni i-injection yesisombululo iqhutyelwa kwiisisitye ezinamafutha angaphantsi. Kule meko, i-anesthesia ye-tuberi ayiyi kusebenza nangoko. Ukugqithisa ubunzulu bokufakelwa kwenaliti kukhokelela kwimiphumo elandelayo:

1. Ukuqaliswa kwe-anesthetic kwi-optic nerve zone kwenza ubumfama besikhashana.
2. Ukungenwa kwesilwanyana kwi-cellulose ye-orbit kubangela umxube wesikhashana.
3. Isisombululo esingena kwi-pterygoid muscle sibangela isifo esibuhlungu sisifo emva kokuba isenzo se-anesthetic siphelile.

Awukwazi ukuvumela isicatshulwa slide phezu kwesiqulana ngethuba le nkqubo, kuba kunokwenzeka ukuba i-perforate nervers and vessels.

Indawo ye-anesthesia

I-Tubal anesthesia kwiamazinyo avumela i-anesthetizing kule mimandla elandelayo:

• Ummandla weentloko eziphezulu;
• I-Periosteum kunye nokugubungela umququzelelo we- alveolar process ;
• I-mucosa kunye nethambo le-sinus maxillary kunye nodonga olusemva lwendawo.

Indawo yomda we-anesthesia edlula ngasemva ihlala ihlala. Ukusuka phambili, inokufikelela emkhatsini we-molar encinci yokuqala kwaye, ngokufanelekileyo, i-mucosa elapha kule ndawo kunye negum.

Intraoral tuberial anesthesia ngokweYegorov

Inkqubo:

1. Umlomo wesigulane useburhulumenteni ovulekile. Udama lugcinwe yi-spatula.
2. Ngokuqondisa ukusikwa kwenaliti kumathambo esithambo, ugqirha wenza i-puncture kwinqanaba le-second molar kwisithambo.
3. Inaliti kufuneka ifumaneke kwinqanaba le-45 ° kwinkqubo ye-alveolar.
4. Inaliti ishukunyuka phezulu, iphinda iphinde ibe phakathi, ngelixa kuyimfuneko ukulawula ukudibanisa kwayo rhoqo kunye nethambo. Kwinkqubo, ixabiso elincinci le-anesthetic lenziwa.
5. Inaliti isetyenziswe kwi-2-2.5 cm. I-piston ikhutshwe kwakhona ukujonga ukungabikho kokukhutshwa kwesitya.
6. Ukuba akukho igazi, vela kwi-2 ml yesisombululo. Isirinji isuswa.
7. Isigulane sicinezela indawo ye-anesthesia ukuphepha ukubonakala kwe-hematoma.
8. Umphumo opheleleyo weziyobisi kubonakala imizuzu eyi-10.

Ukuba i-anesthetic esebenzayo emfutshane isetyenziswa, inkqubo iya kusebenza kwimigangatho engama-45, ukuba ihlala ixesha elide-ukuya kwiiyure ezingama-2.5. I-intraoral tuberial anesthesia yenzelwa imisebenzi yokuphulukana nokugula kunye kunye neengenelo zangexesha elifanayo kwimirhumo emininzi.

Indlela yo kuqhuba

Kungakhathaliseki ukuba yintoni umyalelo wokuba i-anesthesia ye-tuberal iyadingeka, ubuchule bokufeza kufuneka ukuba intloko yesigulane ilahlekwe kwindlela eyahlukileyo. Ngaphambi kwe-anesthesia, ugqirha ugqiba ubunzulu apho inaliti kufuneka ifakwe khona. Lo umda phakathi kwekona elingaphantsi langaphandle le-orbit kunye ne-angle yangaphakathi engxenyeni ye-zygomatic bone.

Udokotela wamazinyo usekunene kwesigulane. Inaliti ifakwe kwindawo yomda we- mlar bone. Kufuneka kube ne-angle ye-45 ° ngokubhekiselele kwinqwelo ye-median ne-angle angle kumgca we-trago-orbital line. Emva kokufaka inaliti ekujuleni kokufunayo, i-anesthetic ifakwe. I-Anesthesia iqala imizuzu emi-5.

