Sarudzo dzeAnesthesia dzemunharaunda mukuvhiyiwa kwemuromo
Kuvhiyiwa kwemuromo kunosanganisira nzira dzakasiyana-siyana dzekuvhiya dzakagadzirirwa kurapa zvirwere zvine chekuita nemuromo, shaya, mazino, matadza, uye chimiro chechiso. Chimwe chezvinhu zvakakosha pakuona kuti nzira idzi dzinoitwa zvinobudirira uye zvakanaka kushandisa mushonga weanesthesia. Anesthesia yemuno inonyanya kukosha mukuvhiyiwa kwemuromo nekuda kwekushanda kwayo mukugadzirisa marwadzo, migumisiro mishoma mumuviri, uye nguva pfupi yekupora. Chinyorwa chino chinoongorora nzira dzakasiyana-siyana dzeanesthesia dzemuno dziripo mukuvhiyiwa kwemuromo, chichiratidza matekiniki, mabhenefiti, matambudziko anogona kuitika, uye kufunga nezvehuwandu hwevanhu vakasiyana.
Basa reAnesthesia Yemunharaunda Mukuvhiyiwa Kwemuromo
Kurapa kwemudumbu kunosanganisira kuisa chiveve panzvimbo chaiyo yemuviri kudzivirira kurwadziwa panguva yekuvhiyiwa uku murwere achiramba achiziva zvizere. Mukuvhiyiwa kwemuromo, chirwere chemudumbu chinoshandiswa zvakanyanya kudzora marwadzo ekurapa kwakadai sekubviswa kwezino, kurapwa kwemidzi yemeno, kuiswa kwemazino akaiswa, uye kumwe kuvhiyiwa kudiki.
Mabhenefiti eAnesthesia Yemunharaunda:
1. Kudzora Marwadzo: Mishonga inonyaradza marwadzo yemunzvimbo inovhara zviratidzo zvetsinga munzvimbo yekuvhiyiwa, zvichiita kuti murwere asarwadziwe panguva yekuvhiyiwa.
2. Kuziva: Murwere anoramba akamuka, izvo zvinogona kubatsira kutaurirana nekushandira pamwe panguva yekuvhiyiwa.
3. Kukanganisa Kushoma Kwemuviri: Kana tichienzanisa neanesthesia yakajairika, anesthesia yemuno ine migumisiro mishoma yemuviri uye inopora nekukurumidza mushure mekuvhiyiwa.
4. Mari Isingadhuri: Maitiro ekurapa ane anesthesia munharaunda anowanzo kudhura zvishoma pane anoda anesthesia yakajairika kana sedation.
Mishonga Inoshandiswa Kazhinji Yekunzwa Kusuruvara Kwemunharaunda
1. Lidocaine
Lidocaine ndeimwe yemishonga inonyaradza marwadzo inoshandiswa zvakanyanya mukuvhiyiwa kwemuromo nekuda kwekutanga kwayo nekukurumidza (maminetsi 2-5) uye kwenguva yepakati yeanesthesia (maminetsi 90-120 ne vasoconstrictors senge epinephrine). Inonyatsoita kuti nzvimbo yaunoda isashande zvakanaka uye yakakodzera kuvhiyiwa kwemazino mazhinji.
Advantages:
- Kutanga nekukurumidza kwekuita.
- Kudzora marwadzo zvinobudirira.
– Chepfu yakaderera.
- Kuwanikwa kwehuwandu hwakasiyana-siyana.
2. Articaine
Articaine imwe nzira yekunyaradza marwadzo inozivikanwa munharaunda, inonyanya kuzivikanwa nekukasika kwayo uye kushanda kwayo nesimba. Ine simba rakakura rekupararira munyama yakapfava nemapfupa, zvichiita kuti ibatsire pakurapa kunoda anesthesia yakadzika.
Advantages:
- Kutanga nekukurumidza (maminitsi 1-3).
