The use of the combined anesthesia method using local anesthesia and percutaneous electroneurostimulation for dental implantation

Abstract

The purpose of the work: to conduct a comparative assessment of the adequacy of pain relief based on the study of the dynamics of pain indicators, the autonomic nervous system and the psycho-emotional status of patients with a combination of local anesthesia and percutaneous electroneurostimulation.
 Materials and methods. 40 patients aged 38 to 63 years took part in the study. The number of patients in the first group amounted to 20 people aged 38 to 63 years, and they all completed the study. In the first group, only local anesthesia (MA) was used by a 4% solution of articaine with epinephrine in a concentration of 1: 200000. In the second group, the number of patients was 20 people aged 38 to 60 years, and all of them also completed the study. In the second group — a combination of percutaneous electroneurostimulation (Chens) with subsequent local anesthesia (Chens+Ma); Electroneurostimulation was carried out using the EPB50-01 Electronics device (Russia), which generates bipolar asymmetric current pulses of 20 s and a frequency of 10 imp/s. The intensity of electroneurostimulation was selected individually until the patient achieve intense non -pain sensations.
 Results. The use of percutaneous electroneurostimulation potentiates the analgesic effect of local anesthesia in the intraoperative period and has a prolonged analgesic effect, which manifests itself in a decrease in the intensity of pain throughout the postoperative period. Analysis of the features of the action of percutaneous electroneurostimulation indicates that this effect is due to exacerbation of not pain sensitivity, but by sensitization (exacerbation of sensitivity) of non -column peripheral nerves and oral trigeminal core, transmitting signals from receptors that are excited with no damaging effects (touches, displacement of tissues). This sensitization can develop as a result of prolonged preliminary electroneurostimulation, which was carried out before the injection. Against the background of sensitization of sensation from any mechanical effects on the tissue, more acute will be perceived, which was evaluated by patients as more intense pain. This feature of the action of percutaneous electroneurostimulation must be taken into account when compiling methods of its application in clinical practice.
 Conclusion. The use of percutaneous electroneurostimulation creates favorable conditions for the period of adaptation and integration of implants in the early stages of the postoperative period.