Into ekufuneka uyazi Nge-Dental Anesthesia

Umxholo

• Zeziphi iintlobo zamayeza okubulala iintlungu?
• I-anesthesia yendawo
• Ukuhlala
• I-anesthesia ngokubanzi
• Ziziphi iziphumo ebezingalindelekanga zeanesthesia yamazinyo?
• Amanyathelo okhuseleko okhethekileyo xa uthatha i-anesthetics yamazinyo
• Ukukhulelwa
• Iimfuno ezizodwa
• Abantu abadala abadala
• Iingxaki zesibindi, izintso, imiphunga, okanye intliziyo
• Iimeko ezithile ze-neurologic
• Ezinye iimeko
• Yeyiphi imingcipheko yeanesthesia yamazinyo?
• Ukuthatha

Ngaba ucwangciselwe inkqubo yamazinyo kwaye unemibuzo malunga neanesthesia?

Ukujikeleza kwabantu banexhala kunye neenkxalabo malunga neentlungu zenkqubo yamazinyo. Ukuxhalaba kunokulibazisa ukufumana unyango kwaye kunokwenza ingxaki ibe mandundu.

I-Anesthetics ijikeleze ngaphezulu kweminyaka eyi-175! Ngapha koko, inkqubo yokuqala ebhaliweyo nge-anesthetic yenziwa kwi-1846 kusetyenziswa i-ether.

Sivela kude ukusukela ngoko, kwaye i-anesthetics sisixhobo esibalulekileyo ekuncedeni abaguli bazive bekhululekile ngexesha leenkqubo zamazinyo.

Ngeendlela ezininzi ezahlukeneyo ezikhoyo, i-anesthesia inokudideka. Siyiqhekeza ukuze uzive uzithembe ngakumbi ngaphambi kokuqeshwa kwamazinyo okulandelayo.

Zeziphi iintlobo zamayeza okubulala iintlungu?

I-Anesthesia ithetha ukungabikho okanye ukulahleka kwemvakalelo. Oku kunokuba kunye okanye ngaphandle kokuqonda.

Namhlanje kukho iindlela ezininzi ezikhoyo kwi-anesthetics yamazinyo. Amayeza anokusetyenziswa wedwa okanye adityaniswe ukuze asebenze ngcono. Ikhethwe ngokukodwa kwinkqubo ekhuselekileyo nenempumelelo.

Uhlobo lweeanesthetics ezisetyenzisiweyo luxhomekeke kubudala bomntu, imeko yezempilo, ubude benkqubo, kunye naziphi na iimpendulo ezingalunganga kwi-anesthetics kwixa elidlulileyo.

I-Anesthetics isebenza ngeendlela ezahlukeneyo kuxhomekeke kwinto esetyenzisiweyo. I-Anesthetics inokusebenza ngokufutshane xa isetyenziswa ngokuthe ngqo kwindawo okanye isebenze ixesha elide xa kufuneka utyando olongezelelekileyo.

Impumelelo ye-anesthesia yamazinyo ixhomekeke:

• iyeza
• indawo engenabungozi
• Inkqubo
• izinto ezizodwa

Ezinye izinto ezinokubangela ukubulawa kwamazinyo kubandakanya ixesha lenkqubo. ikwabonisa ukuba ukudumba kunokuba nefuthe elibi kwimpumelelo yeanesthetics.

Kwakhona, kwi-anesthesia yendawo, amazinyo emihlathini esezantsi (mandibular) kwicandelo lomlomo kunzima ukwenza i-anesthetize kunamazinyo aphezulu (maxillary) amazinyo.

Zintathu iintlobo eziphambili ze-anesthesia: indawo yasekhaya, i-sedation, kunye ngokubanzi. Ngamnye unokusetyenziswa okuthile. Ezi zinokudityaniswa namanye amayeza.

I-anesthesia yendawo

I-anesthesia yendawo isetyenziselwa iinkqubo ezilula njengokugcwaliswa kwesisu, efuna ixesha elifutshane ukugqiba kwaye ngokubanzi kunzima.

