Mhando dzeAnesthesia muDentistry
Kurapa mazino chinhu chakakosha pakurapa mazino nekuti kunobatsira kuderedza marwadzo, kuzvidya mwoyo, uye kusagadzikana panguva yekuvhiyiwa. Nekusarudza rudzi rwakakodzera rwekunyaradza mazino, vanachiremba vemazino vanogona kuita maitiro acho zvinobudirira, ukuwo varwere vachinzwa vakachengeteka uye vakasununguka. Kazhinji, kurwadza mazino kunogona kukamurwa muzvikamu zvikuru: kurwadza kwemazino, kurwadza kwemunzvimbo, kunyaradza (kurwadza kusvika pakati), uye kurwadza kwakajairika. Chimwe nechimwe chine zviratidzo zvaro, mashandiro ekuita, zvakanakira, uye njodzi dzakakosha kunzwisisa.
1. Anesthesia yemusoro
Mishonga inonyaradza marwadzo yemudumbu rudzi rwemishonga inonyaradza marwadzo inoiswa zvakananga pamusoro penyama, kazhinji mumuromo (mazino, matama emukati, kana rurimi). Inogona kushandiswa semagel, mafuta ekuzora, maspray, kana mapetch. Mishonga inonyaradza marwadzo yemudumbu inoshanda nekudzivirira tsinga dziri kunze kwenyama, zvichideredza kurwadziwa munzvimbo yadzinoiswa.
Mashandisirwo makuru emishonga inorwisa marwadzo yeganda anosanganisira:
– Inoderedza marwadzo panguva yekubaiwa jekiseni remudumbu, nekutanga waisa chiveve panzvimbo yekubaiwa jekiseni.
– Inoderedza kusagadzikana panguva yekuvhiyiwa kudiki, senge kuchenesa tartar munzvimbo dzinonetsa kana kuisa mimwe michina yekurapa mazino.
– Kubatsira varwere vane gag reflex yakawandisa (pasi pemamwe mamiriro ezvinhu uye nekungwarira).
Zvakanakira mishonga inonyaradza marwadzo ndeyekuti iri nyore kushandisa, inoshanda nekukurumidza, uye yakachengeteka. Zvisinei, mhedzisiro yayo inogumira panzvimbo yepamusoro uye nguva yayo ipfupi. Mune vamwe varwere, kunyanya vana, kushandiswa zvakanyanya kune njodzi yekumedza, zvichida vanachiremba vemazino kuti vanyatsoverenga chiyero uye nzira yekushandisa.
2. Anesthesia Yemunharaunda
Anesthesia yemunzvimbo ndiyo inonyanya kushandiswa mukurapa mazino. Chinangwa chayo ndechekuita kuti nzvimbo yemuromo isave nechiveve pasina kukanganisa pfungwa dzemurwere. Anesthesia yemunzvimbo inowanzoiswa mutsinga dzakati kana kuti munyama iri pedyo nenzvimbo yekuvhiyiwa.
Panyaya yemuchina, mishonga inonyaradza marwadzo yemuno inodzivirira kutapurirana kwetsinga nekuvhara nzira dzesodium mumasero etsinga, zvichidzivirira zviratidzo zvekurwadziwa kusvika kuuropi. Mienzaniso yemishonga inorwadza yemuno inowanzo shandiswa inosanganisira lidocaine, articaine, mepivacaine, uye bupivacaine. Mishonga inonyaradza marwadzo yemuno inowanzo sanganiswa ne vasoconstrictors (semuenzaniso, epinephrine) kuti iwedzere kushanda kwayo uye kuderedza kubuda ropa.
a. Kupinda muchivande
Nzira yekupinda nayo inosanganisira kubaya mushonga unonyaradza marwadzo munyama yakakomberedza zino kuti arapwe. Nzira iyi inowanzo shandiswa pashaya yepamusoro nekuti pfupa racho rine maburi akawanda, zvichiita kuti mushonga upinde mutsinga diki dziri nyore.
