Dentistry under general anesthesia to children, adults. Effects contraindications when used for the treatment, tooth extraction

dental services treatment, disposal or prosthetics carried out under the influence, both general and local anesthesia. General anesthesia the body appointed by the testimony of the attending physician and anesthesiologist.

Indications for use of general anesthesia

When general anesthesia the patient is in a state of deep sleep. In this further may be used in view of features of a local anesthetic action of various drugs. General anesthesia is divided into categories depending on the complexity of the procedure.

inhaled type

This type represents the classic and most common type of general anesthesia. For administration of hypnotic drugs used special respirator through which the flow of substances in the gaseous state.

These drugs act quickly in the respiratory system, causing the patient to fall asleep fast. The main indications for the procedure is large (broad) surgical operations associated with dental treatment, filling channel stop bleeding.

Procedure is prescribed in the following cases:

• presence of allergic reactions to local anesthetics of destination;
• reduced level of pain threshold;
• extensive surgery;
• vomiting reflex;
• the presence of hypertension or other cardiovascular disease, coupled with a fear of performing dental procedures.

Before the appointment of general anesthesia is necessary to pass all of the recommended expert study and comply with the prescribed instructions. The choice of this method depends on the presence of contraindications and tolerability of drugs.

Intravenous drug or

Dentistry is carried out under general anesthesia by intravenous injection into the patient narcotic substances - one (mononarkoza) or multiple (combined anesthesia). The intravenous form of anesthesia is not administered in childhood because of the fear of the presence of the children before the injections.

Indications:

• heavy flow of dental diseases;
• extensive surgical operation;
• profound loss of hard tissue of the gums;
• Preparations prior to implantation;
• tooth prosthesis;
• presence of allergic reactions to drugs topical administration;
• complete removal of wisdom teeth with the wrong structure;
• diseases of the cardiovascular system;
• well-developed gag reflex;
• mental disorders;
• high sensitivity.

Also, intravenous anesthesia is performed in cases of the presence of a strong fear of performing dental procedures.

Act

Dental means for general anesthesia, have a pronounced degree of activity. Action sedatives occurs almost instantly.

It is noted a gradual immersion in the dream:

Step (Step)	Features, Specifications
analgesia	This stage occurs after a few minutes. after administration to the patient. At the same time there is a loss of consciousness. Speech and motor functions are being violated. Heart rate and heartbeat remain in the normal range, reflexes are also stored. At this stage, operations are carried out with minimum trauma and the region of procedures - processing sites prone to caries by means of a drill.
Excitation	At this stage, motor and voice notes patient anxiety. Thus there is increased activity reflexes, high muscle tone, pupil dilation with the presence of an appropriate response to the light. Breathing inconsistent, there is no rhythm. The stage is a transition in view of what dental procedures are not carried out.
surgical stage	Step characterized by decreased arousal, motor activity, reflexes. In this stage subdivided into several types: light, easy, complete and ultra-deep. The first 2 steps are an indication for simple operations related to the treatment or removal of teeth. In the following 2 steps are carried out surgical interventions associated with severe maxillofacial disorders.

Features of the application

Selected type of general anesthesia, depending on the degree of tolerance, age and the presence of indications / contraindications.

For children up to 18 years

Dentistry under general anesthesia can be performed in children only with the permission of a pediatrician and anesthesiologist. It is necessary to take into account the child's age. In most cases assigned inhalable form of anesthesia in children due to the presence of fear in inserting the needle. At older ages, can be used intravenous anesthesia.

When using the inhalation mask child falls asleep almost instantly. To enter the sleepy state with just a few breaths of sedatives. In this case, the expert monitors the status of the child - evaluates the skin, measures the pressure, following the work of the heart. The procedure is done to children from 1 year.

adult

The duration of anesthesia is between 1 to 3 hours and depends on a variety of factors - the patient's age, state of health. This may be used as inhalation or intravenous anesthesia method depending on the presence of contraindications.

Dosage is calculated based on the characteristics and condition of the patient.

During operations specialist is closely monitoring the condition of the patient - holds measuring actions pulse pressure and heart rate, skin studies. Upon expiration of the patient's condition sedatives normal within the next 5 min.

For pregnant

Dentistry under general anesthesia during child-bearing is carried out only with the permission and a physician anesthesiologist, tracking the course of pregnancy. Dosage thus should be selected with extreme caution due to the high risk effect of drugs on the placenta and maternal condition.

