In modern medicine, there are many ways to relieve pain. One of them is conduction anesthesia. The method consists in blocking the nerve transmission in the place of the human body where the surgical intervention will be performed. The operation site is completely anesthetized and immobilized.
What the patient experiences
During this procedure, patients may feel differently. When a needle is punctured, most often a person feels a slight pain or slight discomfort. In the area where the anesthetic is injected, at the time of its administration, bursting, heaviness, and heat are sometimes felt. If everything goes right, then the discomfort disappears after a few seconds.
During surgery, the patient is in a clear mind, hears and sees everything, but does not experience pain at all. If the patient wants to sleep or experiences severe anxiety, conduction anesthesia is combined with sedation.
Technique
Conductoranesthesia blocks a nerve or a whole group of nerves through which the pain impulse is transmitted from the place where the operation is performed to the brain. The brain processes this impulse and returns it to us in the form of a painful sensation. Anesthesia occurs at the site where the nerve block occurred.
Peripheral anesthesia is done as follows: a local anesthetic solution is injected into the place where the nerve to be blocked is located. One or more injections may be given. For the drug to work, it must be injected very close to the nerve, literally a few tenths of a millimeter from it. If the anesthetic is injected a little further, the anesthesia will not work and the person will be in pain during the operation. In this case, another type of anesthesia is used. When the anesthetic gets directly into the nerve, it is fraught with the development of such a complication as neuropathy.
In what cases is this anesthesia used
The use of PA on all parts of the body, unfortunately, is impossible. This is due to the anatomical features of the human body. But still, the list of operations in which a nerve block is used is not so small:
- various operations in somatology;
- removal of hernias (femoral, inguinal);
- some surgical interventions for diseases of the genital organs;
- treatment of the thyroid gland with an operative method;
- quite complex operations that are performed by specialists on the carotid arteries.
This is not a complete list of cases wherewhich the operation is performed using this type of anesthesia.
Complications of conduction anesthesia
The most serious complications in this type of anesthesia are considered to be an adverse reaction to the anesthetic drug or the development of neuropathy. In this case, the person begins an allergic reaction. Mostly this problem happens due to doctors when they inject the solution into a blood vessel.
Reaction symptoms:
- cardiac arrhythmia;
- a sharp weakening of the body;
- loss of consciousness.
An allergic reaction is very rare, no more than one in 50,000 anesthesias.
Neuropathy occurs when a nerve is damaged or disrupted. With such a violation, after conduction anesthesia, pain, numbness is felt, a feeling as if goosebumps are crawling under the skin. But there is no need to be afraid of PA. After all, complications occur only in 1% of cases, and the performance of the damaged nerve is restored within a few months, in rare cases - up to a year. In addition, new technologies that have appeared recently make it possible to minimize the occurrence of such complications.
Use of conduction anesthesia in dentistry
Since complications in this case are not common, conduction anesthesia in dentistry takes first place. Strong PA is able to anesthetize the area of operation for a long time (6-8 hours), less strong anesthesia is used for surgical interventions.
For the lower and upper jaws, separate types of anesthesia are used. For example, to anesthetize the lower jaw, an intraoral and apodactyl method is used. In the first case, the doctor gropes for the puncture site, in the second case, anesthesia is administered near the extreme molar.
If it is necessary to desensitize the upper jaw, then in this case, infraorbital anesthesia is performed, in which the anesthetic is injected under the eyeball, or tuberal (the solution is injected into the tubercle of the upper jaw). This technique of conduction anesthesia is considered the most correct. Every experienced doctor knows this and should do it this way.
When PA is used
Conduction anesthesia in dentistry is practiced in cases where complex surgical intervention is necessary. Quite often, such anesthesia is carried out when, when extracting a tooth, it is necessary to cut the gum. The cheek in this case completely loses sensitivity.
This method of anesthesia allows you to block the nerve trunk completely, which leads to persistent pain relief during any manipulations in dentistry.
Indications and contraindications
Pain in dentistry by conduction anesthesia for surgical procedures is carried out in the following cases:
- removal of teeth or remaining roots from them;
- if mucosal inflammation is detected;
- if the tooth erupted incorrectly, then in this case they resort to this procedure;
- some people do not tolerate anesthesia very well, so the doctor decides on the use of suchanesthesia, thus making the treatment less dangerous;
- in the treatment of complex caries.
To protect the patient from complications and ensure effective treatment, before choosing a method of anesthesia, the doctor must be sure that the person has no contraindications to it. They can be as follows:
- if a person is allergic to drugs used for conduction anesthesia;
- if there are infectious diseases in the tissues of the face or in the oral cavity;
- if there are changes in the topography of individual areas, for example, when for some reason (surgery, injury) there was a violation of the transmission of nerve impulses;
- this method of pain relief is not recommended for children under 12;
- when the patient is very aroused;
- do not use conduction anesthesia in the case of people with whom it is not possible to establish contact, for example, this applies to patients suffering from congenital deafness;
- In no case should PA be done to people who have septicopyemia (a type of sepsis) - a disease characterized by multiple purulent rashes on the skin.
