牙医必备 | 各类麻醉讲解(附图)建议收藏!

 

口腔颌面外科门诊的临床麻醉,根据麻醉方法,麻醉药物和麻醉部位的不同,可分为局部麻醉和全身麻醉(国外在齿槽外科用笑气)。

 

局部麻醉简称局麻,是指用局部麻醉药暂时阻断机体一定区域内神经末梢和纤维的感觉传导,从而使该区疼痛消失。确切的涵义应该是局部无痛,即除痛觉消失外,其他感觉如触觉,温觉等依然存在。

 

一、常见的局麻药物

 

1.酯类:普鲁卡因,地卡因;

 

2.酰胺类:利多卡因,布比卡因,阿替卡因;

 

3.卡波卡因,丙胺卡因(国外多用);

 

4.必兰麻(阿替卡因+肾上腺素),斯康杜尼(甲哌卡因+肾上腺素)。

 

二、麻醉方法

 

1.表面麻醉:涂布麻醉,是将麻醉剂涂布或喷射于手术区表面,麻醉药物被吸收而使末梢神经麻痹,以达到痛觉消失的效果。

 

2.浸润麻醉:是将麻醉药液注入组织内,以作用于神经末梢,使之失去传导痛觉的能力而产生麻醉效果。

 

QQ截图20170605140024

 

骨膜上浸润法 局部浸润法是将麻醉药注射到牙根尖部位的骨膜浅面;

 

QQ截图20170605140033

 

牙周膜注射法 牙周韧带内注射法 用短而较细的注射针头,自牙的的近中和远中侧刺入牙周膜,深约0.5CM,分别注入局麻药0.2ML,即可麻醉牙及牙周组织。

 

3.阻滞麻醉 是将局麻药液注射到神经干或主要分支附近,以阻断神经末梢传入的刺激,使被阻滞的神经分布区域产生麻醉效果。

 

以下重点讲述设计门诊麻醉的几种阻滞麻醉以及图谱:

 

(1)上颌神经阻滞麻醉 

 

上颌神经出圆孔在翼腭间隙内分支前行,将麻药注入此区的上颌神经阻滞麻醉,亦称圆孔或翼腭窝注射法。(本法门诊少用)

 

翼腭管注射法

 

QQ截图20170605140045

 

QQ截图20170605140054

 

口外注射法(本法适合三叉神经痛局部注射无水酒精或美兰治疗)

 

QQ截图20170605140113

 

(2)上牙槽后神经阻滞麻醉

 

口外法:

QQ截图20170605140123

口内法:(常用)

QQ截图20170605140130

 

(3)眶下神经阻滞麻醉

 

口外注射法(成人唇裂,上唇,面部外伤,上颌前牙手术):

QQ截图20170605140137

口内法:

QQ截图20170605140148

 

QQ截图20170605140203

 

(4)腭前神经阻滞麻醉 将麻药注射入腭大孔或其附近以麻醉腭前神经,又叫腭大孔注射法

 

QQ截图20170605140210

图示同图—36

 

(5)鼻腭神经阻滞麻醉:

 

QQ截图20170605140222

 

(6)下颌神经阻滞麻醉

 

QQ截图20170605140232

 

(7)下牙槽,舌,颊神经一次阻滞麻醉,亦称下颌支内侧隆突阻滞麻醉

 

QQ截图20170605140253

 

QQ截图20170605140303

 

QQ截图20170605140310

 

QQ截图20170605140320

《牙医必备 | 各类麻醉讲解(附图)建议收藏!》上有1,604条评论

  1. Very good site you have here but I was wondering if you knew of any message boards that cover the same topics discussed here? I’d really love to be a part of group where I can get feed-back from other knowledgeable people that share the same interest. If you have any suggestions, please let me know. Kudos!|

  2. I’m really impressed with your writing skills as well as with the layout on your weblog. Is this a paid theme or did you modify it yourself? Anyway keep up the excellent quality writing, it is rare to see a nice blog like this one today.|

  3. you’re actually a just right webmaster. The website loading velocity is incredible. It kind of feels that you are doing any unique trick. Furthermore, The contents are masterwork. you have done a wonderful activity on this subject!|

  4. Hello would you mind sharing which blog platform you’re using? I’m planning to start my own blog in the near future but I’m having a tough time deciding between BlogEngine/Wordpress/B2evolution and Drupal. The reason I ask is because your layout seems different then most blogs and I’m looking for something unique. P.S Sorry for getting off-topic but I had to ask!|

  5. After checking out a few of the articles on your website, I seriously like your technique of writing a blog. I saved it to my bookmark site list and will be checking back soon. Take a look at my web site as well and let me know what you think.|

  6. Can I just say what a comfort to discover somebody who really understands what they are talking about on the web. You actually understand how to bring a problem to light and make it important. More people ought to read this and understand this side of the story. It’s surprising you’re not more popular since you definitely have the gift.|

  7. Thank you for some other fantastic article. Where else may just anyone get that kind of information in such an ideal method of writing? I’ve a presentation next week, and I’m on the search for such info.|

  8. I think this is among the most significant information for me. And i am glad reading your article. But wanna remark on some general things, The site style is wonderful, the articles is really excellent : D. Good job, cheers|

  9. hey there and thank you for your information – I have certainly picked up anything new from right here. I did however expertise some technical issues using this site, as I experienced to reload the website many times previous to I could get it to load correctly. I had been wondering if your hosting is OK? Not that I am complaining, but sluggish loading instances times will often affect your placement in google and can damage your high quality score if advertising and marketing with Adwords. Well I am adding this RSS to my email and could look out for much more of your respective interesting content. Make sure you update this again very soon.|

  10. I have been surfing online more than three hours today, yet I never found any interesting article like yours. It is pretty worth enough for me. In my opinion, if all website owners and bloggers made good content as you did, the net will be a lot more useful than ever before.|

  11. Hey there I am so delighted I found your blog page, I really found you by mistake, while I was researching on Aol for something else, Nonetheless I am here now and would just like to say thanks a lot for a incredible post and a all round entertaining blog (I also love the theme/design), I don’t have time to browse it all at the moment but I have book-marked it and also included your RSS feeds, so when I have time I will be back to read much more, Please do keep up the excellent work.|

  12. You can certainly see your skills in the article you write. The world hopes for even more passionate writers such as you who are not afraid to say how they believe. All the time follow your heart.|

  13. Hey There. I found your blog using msn. This is an extremely well written article. I’ll make sure to bookmark it and return to read more of your useful info. Thanks for the post. I’ll certainly return.|

  14. Hey there would you mind stating which blog platform you’re working with? I’m going to start my own blog soon but I’m having a hard time making a decision between BlogEngine/Wordpress/B2evolution and Drupal. The reason I ask is because your design seems different then most blogs and I’m looking for something completely unique. P.S My apologies for getting off-topic but I had to ask!|