Hi guys

I'm doin a clinical attachment now at Guy's Hospital in London, and yeasterday during my visit to the oral surgery, there was a minor surgery (Apicoectomy) for the upper right lateral incisor.

I noteced that the surgeon did a local anaesthetic injection despite the presence of an abscess in the target area of injection. I was surprised from that and asked him how could we inject at an infecious inflammed area, ans answered me he had to do that in order to reduce the bleeding and gain a deep anaesthesia.

I don't know what's your opinion guys

waiting for participations

Yours

Wesam

المشاركة الأصلية بواسطة Wesambassout

Hi guys

I noteced that the surgeon did a local anaesthetic injection despite the presence of an abscess in the target area of injection. I was surprised from that and asked him [u]how could we inject at an infecious inflammed area[/U]

Wesam

مرحبا
أنا بعرف أنه ممكن تتخدر المنطقة المحيطة بالخراج فهو حسب ظني مادخل جوات الخراج و إنما فقط المنطقة المحيطة و هيك متلما قلك ممكن يستفيد من هل شي يقلل كمية النزف ( هاي إذا في ادرينالين أو مشتق لإله مع المخدر )

لما داومت بالرازي احياناً كانوا يخدروا المنطقة المحيطة بالخراج , و في دكاترة كانوا يقولوا لاء ما بنخدر بيجوز من الاسباب المنطقة الواسعة و الخوف أنو نالم المريض بأبر التخدير اكتر من يلي رح يتوجعه من شق الخراج !!

هادا يلي بعرفه مابعرف إذا بالاسنان غير حكي

Dear Elloni

Thanks for your responce

I'll tomorrow as a consultant in the maxillofacial surgery about this (I considered it important during the rountine dental practice) that I will attend an operation with him tomorrow

Thanks again

السلام عليكم..
أخي الغالي وسام..
الله يوفقك بالستاج الجميل، والله يرجعك إلنا بالسلامة، افتقدناك في المعسكر الإنتاجي..
أنا برأيي إنه إذا كان التخدير حول الخراج في منطقة لم يصلها الإنتان كافياً لتخدير المنطقة المطلوب جراحتها وزوال الحس فيها فهو كافي، أما إن لم يكن كافياً فنخدر أولا ً تخديراً ناحياً ثم إن أردنا يمكننا أن خدر حول الخراج لكي يقل النزف..
وبالتوفــيق إ ن شاء الله..
أخوك: عبد الحليم غريب - حلب - المعسكر الإنتاجي

it is the effect of the adrenalin which is clearly required in this case….
One of the most important rules during a surgery “Good Visibility" take always care of the visibility of the site
For the same reason that we anaesthetize the papillae in periodontal surgeries, to decrease the bleeding, if this is not done the site can be really messy so you can't do a good job.!!!!

local anesthesia is also recommended for patients that have coagulation Disorder per ex Even During General anesthesia when we have a bleeding risk!!!!!!!

when you will have the occasion to try with and without anethesia of the site you will see the difference beleive me.

Any way always remember that anesthesia is rarely effective in an inflammaotry terrain so Premedication is the only arm for you if want to have the operational silence

the vasoconstriction can theoretically (that remains to be confirmed in practice) reduce the diffusion of bacterias when operating on a contaminated site thanks to the vasoconstriction which decreases the blood flow naturally.

Thanks guys for your participations
Actually, I asked a consultant here about this case 2 days ago, he said there is no any problem from the injection at infectious inflammatory site as we inject at the peripheral are of an absces ... etc to reduce the bleedin (applying for the principle of ''Good Visibility'' and gain deeper anaesthesia and elongate the duration of the anaesthesia

So all of your previous opinions are completely right

Thank you