Ukunyanga kwamazinyo kubantwana abangaphantsi kwe-anesthesia: ukuphononongwa

Ngokukhawuleza okanye kamva, wonke umama ubhekane nelokuba umntwana unamazinyo kwaye ufuna ukukhawuleza ukukhokela kwinyango yamazinyo. Iimbangela zokungazinzi zingahluka. Nangona kunjalo, ukuba umntwana sele evelele kwiofisi yamazinyo, ukumcela ukuba eze kwakhona kwakhona kunokuba yingxaki enkulu. Ngokuqhelekileyo, ukuze bafumane uvavanyo olukhuselekileyo, abazali kufuneka baxhomeke kwiiveki okanye baze bathathe isiphofu ngomntwana ngezipho. Kubaluleke kakhulu ukuba ngaphambi kokutyelela eklinikhi abantu abadala baziphatha ngendlela echanekileyo, oko kukuthi, abayitholi imeko kwaye bangamcaphukisi umntwana ukuba abe noloyiko kunye noxhala.

Iingcebiso kubazali

1. Abantwana abaneminyaka engaphantsi kweminyaka emithathu ubudala banomthwalo wokunciphisa ubuhlungu, oku kuthetha ukuba uvakalelo lwentlanzi alubonakali. Eli xesha lilungele ukutyelela kokuqala kwidokotela wamazinyo.
2. Kucetyiswa ukuba ukutyelela kokuqala kufuneka kufundiswe kwaye kuhambisane noviwo lomlomo womntwana kunye nesinconywa sokucoca kakuhle kwamazinyo.
3. Ngaphambi kokutyelela kwikliniki, kubalulekile ukuba uqhube incoko yemfundo nomntwana, cacisa ukuba unyango kunye nokunakekelwa kwamazinyo kuyimfuneko ebalulekileyo kwaye inyanzelekile, ukubonisa ngomzekelo wakho ukuba kubaluleke kangakanani ukuxubha amazinyo akho kusasa nangokuhlwa, ukudlala nomntwana kwimidlalo ebonakalayo.
4. Ukuba isigulane esincinci siziphatha ngesibindi kwaye sinokumkeleka ngokumkelekileyo, kuyimfuneko ukumdumisa, simxelele ngendlela enesibindi nangesibindi. Ukuba umntwana unengqiqo, umele ujonge aze athi ngexesha elizayo uya kuziphatha ngokuthobela.
5. Umama okanye utata angamthabatha umntwana kunye naye ukuba amkele ukuba akukho nto iphosakeleyo kunyango. Kule meko, kubalulekile ukuba uvumelane kwangaphambili nodokotela malunga nokuba khona komntwana.

Ukuba iingcebiso ezingentla zingakhange zancedise okanye azizange zihlangane ngexesha kwaye ngokuchanekileyo, ungakhathazeki. Iyeza zanamhlanje zinika inkqubo ehlawulwayo, kodwa enempumelelo kakhulu - unyango lwamazinyo kubantwana abangaphantsi kwe-anesthesia.

Iintlobo ze-anesthesia

Okwangoku, uninzi lweekliniki ezizimeleyo kunye noluntu ziphantsi kwenkxaso yabo yinkonzo ye-anesthesiologists ekwazi ukukhethayo kunye nokwenza i-aneshesia eyenza umonakalo omkhulu kumzimba. Ukuze abe ne-anesthesiologist kunye no-resuscitator kubasebenzi bakhe, amayeza omntwana kufuneka athole ilayisenisi ekhethekileyo evela kurhulumente, okungenjalo kulula, njengoko kukho uluhlu lweemfuno ezithile zezixhobo, iziyobisi kunye nezinto eziphathekayo, kunye ne-qualification ye-anesthesiologist kunye ne-resuscitator.

Nangona kunjalo, ukongeza kwi-anesthesia yeziyobisi, kukho iindlela ze-anesthesia ezingekho iziyobisi: i-hypnosis, i-electro-analgesia, kunye ne-audio-analogy. Kuzo zonke ezi ndlela, kuphela i-electroanalgia iye yafumana ukuthandwa kwaye ibonwa njengeyasebenza.