Uya kuba nolwazi kwaye ukwazi ukunxibelelana xa ufumana i-anesthetic yendawo. Indawo iya kuba ndindisholo, ngoko awuyi kuva zintlungu.

Uninzi lwee-anesthetics zalapha ziqala ukusebenza ngokukhawuleza (kwisithuba semizuzu eli-10) kwaye zihlala kwimizuzu engama-30 ukuya kuma-60. Ngamanye amaxesha i-vasopressor enje nge-epinephrin yongezwa kwi-anesthetic ukwandisa isiphumo sayo kunye nokugcina isiphumo sokubulala iintlungu ekusasazeni kwezinye iindawo zomzimba.

Ii-anesthetics zalapha ziyafumaneka ekhawuntarini kwaye njengommiselo kwijel, ioyile, ukhilimu, ukutshiza, isiziba, ulwelo kunye neefom zokufaka inaliti.

Zingasetyenziselwa phezulu (zisetyenziswe ngqo kwindawo echaphazelekayo ukuya kwi-numb) okanye zifakwe kwindawo yokunyanga. Ngamanye amaxesha, ukukhanya okuncinci kuyongezwa kwi-anesthetics yendawo ukunceda ukuphumla umntu.

• articaine
• bupivacaine
• lidocaine
• mepivacaine
• prilocaine

Ukuhlala

I-Sedation inamanqanaba aliqela kwaye isetyenziselwa ukuphumla umntu onokuba noxinzelelo, ancede ngentlungu, okanye abagcine besekhona kwinkqubo. Inokubangela nenkqubo ye-amnesia.

Unokuba nolwazi olupheleleyo kwaye ukwazi ukuphendula kwimiyalelo, ukungaboni kakuhle, okanye ungazi nto. Ukuhlulwa kudweliswe njengobumnene, ukumodareyitha, okanye ubunzulu.

Ukuthanjiswa okunzulu kunokubizwa ngokuba kukujonga ukhathalelo lweanesthesia okanye iMAC. Kwi-sedation enzulu, ngokubanzi awuyazi indawo okujikelezileyo kwaye unokuphendula kuphela kukhuthazo oluphindaphindiweyo okanye olubuhlungu.

Iyeza linokunikezwa ngomlomo (ithebhulethi okanye ulwelo), ukufuthiswa, intramuscularly (IM), okanye nge-intravenously (IV).

Kukho umngcipheko ngakumbi nge-IV sedation. Inqanaba lokubetha kwentliziyo yakho, uxinzelelo lwegazi, kunye nokuphefumla kufuneka kubekwe esweni ngononophelo kulungelelwaniso oluphakathi okanye olunzulu.

• diazepam (Valium)
• midazolam (iVenkile)
• ipropofol (iDiprivan)
• initrous oxide

I-anesthesia ngokubanzi

I-anesthesia ngokubanzi isetyenziselwa iinkqubo ezinde, okanye ukuba unexhala elininzi elinokuphazamisa unyango lwakho.

Uya kuba ungazi ngokupheleleyo, ungabi nantlungu, izihlunu zakho ziya kukhululeka, kwaye uya kuba ne-amnesia evela kwinkqubo.

Iyeza linikwa ngesigqumathelo sobuso okanye i-IV. Inqanaba le-anesthesia lixhomekeke kwinkqubo nakwisigulana ngasinye. Kukho imingcipheko eyahlukeneyo ngeanesthesia ngokubanzi.

• ipropofol
• ketamine
• etomidate
• midazolam
• mzantsiweb
• imbalik
• initrous oxide
• lngco
• isoflurane
• seopoplane

Ziziphi iziphumo ebezingalindelekanga zeanesthesia yamazinyo?

Iziphumo ebezingalindelekanga ze-anesthesia yamazinyo zixhomekeke kuhlobo lwe-anesthetic esetyenzisiweyo. I-anesthesia ngokubanzi inobungozi obuninzi obuchaphazelekayo ekusebenziseni kwayo kune-anesthesia yendawo okanye i-sedation. Ukuphendula kuyahluka ngokuxhomekeka kwizinto ezithile.

