Model plaster. Gypsum - Medical Encyclopedia

GYPSUM (Gypsum; CaSO 4 2H 2 O) is a mineral that is a hydrated calcium sulfate. Widely distributed in nature, used in honey. practice (see Plaster technique). Pure crystalline G. is colorless and transparent; in the presence of impurities, it acquires gray, yellowish, brown, pinkish, or other colors. Density 2.3 g / cm 3, solubility in water 2.05 g / l (at 20 °), in dilute hydrochloric and nitrogen acids - higher. In nature, it occurs in the form of gypsum dihydrate (CaSO 4 2H 2 O) and anhydride (CaSO 4). G.-dihydrate, known under the name of gypsum stone, serves as the main raw material for the production of gypsum binders. So called. burnt G., widely used in surgical practice and prosthetics as an astringent, consists mainly of calcium sulfate hemihydrate (CaSO 4 0.5H 2 O). This is a fine white or grayish powder obtained by partial dehydration of natural gypsum stone by heating it to 120-130°. A characteristic feature of calcium sulfate hemihydrate is its ability, after mixing with water to a creamy consistency, to form a plastic dough that can turn into a non-plastic mass within a few minutes: the so-called. setting - hardening as a result of crystallization. G.'s setting time depends on the quality of the raw material, the fineness of grinding, the firing conditions, the temperature of the mixture of burnt G. and water during mixing, the value of the ratio of water: G., the duration and storage conditions of the raw material. The hardening time can be adjusted with special retarding or accelerating additives. In dental practice, it is customary to use 3% solution of common salt or finely ground G., which forms crystallization centers, to accelerate setting, and 3% solution of glycerin or dextrin is used to slow it down.

A feature of burnt G. is an increase in its volume during hardening, sometimes up to 0.5% (usually less - approx. 0.1-0.2%) of the original, which contributes to the best reproduction of the relief of forms that have complex configurations, for example, casts of teeth, jaws, faces, etc. If necessary, G.'s waste can be regenerated by treating them with saturated steam in an autoclave or vulcanizer at 125-130 ° (which corresponds to a steam pressure of 1.2-1.5 am) for 4-5 hours.

Gypsum can cause chronic conjunctivitis, runny nose, weakening of the sense of smell, nosebleeds, dullness of taste, reddening of the pharynx, chronic laryngitis. The maximum permissible concentration of gypsum dust in the air is 2 mg/m 3 . In the industrial development of gypsum deposits and in the production of gypsum products, it is recommended to use respirators.

Medical gypsum is a white powder with a density of 2.66 - 2.67 g/cm2 with increased water absorption. When combined with water, water enters into a chemical reaction with it (2), as a result of which the gypsum molecules again become two-water and the entire mass passes into a solid state. The gypsum hydration reaction is exothermic.

(2) (CaSO4)2 -Н2О + ЗН2О -> CaSO4 -2H2O + t°

The speed of gypsum hardening depends not only on the conditions of gypsum firing, but also on the ratio of water and powder, mixing time, water temperature, as well as the admixture of certain substances to gypsum.

The ratio of water is calculated to 100 g of gypsum. For example, if 100 g of powder is mixed with 80 ml of water, then the ratio of water and powder (W:P) will be 0.8:1 (0.8), when mixing 100 g of powder with 45 ml of water, W:P will be 0, 45.

The B:P ratio is a very important factor that determines the physical and chemical properties of the final gypsum product. Along with the mixing time, the W:P ratio affects the setting time of the gypsum and its strength (Tables 4-2, 4-3).

Table 4-2. Influence of the ratio of water and gypsum powder (W:P) and mixing time on the setting time of semi-aqueous gypsum*

The rate of setting of gypsum is also influenced by the temperature of the water or solution used. Cold and hot water slows down, and water heated to a temperature of 37°C accelerates the hydration reaction (Sidorenko G.I., 1988).

Table 4-3. Influence of the ratio of water and gypsum powder (W.P) and mixing time on the strength of semi-aqueous gypsum*

When using gypsum as an impression material, it is advisable to accelerate the hydration reaction and reduce its strength. The curing time of gypsum can be shortened by the introduction of catalysts. Most often, sodium chloride NaCl is used as a catalyst, which is added to water in an amount of 2.5-3% by weight. In addition to sodium chloride, potassium chloride KC1, potassium sulfate KSO4, sodium sulfate NaSO4, potassium nitrate KNO3, and a number of other salts can be used as catalysts. Catalyst additions make it possible to reduce the strength of gypsum by 2 times and reduce the binding time of the material by 3 times (compared to type II gypsum used for making models).