– Simba guru rekupinda.
– Kuderedza njodzi yekukuvadzwa mumuviri nekuda kwekukurumidza kwemetabolism.
Kufungisisa:
– Articaine dzimwe nguva inobatanidzwa nekukuvara kwetsinga (paresthesia) kwakanyanya kupfuura mimwe mishonga inonyaradza marwadzo yemunzvimbo, kunyange zvazvo ichi chiri dambudziko risingawanzoitiki.
3. Bupivacaine
Bupivacaine inopa nguva yakareba yekushanda (maawa 4-8), zvichiita kuti ikwanise kushandiswa pakurapa kunogona kuda kudzora marwadzo kwenguva refu mushure mekuvhiyiwa. Inobatsira zvikuru pakuvhiyiwa kwenguva refu kana kune varwere vanogona kunetseka kuwana imwe nzira yekuderedza marwadzo mushure mekuvhiyiwa.
Advantages:
- Mushonga unonyaradza marwadzo kwenguva refu.
- Inobatsira pakurapa marwadzo mushure mekuvhiyiwa.
Kufungisisa:
- Kutanga kushanda zvishoma nezvishoma kana tichienzanisa nedzimwe mishonga inonyaradza marwadzo.
– Mikana yakakura yekukuvadza mwoyo, inoda kupiwa mushonga nekutarisirwa kwakanyatsonaka.
4. Mepivacaine
Mepivacaine yakafanana nelidocaine asi inoshanda kwenguva yakareba zvishoma (kusvika maawa matatu). Kazhinji haina mishonga inosimbisa tsinga, iyo inobatsira varwere vane epinephrine kana kuti vane zvimwe zvinopesana nayo pakushandisa kwayo.
Advantages:
– Nguva iri pakati nepakati yeanesthesia.
- Kusava nemishonga inosimbisa ganda, zvichideredza mimwe migumisiro nenjodzi.
Kufungisisa:
– Haina simba zvakanyanya pane lidocaine.
5. Prilocaine
Prilocaine imwe mushonga unonyaradza marwadzo wemunzvimbo ine kushanda kwenguva iri pakati nepakati, unoshandiswa kakawanda pamwe chete nelidocaine kuti uve nemigumisiro yakanaka. Kuderera kwechepfu yayo kunoita kuti ive sarudzo yakachengeteka yekushandisa kwenguva refu.
Advantages:
– Kuderedzwa kwenjodzi yekukuvadzwa mumuviri.
- Inoshanda pamwe chete nedzimwe mishonga inonyaradza marwadzo.
Kufungisisa:
– Methemoglobinemia idambudziko risingawanzoitiki asi rinogona kuitika, apo huwandu husina kujairika hwemethemoglobin hunogadzirwa muropa.
Matekiniki eKutarisira Anesthesia Yemunharaunda
1. Anesthesia yekupinda muropa
Kupinzwa kwemazino mudumbu kunosanganisira kubaya mushonga weanesthetic zvakananga munyama dzakatenderedza nzvimbo yekuvhiyiwa. Nzira iyi inowanzoshandiswa pakurapa mazino rimwe chete kana mapoka madiki emazino.
2. Anesthesia yeTerminal Block Anesthesia
Maitiro ekuvhara mitsinga anosanganisira kubaya mushonga unonyaradza marwadzo pedyo nedumbu guru retsinga kuti nzvimbo yakakura isashande zvakanaka. Mitsinga dzinoshandiswa zvakanyanya mukuvhiyiwa kwemuromo dzinosanganisira inferior alveolar nerve block, iyo inogona kunyaradza mazino epasi kune rumwe rutivi rweshaya, uye maxillary nerve block, inoshandiswa pakurapa shaya yepamusoro.