Zviratidzo: kuzadza mazino, kurapwa kwemazino, kugadzira korona, uye maitirwo madiki munharaunda.
b. Kuvharika kwetsinga
Munzira dzekudzivirira tsinga, mushonga unobaya unobayiwa pedyo nedumbu guru retsinga, zvichiita kuti nzvimbo yakakura ive isina simba. Muenzaniso unozivikanwa zvikuru ndewekudzivirira tsinga dzemudumbu dziri pasi pe alveolar dzinoshandiswa pakurapa mazino emudumbu.
Zviratidzo: kuburitswa kwemazino emusana, kurapwa kwemidzi yemusana pashaya yepazasi, kana kuvhiyiwa nemuromo kunoda nzvimbo yakakura yeanesthesia.
c. Intraligamentary (PDL) uye Intraosseous Anesthesia
Anesthesia yemukati medumbu inosanganisira kubaya mushonga unonyaradza dumbu muropa remazino rakatenderedza mudzi wezino, ukuwo anesthesia yemukati medumbu ichipinzwa zvakananga mubhonzo rakatenderedza zino. Zvose izvi zvinoshandiswa kana kupinda kweropa kana tsinga dzisingashande zvakanaka kana kana uchida anesthesia yakanyanya.
Zvakanakira kushandisa mushonga weanesthesia munharaunda ndekuti unoshanda, unokurumidza, uye murwere anoramba achiziva. Njodzi dzinogona kusanganisira kurwadziwa panguva yekubaiwa jekiseni, hematoma, kusanzwa kwenguva refu, allergic reactions (zvisingawanzoitiki), uye migumisiro yemuviri kana mushonga ukapinda muropa. Saka, kunwa mvura usati wabaya jekiseni uye kutarisa mamiriro emurwere zvakakosha.
3. Kunyaradza muDentistry
Kunyaradza muviri inzira yekuderedza kuzvidya mwoyo uye kuwedzera nyaradzo kumurwere, kunyanya kune varwere vane kuzvidya mwoyo kwemazino, gag reflex yakasimba, kana avo vari kuvhiyiwa kwenguva refu. Kunyaradza muviri kwakasiyana neanesthesia yemuno: kunyaradza muviri kunokanganisa mwero wekuziva uye runyararo, nepo anesthesia yemuno ichideredza nzvimbo chaiyo. Muchokwadi, kunyaradza muviri kunowanzo batanidzwa neanesthesia yemuno kuti ive nechokwadi chekudzora marwadzo zvakakwana.
a. Kurara Kushoma (Anxiolysis)
Kunwa mushonga mushoma kunobvumira murwere kuzorora asi anoramba achiziva zviri nani uye achikwanisa kupindura zvakanaka mirairo. Kazhinji zvinosanganisira mishonga inonwiwa (semuenzaniso, benzodiazepines shoma) inotorwa usati watanga kurapwa.
Zvakakodzera varwere vane shungu dzakadzikama kusvika pakati nepakati, maitirwo mapfupi, kana varwere vanotya tsono.
b. Kurara Pakati Nepakati (Kurara Uchiziva)
Mukurapa zvine mwero, murwere anoramba achiziva uye achipindura, asi anorara uye haazive nguva nenzvimbo dzakamupoteredza. Nzira dzinowanzo shandiswa ndedzekufema ne nitrous oxide (gasi rinoseka) kana kunyaradza ne intravenous (IV).
– Nitrous oxide inotanga nekukurumidza uye iri nyore kushandisa. Mushure mekuvhiyiwa, mhedzisiro yayo inoperawo nekukurumidza, zvichiita kuti varwere vakwanise kupora nekukurumidza.
– Kurapwa netsinga kunopa simba riri nani rekutonga huwandu hwekurapwa, asi kunoda nzvimbo dziri pedyo, kudzidziswa, uye kutariswa.
c. Kugara wakarara zvakanyanya
Kuraramisa murwere zvakanyanya kunoita kuti asazive, zvichideredza zvakanyanya kupindura kwake kune zvinomukurudzira. Nekuda kwenjodzi huru yekufema uye yemwoyo, rudzi urwu rwekuramisa murwere runoda kutariswa zvakanyanya uye runowanzoitwa nevashandi vakadzidziswa vane michina yakakwana yekudzorera mweya.