To obtain a gypsum mass used as an impression material, it is necessary to mix the catalyst solution and the powder in a ratio of 1:2 - 1:1.33 (W:P = 0.5-0.75)1. The preparation of gypsum as an impression material is carried out in the following sequence (Fig. 4-3). A certain amount of catalyst solution is poured into a rubber flask and gypsum powder (4-3.1) is added in portions to it. Gypsum hydrolyses and

Rice. 4-3. Preparing plaster for impressions.

having a density of 2.67 g/cm2, it sinks to the bottom of the flask. The powder is added until a slight excess is formed above the surface of the water. When the gypsum is completely saturated with water, its excess is drained and the components are mixed until a homogeneous mass is formed (4-3.2). Completes the preparation of gypsum by thoroughly mixing the material with a spatula (4-3.3).

1 The ratio of water and powder must be specified separately for each batch of gypsum (taking into account grinding, composition, and other properties).

An excess of water in the gypsum material is undesirable, because, on the one hand, it lengthens the onset of the initial setting period, since many hardening centers are formed in this case, but they are at a great distance from each other for a long time and the gypsum dough is therefore too liquid. When the hardening centers approach, the setting period proceeds so quickly that the doctor does not have time to put the dough on a spoon and introduce it into the oral cavity. On the other hand, an excess of water in the gypsum dough also leads to the fact that between the gypsum molecules that have interacted with water, there is a large amount of free water. After the evaporation of water, pores form in its place, reducing the strength and quality of the gypsum part (G.I. Sidorenko, 1988).

The mixing time of the impression plaster should be 1 minute. The prepared mass is applied to a pre-selected metal impression tray without

Rice. 4-4. The sequence of removing a plaster impression from the oral cavity

perforations. Working time is 2-3 minutes. After 4-5 minutes from the start of mixing, the impression is removed from the oral cavity (Fig. 4-4). First, the impression tray (4-4.1) is separated and removed, then the plaster is divided into parts. For this, the index finger is placed on the vestibular edge of the impression in the region of the chewing teeth and a part of the impression is broken off by rotation (4-4.2). After separation of the first part, the finger is moved to another area and the next fragment of the impression is chipped off. The splitting of the impression can be facilitated by incisions in the plaster in the area of ​​the occlusal surface of the teeth. After removing the impression from the oral cavity (Fig. 4-4.3), its parts are installed in the impression

spoon (Fig.4-4.4). The spoon is wiped from pieces of gypsum present on the outer and inner surfaces. Remove small pieces of plaster from each part of the impression. Particular attention should be paid to cleaning the surface of the gypsum from the side of application to the spoon and along the lines of fractures. When assembling parts of a plaster impression, first large pieces with imprints of the palate or the lingual surface of the alveolar part of the lower jaw are placed in a spoon. Other smaller fragments are successively attached to them, guided by imprints and fracture lines.

After all the pieces are laid, the impression is evaluated. With a properly assembled impression, its parts fit snugly to the tray, the fracture lines exactly coincide without forming gaps (Fig. 4-4.5).

After evaluating the impression, they begin to fix its parts with the help of molten (boiling) wax (Fig. 4-4.6). Getting on the gypsum, the wax penetrates into its pores and reliably glues the impression.

The plaster impression before casting the model is kept for 8-10 minutes in a soapy solution. This is done to prevent the material from bonding to the model plaster.

The disadvantages of gypsum include its low accuracy in displaying the microrelief of the tissues of the prosthetic bed, its connection with the model material, the empirical dosage of the components, the lack of elasticity after hardening, and the impossibility of removing the material from the oral cavity as a whole.

The only positive property of gypsum is the absence of shrinkage of the material after removing the impression from the oral cavity and during its storage.

For a long time, gypsum was practically the only universal impression material. Currently, the medical arsenal has many new high-quality impression materials that have undeniable advantages over gypsum hemihydrate.