Ezinye zeempembelelo ezichazwe nge-sedation kunye neyeza jikelele ze-anesthesia ziquka:

• isicaphucaphu okanye ukugabha
• intloko ebuhlungu
• ukubila okanye ukungcangcazela
• ukubona izinto ezingekhoyo, ukucaphuka, okanye ukudideka
• intetho engacacanga
• umlomo owomileyo okanye umqala obuhlungu
• iintlungu kwindawo yenaliti
• isiyezi
• ukudinwa
• ukuba ndindisholo
• I-Lockjaw (trismus) ebangelwe kukonzakala koqhaqho; ukuvulwa kwemihlathi kuncitshisiwe okwethutyana

I-Vasoconstrictors enje nge-epinephrine eyongezwe kwi-anesthetics nayo inokubangela iingxaki zentliziyo noxinzelelo lwegazi.

Ezi zezinye iziphumo ebezingalindelekanga ezichaziweyo zeanesthetics. Buza iqela lakho lokunakekela amazinyo malunga namayeza akho athile kunye naziphi na iinkxalabo onokuthi ube nazo malunga namayeza.

Amanyathelo okhuseleko okhethekileyo xa uthatha i-anesthetics yamazinyo

Kukho iimeko kunye neemeko apho wena nogqirha wakho okanye ugqirha wamazinyo niya kuxoxa ukuba i-anesthesia yamazinyo lukhetho olufanelekileyo kuwe.

Imvume yonyango yinxalenye ebalulekileyo yengxoxo yangaphambi konyango. Buza imibuzo malunga nobungozi kunye nokukhuselwa okuya kuthathwa ukuqinisekisa umphumo omuhle.

Ukukhulelwa

Ukuba ukhulelwe, ugqirha wakho wamazinyo okanye ugqirha wotyando uya kuxoxa ngobungozi xa kuthelekiswa nezibonelelo zeanesthetics yakho kunye nosana lwakho.

Iimfuno ezizodwa

Abantwana kunye nabo baneemfuno ezizodwa bafuna ukuvavanywa ngononophelo kohlobo kunye nenqanaba leanesthetics abayifunayo. Abantwana banokufuna uhlengahlengiso lwethamo ukunqanda ukusabela okungalunganga okanye ukubanda ngaphezulu.

Ulawulo lwezoKutya kunye neDrug (i-FDA) lukhuphe isilumkiso malunga neearhente ze-numbing ezisetyenziselwa iintlungu zokukhathazeka. Ezi mveliso azikhuselekanga ukuba zingasetyenziswa kubantwana abangaphantsi kweminyaka emi-2. Sukusebenzisa la mayeza ngaphandle kokuxoxa ngengcali yezempilo.

Abantwana kunye nabantu abadala abaneemfuno ezizodwa banokuba nezinye iingxaki zonyango ezonyusa umngcipheko nge-anesthetics. Umzekelo, abantwana abafunyenwe benesifo sokukhubazeka kwengqondo banelona nani liphezulu lempendulo enxulumene nomoya kwi-anesthesia ngokubanzi.

Abantu abadala abadala

Abantu abadala abanengxaki ezithile zempilo banokufuna uhlengahlengiso lwedosi kunye nokubeka iliso ngononophelo ngexesha nasemva kotyando ukuqinisekisa ukhuseleko lwabo.

Abanye abantu banokufumana ukudideka okanye ukudideka kunye neengxaki zememori emva kotyando.

Iingxaki zesibindi, izintso, imiphunga, okanye intliziyo

Abantu abanesibindi, izintso, imiphunga, okanye iingxaki zentliziyo banokufuna uhlengahlengiso lwedosi kuba ichiza linokuthatha ixesha elide ukushiya umzimba kwaye libe nefuthe elinamandla ngakumbi.

Iimeko ezithile ze-neurologic

Ukuba kukho imbali yokubetha, isifo se-Alzheimer's, isifo sika-Parkinson, isifo se-thyroid, okanye isifo sengqondo, kunokubakho umngcipheko okhulayo nge-anesthesia jikelele.

