Okudingeka Ukwazi Nge-Dental Anesthesia

-Delile

• Yiziphi izinhlobo zama-anesthetics wamazinyo?
• I-anesthesia yendawo
• Ukuhlala
• I-anesthesia ejwayelekile
• Iyini imiphumela emibi ye-anesthesia yamazinyo?
• Ukuqapha okukhethekile lapho uthatha izinzwa zamazinyo
• Ukukhulelwa
• Izidingo ezikhethekile
• Abantu abadala asebekhulile
• Izinkinga zesibindi, izinso, amaphaphu noma inhliziyo
• Izimo ezithile ze-neurologic
• Ezinye izimo
• Ziyini izingozi ze-anesthesia yamazinyo?
• Ukuthatha

Ngabe uhlelelwe inqubo yamazinyo futhi unemibuzo mayelana ne-anesthesia?

Cishe abantu banokukhathazeka nokukhathazeka mayelana nobuhlungu ngezinqubo zamazinyo. Ukukhathazeka kungaphuza ukuthola ukwelashwa futhi lokho kungenza inkinga ibe yimbi kakhulu.

Ama-anesthetics abekhona isikhathi esingaphezu kweminyaka engu-175! Eqinisweni, inqubo yokuqala eqoshiwe ene-anesthetic yenziwa ngo-1846 kusetshenziswa i-ether.

Sesihambe ibanga elide kusukela lapho, futhi ama-anesthetics ayithuluzi elibalulekile ekusizeni iziguli zizizwe zikhululekile ngesikhathi senqubo yamazinyo.

Njengoba kunezinketho eziningi ezahlukahlukene ezitholakalayo, i-anesthesia ingadida. Siyayiphula ukuze uzozethemba ngokwengeziwe ngaphambi kokuqokwa kwakho kwamazinyo okulandelayo.

Yiziphi izinhlobo zama-anesthetics wamazinyo?

I-Anesthesia isho ukuntuleka noma ukulahleka kwemizwa. Lokhu kungaba noma ungazi.

Namuhla kunezinketho eziningi ezitholakalayo ze-anesthetics yamazinyo. Imithi ingasetshenziswa yodwa noma ihlanganiswe ukuze ibe nomphumela ongcono. Kwenzelwe umuntu ngenqubo ephephile nephumelelayo.

Uhlobo lwe-anesthetics olusetshenzisiwe futhi luye ngeminyaka yomuntu, isimo sempilo, ubude benqubo, kanye nanoma ikuphi ukusabela okungafanele kuma-anesthetics esikhathini esedlule.

I-Anesthetics isebenza ngezindlela ezihlukile kuye ngokuthi yini esetshenzisiwe. Ama-anesthetics angenza okufushane lapho efakwa ngqo endaweni noma asebenze isikhathi eside lapho kudingeka ukuhlinzekwa okuningi okuhilelekile.

Impumelelo ye-anesthesia yamazinyo incike ku:

• umuthi
• indawo ibulawa umuthi
• inqubo
• izici ngazinye

Ezinye izinto ezingadala ukubulawa kwamazinyo kufaka isikhathi senqubo. futhi kukhombisa ukuthi ukuvuvukala kungaba nomthelela omubi empumelelweni yama-anesthetics.

Futhi, nge-anesthesia yendawo, amazinyo asezingeni lomhlathi ongezansi (mandibular) womlomo anzima ukubulala izinzwa kunamazinyo omhlathi ongaphezulu (maxillary).

Kunezinhlobo ezintathu eziyinhloko ze-anesthesia: indawo, ukuthambisa, nokujwayelekile. Ngayinye inokusetshenziswa okuthile. Lokhu kungahlanganiswa neminye imithi.

I-anesthesia yendawo

I-anesthesia yendawo isetshenziselwa izinqubo ezilula njengokugcwaliswa komgodi, okudinga isikhathi esifushane ukuqedela futhi ngokuvamile kuyinkimbinkimbi kangako.