There are also contraindications against this kind of pain relief, which are relative. With such indications, there is no categorical prohibition, but the specialist must eliminate them, if possible, or take into account that complications may arise. As a rule, such contraindications occurrare enough:
- long operation;
- the patient is in shock;
- excessive development of subcutaneous fat.
Types of conduction anesthesia
There are two types of such anesthesia: central and peripheral. In the first case, nerve anesthesia occurs in the lower or upper jaw. In the second case, anesthesia is also divided into several subspecies, it all depends on where the drug is injected. Peripheral anesthesia can be mental, infraorbital, incisive, etc. Conduction anesthesia of the extremities is known as regional. As a rule, it is done when a person needs to perform a simple operation on a certain part of the body.
PA lower jaw
Conduction anesthesia on the lower jaw is done in the mandibular way. In order to inject a local anesthetic, the patient needs to open their mouth wide. The doctor makes a puncture in the place where the border of the lower and middle pterygo-maxillary folds is located. The syringe should be parallel to the opposite premolars. Then the needle is inserted into the gum tissue, the doctor brings it to the very bone and begins the process of administering the drug, however, not all of it is injected, but only 50%, the remaining 50% is injected from the other side. After the procedure, the lingual and alveolar nerve is blocked. Canines, molars, premolars and the mucous membrane that is located around them are also anesthetized. In addition, there is numbness of some areas of the tongue andlower lip.
In the case of torusal anesthesia, additional anesthesia is given from the side of the cheek.
With mental anesthesia, the drug can be administered in two ways: extraoral and intraoral. In this case, numbness of the lower part of the jaw arch occurs, while fangs, lower incisors, alveolar process, chin, lower lip are anesthetized.
PA upper jaw
The conduction anesthesia of the upper jaw is done in several ways.
The use of the infraorbital method allows you to "freeze" the frontal zone. In addition to teeth, they anesthetize the lower eyelid, the skin in the infraorbital area, the walls of the maxillary bone. The effect of anesthesia is felt on one side of the nose.
With the incisive method, a blockade of the nasopalatine nerve is observed. Thanks to this procedure, the palate, fangs and teeth that are located between them are "freezed".
The tuberal method helps not to feel pain in the mucous membranes, maxillary sinuses, molars located on the upper jaw.
In the case of palatal anesthesia, on the side where the drug was injected, there is numbness of the area from the canine to the extreme molar.
Pros and cons
Like other types of anesthesia, conduction anesthesia has its advantages and disadvantages. We list the advantages:
- you can limit yourself to a small number of injections, in most cases only one;
- due to the high concentration of the anesthetic drug, the "freeze" lasts a long time;
- does not need to inject much medicine;
- due to different PA methods, the drug can be injected away from the source of infection;
- in the place where the operation is performed, the gum is not deformed;
- during the procedure, salivation is reduced.
The disadvantages or disadvantages of this kind of anesthesia include the following:
- anesthesia technique is quite complicated;
- if a blood vessel is accidentally touched during a puncture, a hematoma may form in this place.
These disadvantages are considered relative, it all depends on how experienced the doctor is.
Safety and efficiency
Conduction anesthesia in dentistry is carried out using preparations placed in special ampoules (carpules). This method helps to dose the medicine correctly, excluding the excess of the injected volume, antiseptics are observed.
Due to the fact that the carpula is equipped with a very thin needle, the patient does not feel much pain when a puncture is made. You can also anesthetize the procedure site with a special gel or spray.
Some clinics have machines that help determine the location of the nerve. Thanks to them, the doctor controls the introduction of the needle, which eliminates nerve injury and the occurrence of complications after PA. Ultrasonic testing can also be used.
How is the procedure of anesthesia in children and pregnant women
Problems with teeth in pregnant women are quite common. fruit,which develops, it needs a large amount of calcium, which it takes from the mother's body. In this case, the teeth of a pregnant woman may suffer. Therefore, expectant mothers are frequent visitors to dental offices. Conduction anesthesia for women in position is done only when complex manipulation is necessary, for example, with multiple lesions of the teeth, with severe caries, or when it is necessary to remove a diseased tooth.
Usually, Lidocaine is used as an anesthetic. This is due to the fact that this drug is considered an effective pain reliever, it is quickly excreted from the human body, and is not harmful to either the mother or her unborn child. A drug such as "Ketamine" should not be used in the early stages of pregnancy, because it increases the tone of the uterus, can provoke a miscarriage. If the expectant mother is tormented by severe pain, then in this case, you can use Promedol. This drug is an excellent pain reliever and is not as dangerous as Ketamine.
Conduction anesthesia in pediatric dentistry, if the child is under three years old, is used very rarely. Dental care for young children is different from how it happens in adults. This is because the structure of the jaws in children is not the same as in adults.
