7. Types of anesthesia in oral and maxillofacial surgery. Premedication and general anesthesia. Flashcards
Types of Anesthesia
- Local
- General
- Neuroleptanasthesia
- Sedation
Premedication in the context of maxillofacial surgeries
- Administration of medications with specific pharmacological actions before surgery or anesthesia
- Enhances patient safety and comfort during the surgical procedure
Factors that influence the selection and dosage of premedication drugs
- Patient’s age
- Weight
- Physical status
- Type of anesthesia
- Level of anxiety and fear
- Pre-existing medical conditions.
How timing of premedication determined
- Factors such as => onset
- Peak effect
- Duration of action
- Route of administration
- Ensures medication =>achieves intended effects at the appropriate time
- Optimises its efficacy in preparing the patient for anesthesia and surgery
Used for learning objectives of premedication
10 A’s
10 A’s for premedication
- Anxiolysis-Relief of anxiety
- Analgesia
- Amnesia of preoperative events
- Antisialogogue effects-reduction in salivary and bronchial secretions
- Anti-emetic effect
- Anti-acid effect-reduction in stomach acid
- Allergies
- Antiautomatic-parasympathetic/Sympathetic reflexes care-Vagolytic actions
- Anaesthetic induction
- Antibiotic regime
Routes of administration for premedication
- Enteral
- Parenteral
Enteral routes of administration
- Oral
- Rectal
Parenteral routes of administration
- Intranasal
- Intramuscular
- Intravenous
Premedication drug groups
- Benzodiazepines
- Opoids
- Barbituates
- Phenothiazines
- Butyrophenones
- Anticholinergics
- Alpha adrenoceptor antagonists
First Cranial nerve
-Olfactory nerve(smell)
Second Cranial nerve
Optic nerve (sight)
Third Cranial nerve
Oculomotor nerve (Orbital muscles for eye movement)
Fourth Cranial nerve
Trochlear nerve (Orbital muscles for eye movement)
Fifth cranial nerve
Trigeminal nerve( Motor: movement of the **jaws** and **muscles of mastication** Sensory: sensation of feeling for the **face, teeth, and periodontal ligaments**, and anterior two thirds of the **tongue**)
Sixth Cranial nerve
Abducens nerve (Orbital muscles for eye movement)
Seventh Cranial nerve
Facial Nerve ( Motor: to the muscles of facial expression
Sensory: taste to anterior two-thirds of tongue
Secretory: to submandibular and sublingual glands)
Eighth Cranial nerve
Auditory Nerve(Sense of hearing, position, and balance)
Tenth Cranial nerve
Vagus nerve( Pharyngeal and laryngeal movements: digestive tract)
Eleventh Cranial Nerve
Accessory nerve(Neck movements: sternocleidomastoid and trapezius muscles)
Twelfth Cranial nerve
Hypoglossal nerve ( Motor: tongue movement (muscles)
Largest cranial nerve
Trigeminal nerve
Trigeminal nerve divisions
- Division I- Ophthalmic
- Division II- Maxillary nerve
- Division III- Mandibular nerve
Ophthalmic and maxillary nerve are
Afferent only(sensory)
Mandibular nerve is
Efferent (motor) and afferent (sensory)
Ophthalmic Nerve origin
exits skull through superior orbital fissure on the superior surface of the orbit
Ophthalmic Nerve branches
- *-Lacrimal nerve** (smallest),
- *-Frontal nerve**(largest )
- Nasociliary nerve
Ophthalmic Nerve sensations
-Touch, pain, pressure
-Skin of upper third of face (forehead and anterior scalp, and the skin around the eyeball, eyelid and nose,
and part of the nasal mucosa)
-Maxillary sinus
Maxillary nerve sensations
touch, pain, pressure, and temperature
The maxillary nerve innervates
- Middle third of face and the palate
- Pulp of all maxillary teeth
The maxillary nerve exists the brain through
Foramen rotundum
Four important branches of the Maxillary nerve
- -Pterygopalatine*
- -Posterior superior alveolar (PSA)*
- -Infraorbital*
- -Zygomatic nerve*
Which branch of the Pterygopalatine Nerve passes through the greater palatine foramen and what does it become?
Descending palatine nerve becomes Greater palatine nerve
Greater palatine nerve innervation
- Mucosa of posterior part of hard palate
- Palatal gingiva of posterior teeth
Nerves that arise posterior to the Greater palatine foramen
Middle and Posterior (lesser) palatine nerves enter the palate through the lesser palatine foramen to spread posteriorly to supply the tonsils and mucosa of the soft palate