Uzokwazi futhi ukwazi ukuxhumana lapho uthola i-anesthetic yendawo. Indawo izoba ndikindiki, ngakho ngeke ubuzwe ubuhlungu.

Ama-anesthetics amaningi endawo aqala ukusebenza ngokushesha (kungakapheli imizuzu eyi-10) futhi agcine imizuzu engama-30 kuye kwengu-60. Kwesinye isikhathi i-vasopressor efana ne-epinephrine ingezwa kwi-anesthetic ukwandisa umphumela wayo nokugcina umphumela we-anesthetic ungasakazeki nakwezinye izindawo zomzimba.

Ama-anesthetics asendaweni ayatholakala ekhawunteni futhi njengedokotela ku-gel, amafutha, ukhilimu, isifutho, isichibi, uketshezi, namafomu anokujova.

Zingasetshenziswa ngokwezihloko (zisetshenziswe ngqo endaweni ethintekile ukuze zikindiki) noma zifakwe endaweni ezolashwa. Kwesinye isikhathi, ukufakwa okulula kukhishwa kwi-anesthetics yendawo ukusiza ukuphumuza umuntu.

• articaine
• bupivacaine
• i-lidocaine
• mepivacaine
• prilocaine

Ukuhlala

I-Sedation inamazinga amaningana futhi isetshenziselwa ukuphumuza umuntu ongaba nokukhathazeka, asize ngobuhlungu, noma abagcine besalungele inqubo. Kungadala nenqubo yokunciphiswa komzimba.

Ungahle ube nolwazi oluphelele futhi ukwazi ukuphendula imiyalo, ukukhathazeka ngokweqile, noma ungazi lutho. I-sedation ihlukaniswe ngobumnene, ngokulinganisela, noma ngokujulile.

Ukujula okujulile kungabizwa nangokuthi ukunakekelwa kwe-anesthesia noma i-MAC. Ekujuleni kokujula, ngokuvamile awazi indawo okuyo futhi ungaphendula kuphela ekuvuseleleni okuphindaphindiwe noma okubuhlungu.

Umuthi unganikezwa ngomlomo (ithebhulethi noma uketshezi), uphefumulelwe ngaphakathi, nge-intramuscularly (IM), noma ngemithambo (IV).

Kunezingozi eziningi nge-IV sedation. Ukushaya kwenhliziyo yakho, umfutho wegazi, nokuphefumula kufanele kubhekwe ngokucophelela ekuthomalaliseni okulingene noma okujulile.

• i-diazepam (Valium)
• i-midazolam (Kunamavesi)
• i-propofol (iDiprivan)
• i-nitrous oxide

I-anesthesia ejwayelekile

I-anesthesia ejwayelekile isetshenziselwa izinqubo ezinde, noma uma unokukhathazeka okuningi okungaphazamisa ukwelashwa kwakho.

Uzobe uqulekile ngokuphelele, ungezwa buhlungu, imisipha yakho izobe ikhululeke, futhi uzoba ne-amnesia yenqubo.

Umuthi unikezwa ngemaski yobuso noma i-IV. Izinga le-anesthesia lincike enkambisweni nasigulini ngasinye. Kunezingozi ezahlukahlukene nge-anesthesia ejwayelekile.

• zandisile
• ketamine
• etomidate
• midazolam
• mzingisi
• umaphop
• i-nitrous oxide
• phumzi
• isoflurane
• sevoflurane

Iyini imiphumela emibi ye-anesthesia yamazinyo?

Imiphumela emibi ye-anesthesia yamazinyo incike ohlotsheni lwe-anesthetic esetshenzisiwe. I-anesthesia ejwayelekile inezingozi eziningi ezihilelekile ekusetshenzisweni kwayo kune-anesthesia yendawo noma i-sedation. Ukusabela nakho kuyahluka ngokuya ngezici ezithile.