Unyango lwamazinyo kubantwana abangaphantsi kwe-aneshesia jikelele lunokuba luhlobo lweentlobo ezimbini: i-aneshesia yindawo yokuhlala, igqibe.

Ukusetyenziswa kwesinyathelo se-anesthesia

Le ndlela ibandakanya i-aneshesia ngokukhetha uhlobo lwesicelo. Oko kukuthi, indawo ye-injection ifunwa yintsholongwane yintsholongwane okanye i-gel, kwaye emva kwemizuzu emibini okanye emibini, ijojo kunye ne-anesthetic ifakwe.

Xa uphatha i-caries okanye i-pulpitis kubantwana kwi-anesthesia yendawo, izilwanyana eziqukethe u-artacoin hydrochloride zisetyenzisiweyo, kuba ziphindwe ezintlanu ngaphezu kwe-novocaine, kwaye zingekho nengozi kumzimba. Ukongezelela, i-Artacoin hydrochloride idityaniswe kwiminithi engamashumi amabini ukuya kumashumi mabini anesihlanu.

Ukunyanga kwamazinyo kubantwana abangaphantsi kwe-anesthesia, Ukusebenzisa iziyobisi ezisekelwe kwi-artacoin hydrochloride, ingaqala ngeminyaka emine. Izidakamizwa zeArtikoinosoderzhashchie nazo zikhuselekileyo kumama abakhulelweyo nabancinci.

Ukuphucula umonakalo we-anesthetic kunye nobude beziyobisi, kaninzi la mayeza ancediswa kunye ne-vasoconstrictors (vasoconstrictors), njenge-epinephrine, mezatonum, filipressin. Iintlungu zengingqi ezidibeneyo, ezisekelwe kwi-artacoin hydrochloride, ziveliswa kuphela eJamani, eFransi naseSpain.

Ukunyanga kwamazinyo ezincinci kubantwana abangaphantsi kwe-anesthesia jikelele kunye nokusetyenziswa kwezidakamizwa ezidibeneyo kubonisiwe ukusuka kwiminyaka emihlanu kumlinganiselo welikhulu ukuya kumawaka ayikhulu (artakoin ukuya kwi-adrenaline).

Xa uneminyaka emihlanu ukuya kweyisixhenxe, i-benzocaine-ne-lidocaine ene-sprays isetyenziswe njenge-aneshesia.

Ukulungiswa kwangaphambili kwezonyango zabantwana ngaphambi kokutyelela ugqirha wamazinyo

Ukulungiselela umzimba womntwana nge-aneshesia nokunciphisa amathuba okuba nemiphumo emibi, sebenzisa izidakamizwa ezizodwa, ezibizwa ngokuba yimithi yokuqala.

Kukho iingxenye ezine zentlungu: yengqondo, inzwa, imoto, izityalo.

I-anesthetic yendawo, efana ne-lidocaine, i-articoin, i-benzocaine, isusa isithintelo kwisayithi yokungenelela, isuse inxalenye yecala, kodwa ingathathi indawo yecandelo le-psycho-emotional, motor and vegetative, ngoko kufuneka lisuswe emva kokulawulwa kwe-analgesic.

Ngeendlela zokukholisa nokucebisa, icandelo le-psychoemotional liboshwe.

Iimpawu zokusetyenziswa

Ukunyanga kwamazinyo kubantwana abangaphantsi kwe-anesthesia Amachiza Ukuphucula, kuboniswe xa:

• Ukugula kwengqondo engapheliyo;
• Isifo sokuphefumula esingapheliyo;
• Ukungasebenzi;
• Izifo zenkqubo ye-endocrine;
• Ukutshatyalaliswa okusisigxina kunye nokuhlaziya;
• Itheyibhile yomzimba;
• Ukudandatheka okungapheliyo;
• Phobias.

Imizuzu eyi-10-25 ngaphambi kokuba unyango, umntwana umiselwe i-anxiolytic, umzekelo, i-chlordeepepoxide, eyaziwa ngokuba yi "Sibozone", "Napaton", "Seductin" okanye "Chlozipid".