3. Anesthesia yemudumbu
Kurapa mazino nekushandisa mushonga wekudzivirira marwadzo kunosanganisira kubaya mushonga uyu zvakananga mubhonzo responge rakatenderedza mazino. Nzira iyi inoita kuti munhu anzwe kuda marwadzo nekukurumidza uye inonyanya kushanda kana nzira dzechivanhu dzingasakwanisa kudzora marwadzo zvakakwana.
4. Jekiseni rePeriodontal Ligament
Nzira iyi yehunyanzvi inosanganisira kubaya mushonga weanesthesia munzvimbo ye periodontal ligament yakakomberedza zino. Inowanzo shandiswa sechibatsiro kune dzimwe nzira dzeanesthesia kana pakurapa kunoda kudzora marwadzo nenzira chaiyo uye iri pedyo.
Kufunga Nezvevarwere uye Kuchengeteka
1. Kurwara uye Kusanzwa
Usati wapa mushonga wekurwadziwa kwemudumbu, zvakakosha kuti uongorore murwere kuti aone kana paine allergies kana kusawirirana, kunyanya nemishonga inonyaradza marwadzo kana mishonga yekuchengetedza inoshandiswa mumushonga uyu.
2. Nhoroondo Yezvekurapa
Nhoroondo yezvekurapa yakakwana inokosha kuti uone chero mamiriro ezvinhu kana mishonga inogona kukanganisa mishonga inonyaradza marwadzo yemunharaunda. Semuenzaniso, varwere vane matambudziko emwoyo vangada kutariswa nekungwarira kana mishonga ine epinephrine ikashandiswa.
3. Varwere vevana nevakwegura
Kufunga kwakakosha kunofanira kuitwa kuvarwere vevana nevakwegura maererano nechiyero chemushonga uye kutariswa nekuda kwekusiyana kwemaitiro avo mumuviri pavanoshandisa mishonga inonyaradza marwadzo.
4. Kubata pamuviri
Mimwe mishonga inonyaradza marwadzo inofarirwa panguva yekuzvitakura nekuda kwekuti njodzi yacho haina kunyanya kuipa. Zvisinei, nzira dzese dzinofanira kurongwa zvakanaka kuti amai nemwana ari mudumbu vagare vakachengeteka.
Zvinogona Kukanganisa uye Kutungamira
Kunyange zvazvo mishonga inonyaradza marwadzo yemunzvimbo yacho yakachengeteka, matambudziko anogona kuitika, anosanganisira:
– Kuitika Kwemunzvimbo: Kuzvimba, mavanga, kana hutachiona panzvimbo yekubaiwa jekiseni zvinogona kuitika, zvinowanzorapwa nekurapwa kwezviratidzo.
– Maitiro Emuviri: Maitiro akanyanya kuipa, akadai sechepfu, anogona kuitika kana mishonga yakawandisa ikashandiswa kana mushonga unotindivadza ukapinda muropa. Zviratidzo zvinogona kusanganisira matambudziko eCNS kana matambudziko emwoyo, izvo zvinoda rubatsiro rwechiremba nekukasika.
– Kusawirirana: Kunyangwe zvisingawanzoitiki, kusawirirana kunoda kuzivikanwa nekukurumidza uye kurapwa, kazhinji kunosanganisira antihistamines kana epinephrine muzviitiko zvakakomba.
mhedziso
Kurapa kwemushonga wemumuromo kunoita basa guru munyaya yekuvhiyiwa kwemuromo, zvichipa kudzora marwadzo uye kuona kuti murwere anonzwa kunyaradzwa panguva dzakasiyana-siyana. Nekunzwisisa nzira dzakasiyana dzekurapa kwemumuromo, nzira dzekurapa, kufunga nezvemurwere, uye matambudziko angangoitika, nyanzvi dzemazino dzinogona kupa rubatsiro rwakachengeteka uye runoshanda. Kufambira mberi mukurapa kwemumuromo kunovimbisa kuwedzera kukura kwekubudirira kwekuvhiyiwa kwemuromo, zvichibatsira mukuvandudza mhedzisiro yemurwere uye kugutsikana.