Eminye imiphumela emibi ebikiwe nge-sedation nemithi ejwayelekile yokubulala izinzwa ifaka:

• isicanucanu noma ukuhlanza
• ikhanda
• ukujuluka noma ukuqhaqhazela
• ukusangana, ukudideka, noma ukudideka
• inkulumo engahambi kahle
• umlomo owomile noma umphimbo obuhlungu
• ubuhlungu endaweni yomjovo
• isiyezi
• ukukhathala
• ukuba ndikindiki
• Lockjaw (trismus) okubangelwa ukuhlukumezeka okuvela ekuhlinzweni; ukuvulwa komhlathi kuncishisiwe okwesikhashana

IVasoconstrictors efana ne-epinephrine eyengezwe kuma-anesthetics nayo ingadala izinkinga zenhliziyo nomfutho wegazi.

Lena eminye yemiphumela emibi ebikiwe ye-anesthetics. Buza ithimba lakho lokunakekela amazinyo ngemithi yakho ethize kanye nanoma yikuphi ukukhathazeka ongase ube nakho mayelana nemithi.

Ukuqapha okukhethekile lapho uthatha izinzwa zamazinyo

Kunezimo nezimo lapho wena nodokotela wakho noma udokotela wamazinyo nizoxoxa khona uma i-anesthesia yamazinyo iyindlela engcono kakhulu ongayikhetha.

Imvume yokwelashwa iyingxenye ebalulekile yengxoxo yokwelashwa kwangaphambili. Buza imibuzo mayelana nezingozi nezinyathelo zokuphepha ezizothathwa ukuqinisekisa umphumela omuhle.

Ukukhulelwa

Uma ukhulelwe, udokotela wamazinyo noma udokotela ohlinzayo uzoxoxa ngobungozi obuhambisana nezinzuzo ze-anesthetics yakho nengane yakho.

Izidingo ezikhethekile

Izingane nalabo abanezidingo ezikhethekile badinga ukuhlolwa ngokucophelela kohlobo nezinga lama-anesthetics abawadingayo. Izingane zingadinga ukulungiswa komthamo ukugwema ukusabela okweqile noma ukweqisa ngokweqile.

Ukuphathwa Kwezokudla Nezidakamizwa (i-FDA) kukhishwe isexwayiso mayelana nama-numbing agents ajwayele ukusetshenziselwa ubuhlungu bokubhoboza. Le mikhiqizo ayiphephile ukusetshenziswa ezinganeni ezingaphansi kweminyaka engu-2. Ungayisebenzisi le mithi ngaphandle kokuxoxa ngayo nochwepheshe wezokunakekelwa kwempilo.

Izingane kanye nabantu abadala abanezidingo ezikhethekile bangaba nezinye izinkinga zezokwelapha ezandisa ubungozi nge-anesthetics. Isibonelo, izingane ezitholakele ezine-cerebral palsy zinenani eliphakeme kakhulu lokuphendula okuhlobene nomoya ku-anesthesia ejwayelekile.

Abantu abadala asebekhulile

Abantu abadala asebekhulile abanezinkinga ezithile zempilo bangadinga ukulungiswa komthamo nokuqapha ngokucophelela ngesikhathi nangemva kokuhlinzwa ukuqinisekisa ukuphepha kwabo.

Abanye abantu bangathola i-delirium noma ukudideka nezinkinga zememori ngemuva kokuhlinzwa.

Izinkinga zesibindi, izinso, amaphaphu noma inhliziyo

Abantu abanezinkinga zesibindi, izinso, amaphaphu, noma inhliziyo bangadinga ukulungiswa komthamo ngoba umuthi ungathatha isikhathi eside ukushiya umzimba futhi ube nomphumela onamandla ngokwengeziwe.

Izimo ezithile ze-neurologic

Uma kunomlando wokushaywa unhlangothi, isifo i-Alzheimer's, isifo sikaParkinson, isifo segilo, noma ukugula ngengqondo, kungahle kube nengozi eyengeziwe nge-anesthesia ejwayelekile.

Ezinye izimo

Qinisekisa ukwazisa iqembu lakho lamazinyo uma une-hernia yokubeletha, i-acid reflux, ukutheleleka noma izilonda ezivulekile emlonyeni, ukungezwani komzimba, isicanucanu esinzima nokuhlanza ngama-anesthetics, noma uthatha noma yimiphi imithi engakwenza ukozele njengama-opioid.