Isidakamizwa esinoxinzelelo esicetywayo kubantwana abavela kwiminyaka emine kwisilinganiso seminyaka emihlanu ukuya kweyishumi mg, eneminyaka engama-7 ubudala-ukusuka kwi-10 ukuya kwi-20 mg, kwiminyaka elishumi elinesihlanu ukuya kwishumi elinesibhozo-ukusuka kwi-20 ukuya kwe-30 mg ngosuku. Inqanaba lokugqibela le diazepam kufuneka linxilwe imizuzu elishumi elinesibini ngaphambi kokuya kwinyango yamazinyo.

Ukutshatyalaliswa - enye indlela eya kwi-anesthesia

Ngenxa yokuba imithi yokuqala ayisoloko isebenza kakuhle, kwindlela yokuhlaziywa kwamazinyo yintsholongwane yamanqanaba kwaneendlela ezinjenge-sedation, okanye enye indlela ye-anesthesia.

Ukutshatyalaliswa ("ubuthongo bonyango") bunokuba bunzulu (ukugqiba), oko kukuthi, ukungena kwindawo yokulala nokunciphisa ukuphefumla, kunye nokuthetha (akuphelelwanga), xa isiguli sinakho ukugcina ubudlelwane kunye nokulandela imiyalelo yesigqirha.

Unyango lwamazinyo phantsi kwe-anesthesia jikelele kubantwana lwenziwa kunye nokusetyenziswa kwe-inhalation imizuzu embalwa ngaphambi kokungenelela kwamazinyo, ama-N2 kunye ne-O2-ZAKS asetyenziswa.

Ekuqaleni kwenkqubo, umntwana ufumana i-O2 ecocekileyo kunye ne-nitrous oxide ixesha eliyiminyaka elishumi elinesihlanu kwimaski. Ukugxininiswa kwe-N2 ekuvunyelwene ngayo kwi-SAS akufanele kudlule i-70%. Kwabantwana abaneminyaka engaphantsi kweshumi elinesihlanu, iipesenti ezingamashumi amathathu ze-nitrogen kunye neepesenti ezingamashumi asixhenxe ze-oksijeni yonyango.

Isingeniso kummandla we-aneshesia kunye nomxube weZAKS kubangela umntwana ukuba azive elula, ekhululekile, elele.

Izinzuzo zokudalwa

Inkwenkwe ibona kwaye iva yonke into eyenzekayo, kodwa ayiziveki kakuhle ngexesha elifanayo. Ukunikezelwa komxube we-anesthesia kunye nokususwa kwe- mask oksijini kwenzeka ngoncedo lwezixhobo ezizimeleyo ezizenzekelayo. Ngethuba lexesha lenqubo yamazinyo igqityiwe, i-nitrous oxide iyancipha kwaye ukuxinwa kwe-oksijeni ecocekileyo kwanda kwikhulu leepesenti, emva koko i-mask isuswa. Impembelelo ye-SAS ihamba imizuzu emihlanu ukuya kweyishumi.

Umxube we-sedation nakuba unempahla ethile ye-analgesic, kodwa kungenako ukwanela kwimisebenzi yamazinyo enzima, ngoko unyango lwamazinyo phantsi kwe-anesthesia kubantwana Ivela nge-anesthesia yendawo eyongezelelweyo.

Ngokuqhelekileyo, umxube weZAKS usetyenziswa, ukususela kwiminyaka emine, xa sele sele kunokwenzeka ukuseka uqhagamshelwano nomntwana. Enye yemisebenzi ephambili kulo mzekelo wezokwezinyango kunye nabazali kukunyanzela umntwana ukuba agqoke imaski ngokwakhe. Ukuze wenze oku, sebenzisa ioli ephosakeleyo ebangela ukuba umnqweno womntwana uphefumle igesi ngaphandle kokunyanzeliswa.

Ukukhubazeka kwamanye amazwe ekliniki yamazinyo kusebenzisa ukubonakaliswa kwamathonto akho ozithandayo kunye neenganekwane zomntwana ngexesha "lokulala kwezokwelapha".