Gypsum, or calcium hydrogen sulfate, is a mineral widely used in construction, medicine, and sculptural casting. In finished form, it is a powder that is mixed with water, after which it gradually dries, acquiring high rigidity. Its color can be white, gray or with shades of brown, pink, yellow or red. The hardness of the mineral on the Mohs scale is 2 points.

Gypsum mining

The mineral occurs as inclusions in sedimentary rocks. Its particles are presented in the form of scaly or fine-grained masses. Its deposits are usually found in clayey sedimentary rocks. Outwardly, they resemble marble. The mineral is mined by mining. Underground deposits are broken off from the total mass by point explosions. The extracted gypsum stone is brought to the surface, after which it is ground into powder. Initially, it has a high humidity, so it is initially dried, and then baked for several hours. The gypsum leaving the kiln is already completely ready for use.

The technological process may include additional methods for cleaning the composition from impurities, which depends on the raw materials used. If the production of gypsum for medical purposes is required, then it is refined to a higher quality to increase its binding properties.

Advantages of gypsum as a material

Gypsum has a number of advantages that allow it to significantly outperform the vast majority of other materials used in construction, as well as other areas.

Its undeniable advantages include:

• Light weight.
• Easy mixing when preparing solutions.
• Fast freezing.
• Short drying time.
• Moderate hardness.

The undoubted advantages of gypsum include the possibility of its easy grinding. Thanks to this, you can correct the shape of the product made from it. Depending on the object or surface, this can be done, or special.

The listed properties, which are the advantages of the material, may differ depending on the degree of grinding, cleaning and the presence of plasticizers. It is usually classified according to the degree of compression. According to this criterion, there are 12 types of gypsum. This indicator measures the number of kilograms per square centimeter that must be applied in order to carry out the destruction of the material. The number in the nomenclature name indicates the given number of kilograms. For example, gypsum marked 5 has an upper compression point of 5 kg/cm².

Where is gypsum used?

There are 3 main areas of application of this material:

1. The medicine.
2. Sculpture.
3. Construction.

Medical use

Refined gypsum powder is used to create a bandage to block the limbs, which is necessary for the healing of broken bones. To do this, it is diluted in water, preparing a liquid solution. Bandages are soaked in it, with which the dressing is done. After hardening, the solution reinforced with bandages acquires rigidity, completely protecting the plastered limb from undesirable effects.

For medical purposes, only fine grinding of gypsum is used, which ensures high solidity after setting. In addition to its use in the treatment of fractures, it is also used in dentistry. With its help, casts of teeth are made for the further manufacture of implants. With the advent of more modern non-staining materials, this method is becoming a thing of the past.

Gypsum in sculpture

The use of gypsum has found its application in artistic creativity, in particular the creation of sculptures. For this purpose, high-quality grinding without impurities is used, similar to that in medicine. There are two ways to apply it. The first involves carving works from large gypsum stones, and the second is ordinary casting. Carving on gypsum is practically no longer used, since the resulting works have external defects, which is due to the heterogeneity of the natural material. In addition, this method of production requires great skill and significant time costs. It is much easier to pour gypsum mortar into molds. It hardens quite quickly, so that having an injection mold, such production can be put on stream.

Gypsum products are far from eternal, because their hardness on the Mohs scale is only 2 points, which is of course less than concrete, gaining 4-5 points. Under mechanical action, it is destroyed. Nevertheless, maintainability can be attributed to the advantages of gypsum, because products from it can be glued together, and the resulting seams are easily rubbed with emery cloth. After grinding, defects can be completely hidden with sufficient skill.

Construction use

Most often, gypsum is used to create plasters. Unlike cement or lime compounds, they have a more convenient consistency for work. At an average temperature of + 20 °, the duration of drying of such plasters is only 7 days. During this time, they fully gain their strength, which is 4 times faster than in the case of concrete.

Putties are also made from gypsum. They use a finer grinding fraction than plasters, due to which the resulting surface has a high smoothness. This is especially important if wallpapering is required, and even more so when painting.

Decorative products for decoration are poured from gypsum. It is made from:

• Wall 3D panels.
• Wall tiles.
• Stucco.
• Baguettes.
• Columns.
• Pilasters.
• Moldings.
• Ornaments.
• Designer outlets.

The vast majority of gypsum produced for construction purposes is used to make drywall. It is used as an even base for the rapid construction of interior partitions and suspended ceilings. Also, with the help of drywall, the large curvature of the walls is leveled.

Using plaster to create decorative elements

Gypsum powder is an excellent material for the production of interior decorations. Most often, 3D wall panels are made from it, as well as various products to imitate ancient architecture. With the advent of polyurethane, such interior items began to be made from it, but gypsum is still an affordable material that is used if you wish to make such decorations with your own hands. To do this, 3D molds made of plastic or silicone for casting are offered for sale at quite reasonable prices. When using them, pure gypsum compositions are used. Ideally, the sculptural variety is suitable, but its cost is too high, which is not economically viable. A better choice would be to use granular gypsum, sold in stores under the name alabaster.

For production, alabaster is diluted with water in equal proportions. The resulting liquid composition is poured into the mold, after which it is shaken to ensure the release of air bubbles. It is best to install it on a vibrating machine. Its presence allows you to prepare a solution with less addition of water, which in the future will positively affect the strength. The form is left until the alabaster sets. Usually in the summer, 25-30 minutes is enough for this. After removing the product from it, it is set to dry, and the form can be reused as many times as necessary.

Since the mold depth is usually about 20-25 mm, at an air temperature of + 20 °, the complete drying of the casting takes about 3 days. After that, the product can be used for its intended purpose.

When using molds, they must be lubricated to ensure normal casting output. This can be done with technical petroleum jelly, but the easiest and cheapest way is to use ordinary refined sunflower oil.

Features of working with gypsum plasters

Plasters based on gypsum can be applied to mineral surfaces. First of all, they are suitable for covering walls made of brick, concrete, aerated concrete, expanded clay concrete, etc. They are also used for leveling ceilings.

Although gypsum-based plasters and putties have good adhesion, surface preparation with a deep penetration primer is essential. This allows you to create an impermeable film between the base and the gypsum, preventing the return of moisture to the wall or ceiling. This ensures that during the drying period, the plaster will have enough water for the normal course of the chemical reaction of crystallization between the mixed grinding of gypsum. In the future, this will provide a higher hardness of the material and resistance to mechanical damage.

Typically, gypsum plaster can be applied to the surface with a layer thickness of 0.5 to 3 cm. Some manufacturers offer gypsum mixtures with the addition of special plasticizers and other impurities, making plastering with a large layer thickness quite possible.

Plaster based on gypsum is characterized by less pronounced slippage of the material. Due to this, they need less trimming of the influx. All this contributes to higher labor productivity in their application.

Gypsum is a material that easily absorbs moisture, therefore plasters and putties based on it are of little use for use in bathrooms. Under conditions of high humidity, the possibility of destruction of the layer increases many times over. To solve this problem, special moisture-proof polymer compositions are produced, but even with their use, cement plasters are still more reliable.

A, m. 1. Mineral of white or yellowish color (burned and crushed is used as a building material, in stucco work, for surgical dressings, etc.). Gypsum deposits. Stucco. Gypsum figurine. 2. usually pl. Small Academic Dictionary

Plastic gypsum for the leg and arm is still a completely new invention, which was invented as an alternative to standard gypsum. Nowadays, this tool is becoming more and more popular.

Plastic gypsum is a synthetic polymeric material that is gradually replacing conventional gypsum. You can buy it in specialized stores of medical equipment. Trauma centers and hospitals are increasingly purchasing them from specific manufacturers.

Fracture of the bones of the limbs is an all too common occurrence in our lives. Each time, doctors had to apply a standard cast, which in itself creates too much discomfort. This problem has been around for a long time, because ordinary gypsum gives too much discomfort, makes the patient suffer. In order to reduce pain, add flexibility, a new type of plaster cast was invented.

The bandage plastic devices produced today are called scotchcast and softcast. They are widely used. Medical organizations give the patient a choice between standard plaster and plastic.

