- 치과용 Lidocaine 28 앰플로 국소마취 하에 1차 봉합한 악안면 심부 관통성 열창 -증례 보고-
- ㆍ 저자명
- 김종배,유재하,Kim. Jong-Bae,Yoo. Jae-Ha
- ㆍ 간행물명
- 대한치과마취과학회지
- ㆍ 권/호정보
- 2001년|1권 1호|pp.26-31 (6 pages)
- ㆍ 발행정보
- 대한치과마취과학회
- ㆍ 파일정보
- 정기간행물| PDF텍스트
- ㆍ 주제분야
- 기타
The wide deep penetrating wound of maxillofacial region should be early closed under emergency general anesthesia for the prevention of complications of bleeding, infection, shock & residual scars. But, if the emergency general anesthesia wound be impossible because of pneumoconiosis, obstructive pulmonary disease & hypovolemic shock, early primary closure should be done under local anesthesia by use of much amount of the anesthetic solution. The maximum dose of dental lidocaine (2% lidocaine with 1 : 100,000 epinephrine) is reported to 7 mg/kg under 500 mg (13.8 ampules) in normal adult. But the maximum permissible dose of dental lidocaine can be changed owing to the general health, rapidity of injection, resorption, distribution & excretion of the drug. The blood level of overdose toxicity is above $4.0{mu}g/ml$ in central nervous & cardiovascular system. The injection of dental lidocaine 1-4 ampules is attained to the blood level of $1{mu}g/ml$ in normal healthy adult. The duration of anesthetic action in the dental 2% lidocaine hydrochloride with 1 : 100.000 epinephrine is 45 to 75 minutes and the period to elimination is about 2 to 4 hours. Therefore, authors selected the following anesthetic methods that the first injection of 6 ampules is applied into the deeper periosteal layer for anesthetic action during 1 hour, the second injection into the deeper muscle & fascial layer, the third injection into the superficial muscle and fascial layer, the fourth injection into the proximal skin & subcutaneous tissue and the fifth final injection into the distal skin & subcutaneous tissue. The total 26-28 ampules of dental lidocaine were injected into the wound as the regular time interval during 5-6 hours, but there were no systemic complications, such as, agitation, talkativeness, convulsion and specific change of vital signs and consciousness.