RU2342124C1 - Method of anesthetic tissue injection - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: local anesthetic solution is injected with a vasoconstrictor at a certain injection pressure, namely, 0.7; 1.2 and 1.4 Atm.

EFFECT: increase of local anesthesia efficiency due to local anesthetic solutions injection at certain pressure, additional prelum of vessels and anesthetic resorption retardation.

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Description

The invention relates to medicine, namely to dentistry, and is intended for local injection pain relief.

From the prior art of the introduction of solutions it is known that with infiltration anesthesia anesthetic in the amount of 1.5-2 ml is administered slowly to avoid severe pain from delamination of tissues with a solution (Bizyaev A.F., Ivanov S.Yu., Lepilin A.V. , Rabinovich SA "Anesthesia in the conditions of a dental clinic", Moscow - 2002, p. 40).

However, the rate of introduction of local anesthetic into the tissue should in no case exceed 1 ml per 1 min (E. Borovsky and others, Therapeutic dentistry, M .: JSC "Dentistry" - 2005, p. 14).

At the same time, during the injection of local anesthetics into the tissues, the doctor is guided only by the rate of injection of the solutions, does not know what pressure develops at the time of administration and how it affects the effectiveness of anesthesia.

It is also known that all recommendations for the rate of administration of solutions are given without regard to the content of the vasoconstrictor in the local anesthetic.

The closest analogue to the proposed invention is a method of introducing into the tissue a solution of local anesthetic with a vasoconstrictor, which is carried out under the control of a pressure of 50 mm Hg. up to 500 mmHg (MASARU KUDO, Initial Injection Pressure for Dental Local Anesthesia: Effects on Pain and Anxiety, Anesth Prog. 2005 Fall; 52 (3): 95-101).

However, this method does not eliminate the above disadvantages, in addition, the introduction of anesthetic occurs without taking into account the content of the vasoconstrictor in it.

The problem to which the invention is directed is to create such a method of introducing an anesthetic into the tissue, which would eliminate the above disadvantages.

The technical result achieved by the implementation of this invention is to increase the effectiveness of local injection pain relief by controlling the pressure of the introduction of solutions of local anesthetics into the tissue, taking into account the content of vasoconstrictors in them.

This technical result is achieved in the method of administering an anesthetic, in which the introduction into the tissue of a solution of local anesthetic with a vasoconstrictor is carried out under a pressure control of 0.7; 1.2 and 1.4 atm. The route of administration of the anesthetic is as follows.

In the treatment of, for example, caries (preparation of hard tooth tissues), local anesthesia is performed, a local anesthetic solution with a vasoconstrictor, a syringe and a needle are injected under pressure control. The method of introducing a solution of local anesthetic, taking into account the content of the vasoconstrictor in it, is carried out under pressure control, while the injection pressure of the anesthetic is constant, and the rate of administration of the anesthetic varies depending on the density of the tissues.

Pressure was measured in atmospheres (atm) according to the International System of Units of Measurement (Chertov A.G., 1967) using an analog pressure gauge connected through an adapter between a syringe and a needle.

1 Atm = 760 mmHg.

With the introduction of local anesthetics with vasoconstrictors, the effectiveness of anesthesia increases due to increased pressure.

Anesthesia with the proposed method lasts from 25 to 65 minutes

Example 1. Patient: Klimova VN, 28 years old, blood pressure - 125/90, anesthesia of 26 teeth. The introduction of a 4% solution of articaine with a vasoconstrictor 1: 200000.

The introduction of 1.7 ml of solution.

At a pressure of 1.4 atm - the effectiveness of analgesia is 35 minutes.

At a pressure of 1.2 atm - the effectiveness of analgesia is 35 minutes.

At a pressure of 0.7 atm - the effectiveness of anesthesia for 31 minutes.

At a pressure of 0.3 atm - the effectiveness of analgesia is 28 minutes.

At a pressure of 0.1 atm - the effectiveness of analgesia for 25 minutes

Conclusion: The effectiveness of a 4% solution of articaine with a vasoconstrictor 1: 200000 depends on an increase in the injection pressure into the tissues, and the maximum analgesia efficiency in this patient with the introduction of 1.7 ml of the solution occurred with a pressure of 1.2 atm and lasted for 35 minutes.

Example 2. Patient: Klimova VN, 28 years old, blood pressure - 125/90, anesthesia of 26 teeth. The introduction of a 4% solution of articaine with a vasoconstrictor 1: 100000.

The introduction of 1.7 ml of solution.

At a pressure of 1.4 atm - the effectiveness of analgesia is 65 minutes.

At a pressure of 1.2 atm - the effectiveness of analgesia is 65 minutes.

At a pressure of 0.7 atm - the effectiveness of analgesia is 65 minutes.

At a pressure of 0.3 atm - the effectiveness of analgesia is 47 min.

At a pressure of 0.1 atm - anesthesia effectiveness of 38 minutes.

Conclusion: The effectiveness of a 4% solution of articaine with a vasoconstrictor 1: 100000 depends on an increase in the injection pressure into the tissues; the patient's pain relief with 1.7 ml of the solution occurred with a pressure of 0.7 atm and lasted for 65 minutes.

General conclusion: Local anesthetics with vasoconstrictors have maximum anesthesia effectiveness with increasing pressure, starting from 0.7 atm (532 mm Hg), that is, the introduction of a local anesthetic solution with a vasoconstrictor into the tissues is carried out under pressure control above 0.7 atm.

This is due to the pressure that compresses the vascular bed, and the vasoconstrictor helps to maintain this state, and the higher the pressure (the more blood vessels are squeezed), the more effective is anesthesia, since absorption into the systemic circulation slows down, thereby achieving maximum concentration.

Vasoconstrictors slow the absorption of local anesthetics into the systemic circulation (Kruszkowska VV, Vakhtangishvili R.Sh., “Medicines in anesthesiology. Local anesthetics”, Rostov-on-Don, “Phoenix” - 2006, p. 58).

Moreover, the maximum efficiency develops at a pressure above 1.2 atm with the introduction of a 4% solution of articaine with a vasoconstrictor of 1: 200000, and with the introduction of a 4% solution of articaine with a vasoconstrictor of 1: 100000, efficiency develops at a pressure above 0.7 atm.

With a decrease in pressure, the effectiveness of anesthesia decreases up to the minimum effect, which develops at a pressure below 0.1 atm.

When a local anesthetic solution is administered under pressure control, the effectiveness of anesthesia also depends on:

from the psychophysiology of the patient,

from the anatomical and physiological characteristics of tissues in the area of local anesthetic administration,

from the physicochemical properties of a local anesthetic,

from the presence of a vasoconstrictor and its concentration in a solution of local anesthetic,

from the concentration of the solution at the injection site.

Claims (1)

The method of introducing an anesthetic, characterized in that the introduction into the tissue of a solution of local anesthetic with a vasoconstrictor is carried out under pressure control of 0.7; 1.2 and 1.4 atm.