Higher risk of developing complications in anesthesia are marked with the 2 nd to 8 th week of gestation. Also, risks remain in the 28th week of pregnancy. Appointed by the procedure only when the inevitable surgical intervention associated with serious disturbances in the maxillofacial region.

for elderly

In old age, there are various atrophic changes associated with internal organs work. The dosage is determined by the anesthesiologist with the age, condition and contraindications. In some cases, the use of general anesthesia in the elderly can lead to complications in the form of psychosis, depression and other neurotic disorders.

In carrying out operations related to the treatment or removal of the teeth must be present several experts that monitor the patient's condition.

Measured pulse rate and blood pressure are measured skin and reflex response. Following the success of the surgery in patients older are recommended for continuous (daily) monitoring a specialist.

Contraindications

Dental surgery under general anesthesia has certain limitations for the procedure. Before the appointment of general anesthesia must also undergo a series of laboratory and diagnostic measures, including the study of the general analysis.

Contraindications:

• diseases of the cardiovascular system in the acute stage, including malignant form of hypertension and hypotension development, accompanied by a variety of functional disorders;
• respiratory diseases caused by severe respiratory failure - severe forms of tuberculosis lesions, acute course of pneumonia;
• heart disease;
• hepatic failure, including cirrhosis and hepatitis;
• past history of heart attack or stroke - at least 1 year;
• organism lesion severe infections, as well as the recovery period after infectious diseases complicated shape;
• development intracranial pressure associated with the formation of hematomas and tumors;
• severe endocrine disorders - diabetes at the stage of decompensation;
• toxic damage of the body, including alcohol or drug intoxication.

Before the procedure is recommended to fast for 4-5 hours before the operational actions and for 4 h - from the use of any liquid. You should also renounce the use of any drugs.

Side effects and consequences

When properly designed dosage of the development of side effects is very rare. In some cases, the presence of the consequences in the form of swelling of the lips or cheeks, pain in the surgery, or headache and is normal runs independently for subsequent a few hours.

Side effects and possible consequences:

• allergic reactions - urticaria, angioneurotic edema, anaphylactic shock;
• toxic damage - is observed in case of hypersensitivity to the components used during anesthesia means;
• bruising, bruising - develop as a result of injury to vascular injection needle;
• pain, burning sensation - in most cases are the norm;
• spazmicheskoe defeat masticatory muscles (lockjaw) - is observed in the case of damage or nerve fibers;
• a temporary reduction or complete loss of sensation - is formed by the accidental damage of the nerve;
• soft tissue lesion - occurs at random (reflex) biting the cheek or lips;
• the development of infection - is formed by the non-observance of the rules of antisepsis.

An important factor in the development or absence of adverse effects from the procedure is a professional specialist.

Rating drugs

There are some of the most effective drugs for general anesthesia, exhibiting minimal amount of or no side effects.

ether medical

It is produced in the form of a clear volatile liquid. It belongs to a class of narcotic drugs used during general inhalation anesthesia. The main component is diethyl ether. Appointed in all types of surgical procedures, including dental procedures.

Used in combination with oxygen relaxants or dinitrogen oxide. The dosage is calculated based on the characteristics of the patient and the patient's age.

Nitrous oxide

The drug belongs to a group of anesthetic agents. Active substance - dinitrogen oxide. It is produced in the form of compressed gas. Means shown during general inhalational anesthesia the body during surgery. It can be used as the main amplifier anesthetic.

It used when pain syndrome, as well as anesthesia, does not require a deep immersion in the dream state. The drug is contraindicated during hypoxia, hypersensitivity, pathologies of the nervous system, as well as in chronic alcoholism. To disable consciousness, a mixture of oxygen and 25-50% of the Agent.

geksenal

The main active component of the drug is hexobarbital. It is produced in the form of an injectable solution. It belongs to a group of anesthetic agents. Applied prior to the operational activities in conjunction with the local destination therapy.

The solution is contraindicated in hepatic and renal disorders, septic lesions, diabetes, hypertension. Extreme care agent appointed in children, the elderly, as well as during pregnancy. Dosage is calculated specialist and ranges from 0.3 to 1 g In this case administration is intravenously 1 ml of the finished mixture for 1 min.

propofol

It refers to a group of anesthesia, sedation. The main component - propofol. Appointed as maintenance of anesthetic agents in carrying out the diagnostic or surgical interventions associated with mechanical ventilation. The drug is banned for use in children younger than 1 month as a means of supporting the anesthetic state.

Not assigned to adolescents up to 16 years to maintain sedation. The dosage is calculated taking into account the state of the anesthesiologist and the patient's age. Dental procedures under the influence of a general anesthetic is carried out only after consultation and strictly on the testimony of a doctor.

Video of dentistry under general anesthesia

Dental treatment under general anesthesia, tips for parents: