Local anesthesia
To make a local Anesthésie consists in inhibiting in a reversible way the propagation of the signals along the Nerf S.
If this anesthesia is carried out on the level of specific nervous ways, it is likely to produce effects such as the Analgésie (reduction of the feeling of Douleur) and the Paralysie (loss of power of the Muscle).
There exist various types of Anesthésie S local:
- anesthesia topics = of surface: the anesthetic in the form of freezing or pomade is deposited on the mucous membrane.
- anesthesia by infiltration: the anesthetic is deposited near or of the nerves to be deadened, thanks to a needle.
- block tronculaire: consist in infiltrating a nervous trunk to obtain the anesthesia of its territory; for example the block of the cubital nerve involves the anesthesia of the internal edge of the hand.
- block plexic: consist in infiltrating a plexus (together of nerves) to obtain an anesthesia of a whole area. For example, the infiltration of the plexus brachial involves an anesthesia of all the upper limb.
- epidural blocking (or infiltration of space péridural). According to the infiltrated level can give an anesthesia of the lower half of the body, or simply of several métamères (péridurale suspended)
- rachianesthesy: injection of local anesthetic in the rachidian liquid céphalo, gives an anesthesia of the lower half of the body.
Local anesthesias by infiltration in dentistry
- perish-apical: most frequent. The anesthetic is deposited near the Apex of the tooth. Used for all the former Tooth S jawbones, and teeth mandibulaires (to the first premolar).
- intraseptales: the anesthetic is deposited inside the alveolar Os, under the cortical osseous one. Used for the molars mandibulaires.
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Transcorticale: The anesthetic is deposited in a deep osseus layer to tend more.
- intraligamentaires: the anesthetic is deposited inside the Desmodonte or alvéolo-dental ligament. Generally used as complement of another anesthesia, in particular at the time of surgical acts (extraction).
- intrapulpaires: the anesthetic is deposited in the pulp of the tooth. Used in complement, in particular at the time of endodontical acts (devitalisation).
- loco-regional Anesthesia = tronculaire (= anesthesia with the spine of Spix): allows to deaden the molars mandibulaires correctly (impossible to deaden by para-apical). One anesthesia the nerve mandibulaire (V3) before it enters the bone mandibulaire. One obtains an anesthesia of the molars and premolars, lingual mucous membrane, and hémi-lip on the side where the infiltration was made. It is this type of anesthesia which one carries out at the time of an avulsion of the Tooth wisdom.
Types of anesthetic
There exists many anesthetic buildings.The first used was the Cocaïne. Then came: the Lidocaïne, the scandicaïne, the prilocaïne, the étidocaïne and the bupivacaïne. Most modern are the ropivacaïne, the levobupivacaïne and the mépivacaïne.
The techniques of regional anesthesia loco now call upon the use of stimulative in order to facilitating the location of the nerves and improving the percentage of success of these anesthesias.
See too