Izingozi nazo ziphakeme kulabo abane:

• ukulala ubuthongo
• ukuphazamiseka kokuquleka
• ukukhuluphala ngokweqile
• umfutho wegazi ophakeme
• izinkinga zenhliziyo
• izingane ezinenkinga yokunakwa noma yokuziphatha
• isifo esingapheliyo sokuvimbela kwamaphaphu (COPD)
• ukuhlinzwa okudlula esiswini
• ukusetshenziswa kabi kwezidakamizwa noma ukuphazamiseka kokusetshenziswa kwezidakamizwa

Ziyini izingozi ze-anesthesia yamazinyo?

Iningi labantu alikutholi ukusabela okungalungile nge-anesthesia yendawo.Kunezingozi eziphakeme nge-sedation kanye ne-anesthesia ejwayelekile, ikakhulukazi kubantu abadala asebekhulile kanye nabantu abanezinye izinkinga zezempilo.

Kukhona nengozi eyengeziwe ngomlando wokuphazamiseka kokopha noma ngemithi eyandisa ingozi yokopha njenge-aspirin.

Uma uthatha imishanguzo yobuhlungu efana nama-opioid noma i-gabapentin, noma imishanguzo yokukhathazeka efana ne-benzodiazepines, vumela udokotela wamazinyo wakho noma udokotela ohlinzayo bakwazi ukulungisa izinzwa zakho ngendlela efanele.

Izingozi ze-anesthesia zifaka:

• ukusabela okweqile. Qiniseka ukuthi wazisa udokotela wamazinyo nganoma yikuphi ukungezwani komzimba onakho; lokhu kufaka phakathi odayi noma ezinye izinto. Ukusabela kungahle kube mnene noma kube nzima futhi kufaka phakathi ukuqubuka, ukulunywa, ukuvuvukala kolimi, izindebe, umlomo, noma umphimbo, nobunzima bokuphefumula.
• i-anesthetics articaine ne-prilocaine ekugxileni kwe-4% kungadala ukulimala kwezinzwa, okwaziwa nge-paresthesia
• isithuthwane
• ikhoma
• ukumisa ukuphefumula
• ukuhluleka kwenhliziyo
• isifo senhliziyo
• unhlangothi
• umfutho wegazi ophansi
• i-hyperthermia ebulalayo, ukwanda okuyingozi kokushisa komzimba, ukuqina kwemisipha, izinkinga zokuphefumula, noma ukukhuphuka kwenhliziyo

Ukuthatha

Ukukhathazeka okuhlobene nezinqubo zamazinyo kuvamile kepha kungayinkimbinkimbi ukwelashwa. Kubalulekile ukuxoxa ngakho konke ukukhathazeka kwakho mayelana nenqubo kanye nokulindelwe kwakho nethimba lakho lokunakekela amazinyo ngaphambili.

Buza imibuzo ngemithi ezosetshenziswa nokuthi yini ongayilindela ngesikhathi nangemuva kokwelashwa.

Yabelana ngomlando wakho wezokwelapha, kufaka phakathi ukungezwani komzimba neminye imithi oyiphuzayo. Qiniseka ukuthi lokhu kufaka izidakamizwa ezithengiswa ngaphandle kwamakhompiyutha, imiyalo, nezengezo.

Buza nganoma yimiphi imiyalo ekhethekile okudingeka uyilandele ngaphambi nangemva kwenqubo. Lokhu kufaka ukudla neziphuzo ngaphambi nangemuva kokwelashwa.

Buza ukuthi ngabe udinga ukuhlela izinto zokuhamba ngemuva kwenqubo kanye neminye imininingwane odinga ukuyazi.

Umhlinzeki wakho wamazinyo uzokunika imiyalo okufanele uyilandele ngaphambi nangemva kwenqubo. Futhi bazokunikeza indlela yokuthi uxhumane nabo uma kwenzeka uba nezinkinga noma imibuzo.