The new bandage technology has other advantages. They are as follows:

1. The plastic shape allows the patient's skin to breathe, which is very important for the healing process.
2. The attending specialist can examine in detail the damaged area of ​​​​the limb. For this, X-ray machines are used. Moreover, the objective clinical picture as a result is not distorted in any way. The proportion of X-ray exposure is reduced.
3. When forming a synthetic bandage, a certain anatomical surface relief of a previously damaged limb is reproduced. A well-coordinated scheme does not give shrinkage typical of standard gypsum, beautiful laying gives a tangible plus. For variety, it is available in different colors for the choice of the patient, who himself chooses how his bandage looks.
4. Synthetic gypsum does not cause any allergic reactions, this is practically impossible when using it.
5. When wearing a plastic cast on a broken leg, regular shoes can be used, which is impossible or very problematic when wearing a regular cast.
6. The polymer structure of the bandage ligament ensures low material consumption during its use, which affects the weight.
7. If desired, a synthetic bandage can be wiped with a damp cloth; this cannot be done with ordinary plaster.
8. With plastic plaster, you can wash in the bath or take a shower.
9. A plaster bandage, consisting of plastic, does not stick to the hair, depriving the patient of this unpleasant effect.

This invention has a lot of advantages and, it would seem, there are no disadvantages. But they are. The disadvantages of this type of gypsum are as follows:

1. Possible atrophy of muscle tissue as a result of wearing such a bandage for too long.
2. The plastic form of gypsum cannot be cut with scissors if it is squeezing somewhere. This can only be done with a specialized saw. Ordinary gypsum can be easily cut with simple scissors, which is an undoubted advantage of the old technology.
3. The skepticism of many doctors towards the new technology, who believe that the old medical plasters still cannot be written off due to the fact that the new ones are too hard.
4. Too high price of new gypsum material.
5. Plastic technology must be applied by an experienced specialist, and this is quite expensive.

This is where the cons end.

What is duct tape?

The production of a fundamentally new technology eventually made it possible to apply special polymer bandages to a broken limb, which belong to a new type of means for immobilizing injured limbs. The plastic form of gypsum weighs 4 or 5 times less than usual. This not only reduces pain, but also adds the necessary flexibility when walking. Having a plastic device, you can safely go to the shower, which is a big problem with ordinary gypsum, since it crumbles, collapses when water penetrates, and can lead to the appearance of bloody blisters. Often the usual bandage needs to be redone.

Plastic plaster is used not only for fractures of the arm or leg - it can also be used for bone injuries in the area of ​​​​the foot, hand or shoulder. Regardless of what is broken - an arm or a leg - there is a way to fix the problem with minimal loss for the victim.

Read more about foot fractures here.

For injuries of a less dangerous nature, an elastic medical bandage is applied.

Also read about the use of corsets for compression fractures of the spine.

Softcast material

The production of plastic plaster devices is not limited to the scotchcast model. To date, alternative options have already been created for scotchcast. The patient can choose what he likes more and wear it for fractures of the limbs.

Softcast is the same plastic material as Scotchcast, but the cardinal difference is that softcast is a softer material. It is also called semi-rigid plastic, in which the mechanism allows you to create bandages of varying degrees of rigidity. That is, the patient himself can determine the degree of rigidity of the material applied to him.

The bandage is produced in the form of a roll of fiberglass fabric, which contains a polyurethane resin in its composition, which hardens well under the influence of water. The difference from the scotchcast bandage is that during the hardening process the material does not become completely rigid, but remains semi-rigid. This allows you to apply certain dressings that keep the muscle ligaments well in good shape, reduce the risk of swelling, atrophy, and significantly reduce the rehabilitation time.

They are breathable and water resistant, they can be easily cut with ordinary scissors, which is not possible with an adhesive tape bandage. They are much easier to take off. The material used has a unique property: it can be removed even without the use of scissors, simply by unwinding the bandage. The instructions for use tell you how to remove the bandage at home.

All this encourages patients to purchase a softcast to be applied to the arm or leg. These dressings are recommended when applying bandage layers in the following cases:

1. When applying a combined bandage according to the method of functional stabilization, in combination with a rigid form of adhesive tape. This combination is assumed when it comes to injury or disease of the lower limb ulcer in the foot area.
2. With damage to the ligamentous apparatus of the upper and lower extremities.
3. If the patient has undergone osteosynthesis, but only if indicated.
4. When it comes to a bandage for a child
5. If urgent plaster replacement is needed.

To apply a softcast bandage on an arm or hand, 3 or 4 layers of material are sufficient. The bottom one takes a little more, from 4 to 6 layers. The patient is offered a choice of different colors of the material.

Another interesting development in the field of polymeric materials was primcast gypsum, which has received a certain amount of popularity due to its qualities. Primcast material consists of a substance called polyester fiber. It differs from the fiberglass used in other gypsum devices. This material simply does not break down into small particles that can cause any irritation on the skin itself.