Unyango lwamazinyo phantsi kwe-anesthesia jikelele kubantwana abanama-sedation kunokuthathwa njengenkqubo engeyona nengozi, njengoko isetyenziswe kuwo onke amazwe aphuhlisiwe ehlabathini.

Amazinyo abantwana baseRashiya

Ayikho imfihlo ukuba le ndawo ingumncinci kwaye ngexesha elifanayo lisebe eliyinkimbinkimbi kunazo zonke, elibandakanya izikhokelo ezininzi.

Umsunguli wamazinyo kubantwana angabonwa ngokuba nguA AK Limberg, osukela ngo-1901 ephethe isihlalo esingaziwayo kwikholeji yaseSt. Petersburg.

Ngowe-1974-1975, ukuhlolwa kweeklinikhi kwabantwana kumaofo angamazinyo kwamkelwa ngokusemthethweni, kunye ne-aneshesia ngexesha lokusebenza kakubi.

Ngowe-1985, u-specialty "wamazinyo omntwana" wafakwa ngokusemthethweni kwi-nomenclature yezodwa zempilo.

Kuze kube namhlanje, iiklinikhi zamazinyo eziphezulu zezintlu zifumaneka kuwo wonke umzi. Ukongeza kwiinkqubo eziqhelekileyo ezinjengeyeza, unyango lwe-maxillo-facial, u-optic surgery, i-orthodontics yabantwana kunye ne-prosthetics, uviwo lwezonyango kunye noonyango, amaziko angonyango angakunika isilation okanye i-anesthesia jikelele.

Ukuphononongwa kweekliniki zamazinyo zabantwana

Ngaba amayeza omzimba aphethwe njani abantwana phantsi kwe-anesthesia eMoscow? Iindleko ze-sedation, iklinikhi eyenzayo, zidweliswe ngezantsi.

Kwi-capital yaseRussia, inani leeklinikhi zinokunikela ngenkonzo enjalo:

• "Baby kunye neCarson" - indleko ye-nitrous sedation sedation (imizuzu engama-30) ngama-ruble angu-2500. Iklinikhi inika neenkonzo zonyango kwiimeko ze- anesthesia jikelele. Iindleko ze-anesthesia "Sevoran" (imizuzu engama-30) ngama-ruble angu-4 500. Ixabiso lomzuzu omnye we-aneshesia jikelele yi-ruble ayi-165.
• ICandelo leZonyango kwiZiko leMpilo "KOLONI" linika iinkonzo ezilandelayo: inhalation ye-anesthesia (imizuzu engama-30) - ii-ruble ezingama-5500.
• Iikliniki yamazinyo entsapho "I-Nutcracker" indleko ye sedation ne nitrous oxide (imizuzu engama-30) - i-ruble 2940. Jikelele i-aneshesia (imizuzu engama-30) - i-ruby 5940. Iziko lezonyango libonelela ngeenkonzo zangaphambili zonyango - ii-ruble eziyi-1500.

KuMoscow kuphela, amazinyo aphathwa phantsi kwe-anesthesia kubantwana. I-Novosibirsk inikezela ngeenkonzo ezifanayo:

• Iiklinikhi yamazinyo "I-Style Dent" - iamazinyo kubantwana abangaphantsi kwe-anesthesia (i-iriyure jikelele) iindleko zeeruble ezingama-5500. I-Anesthesia inokufakwa kwi-mask ye-oxygen okanye ngejoyi.
• "Iziko leeDentistry" - iyure ye-aneshesia kwikliniki ixabisa iiruble ezingama-3900.
• "Isibhedlele seKliniki yeNdlela" - ulwazi kwiziko lithi iindleko ze-aneshesia yi-25% yeendleko zonyango.

Kwakhona, unyango lwamazinyo phantsi kwe-anesthesia kubantwana beekliniki zamazinyo eMinsk:

• "Isiko soMzimba wamaDentistry" - i-anesthesia ene-intravenous 78 i-rublebhu yaseBelarusian (2,530 i-ruble yesiRashiya).
• Iziko lezonyango "uMelissa" uphinde unikezele ngeenkonzo ze-anesthesiologist kwiintsana - iindleko zenkonzo kufuneka zibonwe kwiklinikhi ngokwamntu ngamnye.

