Added: 12/27/2005 |
Proper Use of Sedatives in Modern StomatologyModern stomatology does not approve of an old principle - "it is necessary to suffer a little pain in order to enjoy a little pleasure"! The patient should not experience not only a toothache, but also simply unpleasant sensations at treatment and prosthetics of the teeth. Various kinds of sedatives allow the doctor to carry out necessary medical actions, not causing the unpleasant sensations to patient. At each certain stomatologic manipulation, the most suitable method of anesthesia is used.
Contact sedatives are very popular. Lidocaine is used most frequently for contact anesthesia. These superficial sedatives do not extend on deep-laying tissue. It is applied during the removal of the dental adjournment, the removal of mobile teeth, opening small periodontal abscesses, and before carrying out of deeper kind of anesthesia to remove unpleasant sensations from an injection.
The infiltration sedatives make the most widespread kind of anesthesia in stomatology, all familiar injection. The infiltration anesthesia carries out an injection of a preparation under a mucous membrane, periosteum or intraosseous introduction. The preparation (oral sedatives) will penetrate into tissues well, and there comes anesthesia in 3-5 minutes. This kind of anesthesia is applied at the most various stomatologic operations - at treatment of teeth and dental channels, operations on a pulp of a tooth. Depth and duration of anesthesia are sufficient for any stomatologic intervention within not less than 60 minutes.
The intraveneous sedatives are the next type. At this kind of anesthesia, the preparation penetrates into fiber of trigeminal nerve, carrying out blockade of one of its branches. Thus, the anesthetizing effect is observed in the certain area, which this branch innervates. The intra-veneous anesthesia is applied at operative interventions in the field of the big molars, at operations on gums and the big interventions.
The stem (regional) anesthesia is carried out at the basis of a skull for blockade of branches of a trigeminal nerve. This kind of anesthesia is used in a hospital at operative interventions, at a heavy painful syndrome, neuralgia and traumas. It is necessary to note especially that at carrying out of anesthesia the doctor necessarily should ask the patient about presence of any other diseases - hypertonic illness, diseases of heart and vessels, a diabetes, allergies. Only after that, the doctor should choose necessary tactics of carrying out of anesthesia, safe and convenient for the patient.
The stomatologic outpatient practice applies multi-component intravenous narcosis at adults. The preparation for a narcosis is carried out with use of tranquilizers (reduce fear, alarm, pressure) and anti-cholinergic drugs (suppress undesirable reflexes and reduce salivation). The basic narcosis supports a combination of preparations for a narcosis in various combinations, depending on features of the patient and traumatic influence of interventions (treatment of caries or plural removals of teeth) with narcotic and not narcotic analgesics.
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