Primcast has the following characteristics:

1. Polyester material makes it possible to vary the tightening of the bandage at the time of its application to the damaged area, while the material itself does not foam.
2. The material has a different degree of rigidity, which is determined by the specialist and the patient. In total, there are 2 different stiffness options.
3. The mesh structure and a small amount of the polymer substance used allows for continuous gas exchange, improves blood circulation, which is especially useful for people with spinal cord injury.
4. The material is almost completely harmless to the body, does not cause side effects.
5. The effect of a muscle pump is realized, i.e. the decrease in puffiness is accelerated by 5 or 7 days, in the old technology this process takes 3 or 4 weeks.

To all of the above, it is worth adding that the use of Primcast materials has a tangible plus - relative cheapness. The average price of such material is from 1 thousand to 1.5 thousand rubles, which is really cheap for a new technology material.

Advantages of a turbocast

Another plastic material used as a plaster cast is turbocast. Its main property is that it is a low-temperature material used as a plaster cast. When heated to a temperature of 60 ° and up to 100 °, it takes its plastic form. When the material cools down a little, it makes it possible to apply the plaster material to the arm or other damaged area of ​​the upper or lower limb. Then it hardens, turns into a rigid, resistant structure.

To date, turbocast bandage is the newest and most expensive development in the field of gypsum technology. Its individual properties are as follows:

• very light weight, which gives tangible comfort to the patient;
• the presence of a plastic form of memory, i.e., a property of a material that allows it to return to its original form;
• the possibility of modeling;
• good compatibility with radiography, reduction of the radiation dose;
• absence of any toxicity and allergic reflexes;
• the absence of any reactions in contact with the aquatic environment;
• the presence of certain fixing devices that allow the gypsum carrier to independently remove it and put it on again;
• the material practically does not cause damage to muscle tissue;
• freely used for the child;
• the complete harmlessness of the material is a property that is extremely rare in medicine.

Turbocast is made from a material called polycaprolactone. This material is absolutely harmless to all living beings - people and animals. When using this material, such phenomena as itching, allergic reflexes, and a negative impact on a person's well-being are excluded.

This type of gypsum has only one drawback - it is expensive and its installation is also expensive. The average price for laying in the area of ​​the lower limb ranges from 16 to 17 thousand rubles. Imposition on the metatarsal bones will cost 17 thousand rubles. It will be cheaper to patch the radius or the elbow joint - it will cost about 14 thousand rubles. Prices are very high and they often scare away patients who prefer cheaper models.

Turbocast, despite its youth, quickly stepped into medicine and is widely used in 70 countries of the world, including Russia.

The cost of plastic plaster

The cost of plastic gypsum varies; the price depends on the part of the body for which it is needed, the material from which it is made, the medical institution that sells this orthopedic device.

It is cheaper to buy a cast for an arm than for a leg. The smaller the amount of material needed, the cheaper the purchase will cost.

Turbocast is considered the most expensive option. The polymer material used to create it is safe and does not cause discomfort to the owner. On the territory of the Russian Federation, you can buy it for 9000-15000 rubles.

Softcast made of polyurethane fiber is more affordable: its cost ranges from 2000 to 4000 rubles.

Cheaper than other options, Primkast, made of polyester, is an analogue of a plaster fixing bandage, which can be purchased for 1000-2000 rubles.

Intra Rich Cast Soft options also have a small price. This semi-rigid polymer bandage allows you to create bandages of varying degrees of rigidity, has a small mass.

Scotchcast is a bandage made of polymer material that provides air access to the limb. The disadvantage is the need to wear a special cotton stocking under it, which can cause discomfort. Its cost is approximately equal to the price of Softkast.

Additionally, you will have to pay for the services of imposing and removing the immobilizing device. The cost will vary depending on the hospital, region.

Blockade of the spine is a medical manipulation, which is intended for analgesia (pain relief) near the spine. With this procedure, an injection with an anesthetic is performed into the paravertebral zone in the area of ​​​​the exit of the spinal nerve to “turn off” the pain reflex. Additional substances, together with an anesthetic, help reduce swelling around the nerve and improve its nutrition.