Ezinye iimeko

Qiniseka ukuba iqela lakho lamazinyo liyazi ukuba une-hernia yokubeleka, i-acid reflux, usulelo okanye izilonda ezivulekileyo emlonyeni, i-allergies, isicaphucaphu esiqatha kunye nokugabha nge-anesthetics, okanye uthatha nawaphi na amayeza anokukwenza wozele njengama-opioid.

Iingozi zikwindawo ephezulu kwabo bane:

• ubuthongo bokulala
• ingxaki yokuthimba
• ukutyeba kakhulu
• igazi elonyukayo
• iingxaki zentliziyo
• abantwana abanengxaki yokuqwalaselwa okanye yokuziphatha
• isifo esinganyangekiyo semiphunga (COPD)
• uqhaqho olwenzeka esiswini
• Ukusetyenziswa gwenxa kweziyobisi okanye ingxaki yokusebenzisa iziyobisi

Yeyiphi imingcipheko yeanesthesia yamazinyo?

Uninzi lwabantu alufumani mpendulo gwenxa nge-anesthesia yendawo. Kukho imingcipheko ephezulu ye-sedation kunye ne-anesthesia ngokubanzi, ngakumbi kubantu abadala kunye nabantu abanezinye iingxaki zempilo.

Kukho umngcipheko okhulayo kunye nembali yokuphazamiseka kokopha okanye ngamayeza anyusa umngcipheko wokopha njengeasprini.

Ukuba uthatha amayeza entlungu afana ne-opioids okanye i-gabapentin, okanye amayeza oxinzelelo njenge-benzodiazepines, vumela ugqirha wakho wamazinyo okanye ugqirha wotyando abakwaziyo ukuze bahlengahlengise i-anesthetic yakho ngokufanelekileyo.

Umngcipheko we-anesthesia ubandakanya:

• impendulo engavumiyo. Qiniseka ukuba ugqirha wamazinyo uyazi malunga naziphi na izinto ezibangela ukwaliwa; oku kubandakanya iidayi okanye ezinye izinto. Ukuphendula kunokuba kubuthathaka okanye kubenzima kwaye kubandakanya irhashalala, ukurhawuzelela, ukudumba kolwimi, imilebe, umlomo, umqala, kunye nobunzima bokuphefumla.
• I-anesthetics articaine kunye ne-prilocaine kwi-4% ye-concentrations kunokubangela umonakalo we-nerve, owaziwa ngokuba yi-paresthesia
• ukuxhuzula
• ikhoma
• ukuyeka ukuphefumla
• ukumelwa yintliziyo
• ukuhlaselwa yintliziyo
• ukubetha
• uxinzelelo lwegazi oluphantsi
• hyperthermia enobungozi, ukwanda okuyingozi kubushushu bomzimba, ukuqina kwemisipha, iingxaki zokuphefumla, okanye ukubetha kwentliziyo

Ukuthatha

Ukuxhalaba okunxulumene neenkqubo zamazinyo kuqhelekile kodwa kunokuba nzima kunyango. Kubalulekile ukuba uxoxe ngazo zonke iinkxalabo zakho malunga nenkqubo kunye nolindelo lwakho neqela lakho lokunyamekela amazinyo ngaphambili.

Buza imibuzo malunga namayeza aza kusetyenziswa kunye nento onokuyilindela ngexesha nasemva konyango.

Yabelana ngembali yakho yezonyango, kubandakanya nakuphi na ukwaliwa kunye namanye amayeza owathathayo. Qiniseka ukuba oku kubandakanya iziyobisi ezingaphaya kwekhawuntareni, imigqaliselo, kunye nezongezelelo.

Buza malunga nayiphi na imiyalelo ekhethekileyo ekufuneka uyilandele ngaphambi nasemva kwenkqubo. Oku kubandakanya ukutya neziselo ngaphambi nasemva konyango.

Buza ukuba ufuna ukulungiselela ukuthuthwa emva kwenkqubo kunye nolunye ulwazi oludingayo.

Umboneleli wakho wamazinyo uya kukunika imiyalelo ekufuneka uyilandele ngaphambi nasemva kwenkqubo. Baza kubonelela ngendlela yokuba uqhakamshelane nabo xa unokufumana naziphi na iingxaki okanye imibuzo.