Mhlawumbi kwezinye iidolophu, unyango lwamazinyo phantsi kwe-anesthesia kubantwana. I-Krasnoyarsk ayifuni emva kweMoscow kwaye inikezela ngeenkonzo ze-sedation kunye ne-anesthesia jikelele:

• Iziko leDentistry "ASTREA" - isebenzisa izilwanyana "Sevoran", ubude kunye neendleko zenkonzo zingatholakala kwi-dokotela okanye kumcebisi.
• "IYunivesithi yeDentistry" - ukufumana iqhutyelwa ngumntwana we-anesthesiologist yezingane, owathi, ngokutsho kobubungqina kunye nobudala bomntwana, uncoma uhlobo kunye neendleko ze-anesthesia.

Ukunyanga kwamazinyo kubantwana abangaphantsi kwe-anesthesia: ukuphononongwa

Uninzi lwabantwana luyesaba oogqirha, kwaye ngoko yonke indlela eya ekliniki ihamba kunye neengca, iinyembezi kunye neengqungquthela. Ukuze bangalimazi ingqondo yengane, uninzi unina uthabatha unyango lwamazinyo phantsi kwe-anesthesia. Inzuzo yale ndlela kukuba umntwana uphefumlela igesi elihlezayo aze alele ebuthongweni, ngaphandle kokwesaba ugqirha kunye nokugxotha.

Yile ndlela amazinyo aphathwa ngayo nomntwana phantsi kwe-anesthesia jikelele. Uphononongo Abazali uya kufunda apha ngezantsi.

Ngokuqhelekileyo, oomama, ngaphambi kokuthatha umntwana kumgqirha, cela iingcebiso kubahlobo kunye nabaqhelana nabo. Iiklinikhi zangasese ezinikezela ngeenkonzo zamazinyo, njengonyango lwamazinyo phantsi kwe-anesthesia, zikhethwa ngokukhethekileyo. Abantu abaninzi bathi i-anesthhesiologist ikhetha uvavanyo lwegazi kunye nomchamo, uviwo lomntwana ngumbhali. Imilinganiselo eyahlukileyo impilo efanelekileyo ngexesha lokunyanga, oko kukuthi, ubukho bokushisa okanye ukukhwehlela akuvumelekanga. Musa ukwenza imisebenzi kwisisu esingenalutho. Emva kwonyango, kuxhomekeke kwiminyaka yengane, ukuxhamla, ukucabisa, ukuhlanza, ukuxhalaba, ukunyaniseka kungaqwalaselwa, abazali bayayiqaphela. Konke oku ku funeka kuhambe ngeeyure eziyi-12-14. Ngokukodwa ukonyango kwamazinyo kunye nomxube weZAKS okanye izilwanyana "Sevoran" Kunconywa ngoomama wabantwana abanempilo embi.

Ukunyanga kwamazinyo kubantwana phantsi kwe-anesthesia jikelele, ukuhlolwa koogqirha

Iingcali ziqaphele ukuba ngexesha lobuninzi beli liza "Sevoran" laphethwe inani elininzi labantwana, ininzi zazo ziyizingane ezinezifo zesistim se-nervous. Ngelo xesha, oogqirha bakhumbuza ukuba imeko efunekayo yindlela yokuziphatha kwezonyango phantsi kolawulo lwe-anesthesiologist efanelekileyo kakhulu kunye ne-resuscitator. Iikliniki kufuneka ibe nezixhobo eziphezulu eziphezulu: ixhobo zokufakelwa umoya, izixhobo zokuphefumula, i-anesthetics yanamhlanje, izixhobo ezinamandla zokulandelela. Kubaluleke kakhulu ukuba i-aneshesia ikhuselekile kwimpilo yengane kwaye ayibangeli imiphumo emibi.

Ngokudla kaninzi, oomama baqala ukucwangcisa le nkqubo, xa abantwana behlenga amazinyo - malunga neminyaka eyi-3-4. Ukunyanga kwamazinyo kumntwana (iminyaka emithathu) phantsi kwe-anesthesia Kuthatha malunga neeyure ezingama-4 kwaye idlule ngaphandle kweengxaki.