Tuberal anesthesia is the most dangerousin terms of complications, injection technique. At the moment, this procedure is used infrequently. It is carried out by extraoral and intraoral administration of drugs. Anesthesia is used to anesthetize the area of the upper molars, in particular for blocking the alveolar nerves.
The complex anatomical characteristics of the drug administration zone increase the risk of complications and reduce the effectiveness of anesthesia. Consider some points.
В височно-крыловидном пространстве над верхней jaw is venous plexus. It occupies the area from the infraorbital fissure to the lower jaw. Accidental puncture of the venous wall causes the formation of an extensive hematoma, which is difficult to prevent.
Inserting a needle to an insufficient level leads tothe fact that the injection of the solution is carried out in the subcutaneous fatty tissue. In this case, tubular anesthesia will not be effective at all. Exceeding the depth of the needle leads to the following consequences:
The tip should not be allowed to slide along the tubercle during the procedure, as it is possible to punch nerves and small vessels.
Tuberal anesthesia in dentistry allows you to numb the following areas:
Boundary area of anesthesia passingrear is constant. In front, it can reach the middle of the first small molar and, accordingly, the mucous membrane located in this area along the gum.
The progress of the procedure:
Если использовать анестетик короткого действия, The procedure will be effective for 45 minutes, if long - up to 2.5 hours. Intra-oral tubular anesthesia is performed for outpatient operations and with simultaneous intervention on several molars.
No matter which side is neededtubular anesthesia, the technique requires a deviation of the patient's head in the opposite direction. Before the anesthesia itself, the doctor determines the depth to which the needle will need to be inserted. This is the distance between the lower outer angle of the orbit and the anterior lower angle of the zygomatic bone.
The dentist is located to the right of the patient. The needle is inserted in the area of the anterior low angle of the zygomatic bone. It should have an angle of 45about in relation to the median sagittal plane and the right angle to the trago-orbital line. After inserting the needle, an anesthetic is injected to the desired depth. Anesthesia develops over 5 minutes.
Tuberal anesthesia is performed using local anesthetics:
All funds are used in conjunction withvasoconstrictor (adrenaline). When choosing a drug, a specialist determines individual tolerance and maximum dose, takes into account the patient's age, as well as the presence of pregnancy and comorbidities.
Tuberal anesthesia, reviews of whichambiguous (patients note an excellent analgesic effect, but some complain that numbness lasts a long time, up to 5 hours, plus the side effects already mentioned above are not like many) should be carried out by a highly qualified specialist who can take into account all the necessary nuances of the event . Some of the possible complications have already been considered. Time should be devoted to the issue of their prevention.
Vascular injury and hematoma formation in the areapain relief can be prevented. For this purpose, during anesthesia, the needle contact with the bone tissue should not be lost and should not be injected by more than 2.5 cm. After the needle is removed, the infiltrate formed by the injected anesthetic is massaged upwards beyond the maxillary tubercle. Tuberal anesthesia is allowed only in the absence of inflammatory processes at the injection site.
Getting hit is dangerous for the patient.solution into the bloodstream. Its toxicity increases 10 times, and the effect of the vasoconstrictor is 40. The patient may experience shock, collapse, syncope. To prevent such a complication, before injecting the anesthetic, the syringe plunger is pulled back. This helps to ensure that the needle does not fall into the vessel. If blood appears in the syringe, you need to change the direction of the needle and only then inject the drug.
Violation of the rules of asepsis during the procedure can lead to infection. Introducing the needle in your mouth, you need to make sure that it does not touch the tooth. The entry of plaque will lead to the development of phlegmon.
Due to the large number of complications and the complexity of the technique of conducting tuberous anesthesia is practiced quite rarely. The choice of anesthesia should be entrusted to a specialist.