Zvakanakira kushandisa mushonga wekunyaradza ndekuti unobatsira varwere vanoomerwa nekushanda pamwe chete uye unobvumira chiremba wemazino kushanda zvakanaka. Njodzi dzekunyaradza dzinosanganisira kudzikira kwekufema, kuda kurutsa, dzungu, kudzikira kweBP, uye kudiwa kwekutariswa mushure mekuvhiyiwa. Varwere vanowanzo kurudzirwa kuti vasatyaira mota uye kuti vaperekedzwe kumba, kunyanya kana vaine mushonga wekunyaradza nemuromo kana wekusvimha.
4. Anesthesia Yakajairika
Anesthesia yakajairika inoita kuti murwere asazive zvachose, asarwadziwe, uye asayeuke maitiro acho. Rudzi urwu rweanesthesia runopa kudzora kwakanyanya, asi rune njodzi huru. Mukurapa mazino, anesthesia yakajairika haiwanzo shandiswa pakuita mabasa enguva dzose, asi pane mamwe mamiriro ezvinhu.
Zviratidzo zveanesthesia yemudumbu zvinosanganisira:
– Kuvhiyiwa kukuru kwemuromo (semuenzaniso mamwe maoparesheni eshaya).
– Varwere vane zvinodiwa zvakasiyana vasingakwanise kubatsira kunyangwe mushure mekuedza dzimwe nzira.
– Vana vadiki vane mazino akaora zvakanyanya vanoda kurapwa kakawanda panguva imwe chete.
– Kutya zvakanyanya kurapwa kwemazino, kana dzimwe nzira dzisina kushanda.
Nekuti anesthesia inokanganisa mashandiro ese emuviri, nzira iyi inoda nzvimbo yakakodzera (chipatara kana kiriniki ine zvivakwa zvakakwana), kuongororwa kwechiremba usati waita oparesheni, uye kutariswa kwakanyatsoitwa nachiremba weanesthesia.
5. Zvinhu Zvinoita Kuti Usarudze Rudzi rweAnesthesia
Sarudzo yemushonga wekutindivadza haisi yekungoerekana yaitwa. Vanachiremba vemazino vanofunga nezvezvinhu zvakati wandei, zvakaita se:
– Rudzi uye nguva yekuvhiyiwa (semuenzaniso chigamba chidiki vs kuvhiyiwa).
- Kunetseka kwevarwere uye nhanho dzekushandira pamwe.
– Nhoroondo yezvekurapa (BP, chirwere chemwoyo, asima, chirwere cheshuga, zvirwere zvechiropa/itsvo).
– Kurwara nemishonga uye nhoroondo yekurwadziwa kwemudumbu.
– Zera uye mamiriro emuviri (vana, vakwegura, vakadzi vane pamuviri).
- Kudiwa kwekudzora kubuda ropa, kunyanya mukuvhiyiwa.
Kuongorora kwekutanga uye kubvunzurudzwa kwenhoroondo yezvekurapa kunobatsira chiremba wemazino kusarudza nzira dzakachengeteka. Kutaurirana pakati pemurwere nachiremba wemazino kwakakoshawo kuitira kuti murwere anzwisise zvekutarisira uye zvekutarisira mushure mekurapwa.
Mhedziso
Anesthesia mukurapa mazino inosanganisira nzira dzakasiyana-siyana, kubva paanesthetics dzinoshandiswa pakurapa mazino kuderedza marwadzo epamusoro, anesthetics dzemunharaunda kuti dzisanyanye kunzwa, anesthesia yekuderedza kuzvidya mwoyo nekuwedzera nyaradzo, uye anesthesia yeruzhinji kune vanhu vanoda kusaziva zvachose. Rudzi rumwe nerumwe rune mabhenefiti nenjodzi dzakasiyana, saka sarudzo inofanira kugadziriswa zvichienderana nezvinodiwa nemaitiro acho, hutano hwemurwere, uye nyaradzo. Nenzira chaiyo, anesthesia inogona kuita kuti kurapwa kwemazino kuve kwakachengeteka, kunoshanda, uye kusanyanya kushungurudza varwere.
