Anesthesia

Anesthesia in surgery - induced shutdown of pain sensitivity. Anesthesia may be a consequence of inhibition of the Central nervous system with the loss of consciousness (see Anesthesia) or blockade of the peripheral nervous system at different levels with preserved consciousness - local anesthesia. Local anesthesia can be obtained in several ways: cooling the skin, lubricating mucous membranes and the introduction of solutions of painkillers tissue or body cavity.
Anesthetics by cooling is applied at the opening superficial ulcers. Usually achieved by spraying it on the part of the body jets of chloroethyl of the ampoule until you see white skin spots.
Anesthesia lubricating mucous membranes (1-3% solution dikaina) is used in urology, otorhinolaryngology. Analgesia usually occurs after 4-8 minutes after lubricating mucous membranes (sometimes repeated). In ophthalmic practice for pain cornea and conjunctiva in kongungualny bag buried 1-2% solution of cocaine (rarely) or 1% solution dikaina.

Introduction solutions painkillers in tissues and body cavities

Infiltration anesthesia -layered soaking fabrics anesthetic solution, acting on the nerves and nerve trunks passing through the distribution of the solution. The most perfect way infiltration anesthesia is casing anesthesia method Century A. Vishnevsky. The essence of the method consists in tight infiltration fascial spaces 0.25% solution novokaina. Procaine infiltrate as "crawling" on the fascial spaces (a"creeping infiltration"), washing the end of the nerves. Anesthesia by A. C. Vishnevskaya provides the perfect anesthesia with operations in almost all organs. In addition, with casing of anesthesia is the so-called hydraulic preparation of tissues that make your surgeon. Anesthesia this method begins with an intradermal injection of a solution through a thin needle (formed the so-called lemon peellemon peel, Fig. 1). Then, in a separate injections another, long, needle introduce a solution into the subcutaneous tissue, then in the subfascial space. Further technique of anesthesia is determined by transaction type and area of intervention. Infiltration anesthesia should not be performed in children at an early age , and in patients with particularly vulnerable nervous system.
Conduction anesthesia is achieved by the introduction of the solution usual means in the shell major nerve trunks or more in surrounding tissues. The result is the loss of pain sensitivity in the field, innerved by this nerve block anesthesia). To block anesthesia used 0,25; 0,5; 1 or 2% solution novokaina. When anesthesia cervical plexus needle is injected in the middle of the rear edge of the sternoclavicular-liners muscles to transverse processes of the III - IV cervical vertebrae, in anesthesia brachial plexus - medially from the middle clavicle towards the vertebrae. When barsakrlmes anesthesia novocaine enter on the side of the coccyx, sacral (the sacrum) and the sacral hole to the fiber pigtails. Anesthesia intercostal nerves produce injections of Novocain on the bottom edge of the ribs, some distance on 5-6 cm from the spine. Kind block anesthesia is car-sympathetic blockade (see Blockade procaine). Intravenous produce anesthesia in surgical interventions on the limbs; enter 100-250 ml of 0.5% solution novokaina in the veins below the tourniquet (Fig. 2). intravenous or intraosseous anesthesiaIntraosseous anesthesia is performed by the introduction of 50-100 ml of 0.5% solution novokaina in the epiphysis bone through a thick needle (1 mm in diameter) with mandrel (Fig. 3). Previously raised up to 2 - 3 minutes limb tight bontout rubber bandage from your finger-tips (shading shows the dispersion anesthetic solution)
Contraindications to intraosseous and intravenous anesthesia are thrombophlebitis, varicose veins, the need for long-term intervention (more than 40 - 60 minutes).
For anesthesia maxillofacial area used infiltration or block anesthesia. To block anesthesia person anaesthetic substance is injected into the hill of the upper jaw, infraorbital, palatal, cutting holes. The blockade II branches trigeminal nerve produces the introduction of the solution in the region wing-palatal fossa. During operations on the lower jaw solution is injected into the temporomandibular holes or temporomandibular exaltation. The blockade III branches of the trigeminal nerve produces the oval holes on the base of the skull. Some of the ways block anesthesia maxillofacial area are presented in Fig. 4. ( 1 - infraorbital; Mr. infraorbital extraoral way; 3 - podkolokol way anesthesia II branches of the trigeminal nerve. 4 temporomandibular anesthesia)
Spinal anesthesia produced by puncture of the Dura in between XII thoracal and I lumbar vertebrae or between I and II of the lumbar vertebrae and the introduction of anaesthetic substance (usually 1% solution of 0.5-0.8 ml of soukaina) in the subarachnoid space. Anesteziruty solution is mixed with spinal cord fluid and in 5-10 minutes there comes the blockade roots sensory and motor nerves, which ensures complete pain relief and muscle relaxation. It is mainly used in operations on the organs of small pelvis, abdominal cavity, the operations on the lower extremities.
Contraindications for spinal anaesthesia: low blood pressure, acute blood loss, obesity patient, tumors of the brain or spinal cord, syphilis Central nervous system, meningitis, sepsis, pustular skin lesions in the lumbar region, curvature of the spine of the lumbar spine. In the first hours and days after spinal anaesthesia may develop a headache, so the patient should be prohibited to raise your head that you are experiencing pain at rest, on the head of an ice pack, intravenous 5 ml of 40%solution of hexamethylenetetramine (urotropine), or 100 ml of 0.5% solution of sodium chloride, or 100 ml of 40% solution of glucose. Cm. also Spinal tap.
Epidural anesthesia is performed by the introduction of anesthetic solution into the epidural space. When an epidural anesthetic solution is blocking the transmission of nerve impulses on the spinal nerve roots, not mixing with cerebrospinal fluid.
Contraindications for epidural anesthesia: curvature and spine deformation, ulcers in the area of the proposed puncture, ectopic pregnancy, low blood pressure, severe nephritis, decompensated heart disease.