Ukulungiselela

I-tubal anesthesia yenziwa nge-anesthetics yendawo:

1. I-Lidocaine yi-derivative yokuqala ye-amide ngesiseko esithi "Bupivacaine", "Artikain", "Mesocaine" kunye namanye ama-agent agqityiweyo. Isetyenziswe njengesisombululo se-1-2%. I-Lidocaine iyilwa ephantsi. Ukuchasene kwizigulane ezinezilonda ezinobungozi zesibindi.
2. I-Trimekain yi-derived amide. Ngokusebenza kwayo, isivinini kunye nobude bezenzo, iNovocaine iphindwe kaninzi. Itholakala ngeendlela zesisombululo seendawo ezahlukeneyo. Njengefuthe eliphambili lokusungulwa kweyilungiso, isikhumba sekhanda, isicupunu, intloko iyakwenzeka.
3. Isilwanyana "Ultrakain", esinamaxabiso ama-1.5-2 amaxesha angaphezulu kunabanye abameli be-anesthetics yendawo (i-ruble engama-50 nge-ampoule), inenzuzo enkulu ekusebenziseni. Ukugqithisa okuphezulu kunye nobude bentshukumo-mvume vumela ukusetyenziswa kungekhona kuphela ekutyunjweni, kodwa nakwezinyo zomzimba wamazinyo. Ixabiso lini "i-Ultracaine"? Ixabiso leziyobisi (kwi-anesthesia, oku kuthetha ukuba kwiikliniki zamazinyo eRashiya kuya kufuneka zihlawule ukusuka kuma-ruble angama-250 ukuya kuma-300) ichazwa ngumvelaphi wangaphandle. I-Analogues - "Artikain", "Alfakain", "Ubistezin".

Zonke iimali zisetyenziselwa ukudibanisa ne-vasoconstrictor (adrenaline). Xa ukhetha i-ingcali yonyango inquma ukunyamezela komntu kunye nenani eliphezulu, liqwalasela iminyaka yobugulane, kunye nobukho bokukhulelwa kunye neepatilo ezihambayo.

Iingxaki zenkqubo

I-anesthesia ye-tuberial, ehlolwayo idibeneyo (izigulane ziqaphele i-analgesic effect, kodwa ezinye zikhalaza ukuba i-numbness ayihlali ixesha elide, ukuya kwiiyure ezingama-5, kunye neempembelelo ezikhankanywe ngasentla ezingathandi abaninzi), kufuneka ziqhutywe yingcali eqeqeshe kakhulu, Unako ukuqwalasela yonke imiba efunekayo yomcimbi. Ezinye zeengxaki ezinokwenzeka sele ziqwalaselwe. Ixesha kufuneka linikezelwe kwingxaki yokuthintela kwabo.

Ukutshatyalaliswa kwemithambo yegazi kunye nokwakhiwa kwama-hematomas kwintsimi ye-anesthesia inokuthintelwa. Ngenxa yale njongo, ngexesha le-anesthesia, awukwazi ukulahlekelwa udibaniso phakathi kwentsalane kunye neethambo zamathambo uze uyijobe ngaphandle kwe-2.5 cm. Emva kokususa inaliti, ukungena kwe-inested anesthetic ixutywa ngaphaya kwe-tuber maxillary. I-tubal anesthesia ivunyelwe kuphela ekungabikho kweenkqubo zokuvuvukala kwiziko lokuxela.

Ingozi kwisigulane ifumana isisombululo kwigazi. Ubunobuthi bayo bunyuselwa ngamaxesha angama-10, kwaye isenzo se-vasoconstrictor siyi-40. Isigulane sinokutshatyalaliswa, ukuwa, ukuphazamiseka. Ukuthintela le nkcenkceshe, ngaphambi kokuba ujobe i-anesthetic, i-piron ye-syringe iyasuswa. Oku kwenza kube lula ukuqinisekisa ukuba inaliti ayifaki isitya. Ukuba igazi livela kwisirinji, kufuneka utshintshe isalathisi senaliti uze ufake injini kuphela.

Ukuxhatshazwa kwemithetho ye-asepsis ngexesha le nkqubo kungakhokelela ekusulelekeni. Ukufakela inaliti emlonyeni wakho, kufuneka uqiniseke ukuba ayithinti inyo. I-ingress ye-plaque iya kukhokelela ekuphuhliseni i-phlegmon.

Isiphelo

Ngokumalunga nenani elikhulu leengxaki kunye nobunzima beendlela zokuqhuba i-anesthesia ene-tuberous, akunqabile. Ukhetho lwe-anesthesia lufanele luphathwe kwiingcali.