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Chirurgie OMF > Accidente/Complicatii anestezie > Flashcards

Accidente/Complicatii anestezie Flashcards

1
Q

Cauze ale durerii in anestezie

A
  1. Intepare trunchi nervos/teaca nervoasa
  2. Intepare/traumatizare tesuturi
  3. Distensie brusca/dilacerare tesuturi
  4. Solutiile anestezice
  5. Anestezie tesuturi inflamate
  6. Erori de substanta
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2
Q

Cand apare dureea in inteparea trunchiului nervos si ce consecinte are?

A
  • nervi din canale osoase: mentonier, incisiv, palatin, NIO
  • anestezie prelungita 5-6 ore
  • nevrita traumatica la tronculare periferice
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3
Q

Unde se produce cel mai des distensia brusca si dilacerarea tesuturilor?

A
  • In zone cu tesut inextensibil, aderente de plan osos
  • fm palatina
  • gm fixa
  • periost
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4
Q

Ce poate aparea drept urmare folosirii anestezicului contaminat?

A
  • leziuni tisulare
  • trismus
  • edem postanestezic
  • parestezie tranzitorie
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5
Q

Care sunt efectele reducerii pH-ului, adica a cresterii aciditatii in inflamatie de catre anestezic?

A
  1. Limitarea formarii bazelor neionizate, ce in mod normal difuza in nerv
  2. Modifica produsii de inflamatie
  3. Ansorbtie mai rapida a anestezicului
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6
Q

Care sunt metodele pt obtinerea anesteziei in inflamatie tisulara?

A
  1. Adm anestezic la distanta de zona de inflamatie
  2. Inj unor cantitati mai mari de anestezic in regiune, printr-o anestezie de baraj (crescand asftel bazele neionizate necesare difuzarii prin teaca)
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7
Q

Caracteristici generale hematom

A
  • extravazarea se produce pana cand presiunea extravasculara o depaseste pe cea intravasculara sau pana la formare cheag
  • tuberozitate>spix/mentonier
  • f rar in bolta palatina
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8
Q

Ce se lezeaza in hematomul de obraz?

A
  • plex venos pterigoidian
  • art. alv post-sup
  • artera maxilara interna (post si medial de tuberozitate)
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9
Q

In cat timp se resoarbe hematomul?

A

7-10 zile

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10
Q

Semne clinice ale parezei tranz de facial (inj prea profunda la spix, prea post, in parotida)

A
  • exoftalmie
  • coborare comisura bucala
  • disparitie miscari mimica
  • asimetrie faciala
  • cateva ore
  • daca VC produce ischemie la n. facial- tulb motorii dureaza mai mult
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11
Q

La ce duce anestezia la nervul auriculotemp, cand se introduc eacul prea sus pt Spix?

A

regiunea temporala

pavilion ureche

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12
Q

Anestezie nerv infraorbitar-accidente: difuzzre in orbita

A
  • edem palpebral
  • oftalmoplegie
  • exoftalmie
  • diplopie
  • pierdere temp vedere
  • 1-1,5 ore remisie fara trat
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13
Q

Anestezie nerv infraorbitar-accidente: acul intra in orbita

A
  • hemoragii
  • hematoame IO/intraoculare
  • echimoze palpebrale/conjunctivo-bulbare
  • tulb persistente de vedere
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14
Q

Care sunt complicatiile locale ale anesteziei loco-regionale?

A
  1. Descuamare epiteliala si ulceratii mucoasa
  2. Necroze mucoasa
  3. Injectite postanestezie
  4. Trismus persistent
  5. Parestezii persistente
  6. Alveolita postextractionala
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15
Q

Etiologia ulceratiei mucoase

A
  • stomatita aftoasa recidivanta (mucoasa mobila-vestibul bucal frecv)
  • herpes simplex (mici vezicule pe BP-muc fixa)
  • traumatisme tisulare
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16
Q

Tratament ulceratii mucoasa

A
  • simptomatic
  • protejare zona ulcerata
  • irigatii cu antihistaminic, AI, analgezic local
  • NU corticosteroizi
  • 7-10 zile dureaza ulceratia
17
Q

Tratament necroze mucoasa

A
  • 7-10 zile
  • detasare zone necrozate
  • mese iodoformate pt antisepsie
  • placa palatina acrilica pt epitelizre secundara
  • analgetice si AINS
18
Q

Unde se dezvolta procesul septic din injectite si cum se manifesta?

A
  • in spatiile pterigomaxilar, pterigo-mandibular, planseu bucal, obraz
  • se manifesta ca celulite infiltrative sau colectii supurate
  • la 2-3 zile de la punctie apare simptomatologia
19
Q

Etiologia trismusului

A
  • Punctia anestezica (pucntii profunde si repetate)
  • Hemoragia
  • Cant mari de anestezic local
  • Punctie septica
  • Ischemie prelungita
20
Q

Tratament trismus

A
  • Faza acuta: prisnite calde/analgezice, miorelaxante
  • daca nu cedeaza: midazolam sau alte benzodiazepine
  • mecanoterapie (ameliorare in 48 h)
  • DAca dupa 58-72 h nu se amelioreaza-proces supurativ- incizie si drenaj
  • daca nici acum nu se amelioreaza- posibila afectare ATM
21
Q

La cat timp se remit majoritatea paresteziilor persistente si ce nervi afeceteaza cel mai des

A

8 sapt, fara trat

n. lingual>NAI

adm vitamina b12

Chirurgie OMF (16 decks)

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