Paravertebral blockades are used in medicine to prevent concomitant diseases (prolonged back pain leads to spasm of the back muscles, curvature of posture, which can further affect the health of internal organs).

Benefits of manipulation

There are a large number of methods for relieving pain, but not all give the desired effect in the treatment, and some have serious complications.

Paravertebral blockade has several advantages over other methods:

• The maximum proximity of the injection to the location of the nerve, which provides quick access to the affected area.
• The ability to use the method repeatedly.
• Fewer complications compared to other types of anesthesia.
• A quick analgesic effect, since the focus of pain and the nerve are in close proximity to the injection site.
• The measure of pain relief after blockade is significantly higher than after spinal or epidural anesthesia.

The attending physician determines the method of treatment, paying attention to the individual characteristics of the patient and the presence of relevant indications.

Indications

The blockade of the spine is one of the effective methods of treatment used for pain in the back and lower back. Such treatment is carried out exclusively according to the doctor's prescription, taking into account the general condition and data after the examinations.

Paravertebral blockade can become effective in the following processes, which are accompanied by severe pain:

1. With osteochondrosis, herniated disc, protrusions and other diseases of the spine.
2. With fractures of the ribs and injuries of the spine.
3. With pathologies of the peripheral nervous system (nerve infringement, neuralgia, sciatica).
4. During renal or hepatic colic.
5. With significant pain in the lower back, sacral back, myalgia.
6. During operations on the heart, kidneys, in the abdominal organs, cholecystectomy (as an addition to anesthesia).

Depending on the causes of pain in the back, lower back, the doctor may prescribe lidocaine or novocaine blockade.

The main cause of pain in our time is osteochondrosis, which can first affect only the cervical, thoracic, lumbar, sacral back, and after some time the process spreads to several departments at once.

cervical

Widespread blockade of the cervical spine due to an increase in the incidence of cervical osteochondrosis.

Often the cause of pain in the back of the head is irritation in the neck of the nerve root after deforming spondylosis, osteochondrosis, intervertebral hernia.

Osteochondrosis of the cervical region develops as a result of a sedentary lifestyle, spending a long time at a computer in a sitting position.

Types of blockade:

• Muscles of the anterior staircase.
• Greater occipital nerve.
• Articular.
• Star node.

To relieve pain, a pervertebral blockade with a solution of novocaine is used.

Thoracic

There are several types of blockade to remove pain in the thoracic region:

• Vegetative paravertebral.
• Costovertebral.

After the injection, the pain disappears almost immediately. The procedure is carried out every 2-3 days.

It must be remembered that manipulation can not only improve the patient's condition, but also turn out to be a factor in complications and even death, so it is dangerous for health and life to carry it out without special need.

Lumbosacral region

With pain in the spine, lower back, doctors often recommend a paravertebral novocaine blockade.

Varieties:

• Perineural foraminal selectin.
• articular blockade.
• Epidural.

With a hernia of the spine, an intercostal or epidural blockade is performed.

Diseases that are an indicator for the paravertebral anesthesia technique:

• Headache, facial pain.
• Neuralgia.
• Hernias.
• Osteochondrosis of the lumbar and other parts of the spine.
• Joint diseases.
• Strangulated peripheral nerve.

Which type of blockade to apply can only be chosen by the attending physician.

Contraindications

Blockades in neurology have a number of contraindications. They are divided into 2 groups: absolute (an injection is prohibited), relative (blockade is not recommended).

In what cases it is impossible to use this method of anesthesia:

1. Intolerance to drugs, hypersensitivity to them in history (especially when performing novocaine blockade).
2. Insufficiency of various organs (hepatic, renal, cardiac).
3. Reduced blood pressure.
4. Pathological processes in the central nervous system.
5. Tumors or an inflammatory process that is localized in the paravertebral space, in the intervertebral fissure.
6. Pregnancy period (any trimester).
7. Acute infectious processes.
8. Epilepsy.
9. Fever.
10. Violation of coagulation, hemorrhagic syndrome, treatment with prophylactic doses of heparin.
11. Wounds, injuries, pustular or inflammatory lesions of the skin of the back, where the injection should be made.

With caution, it is necessary to carry out injections for violations of posture, scoliosis, since the epidural cavity can be punctured.

Mechanism of action

The blockade develops due to the direct effect of a local anesthetic on the posterior (sensitive) roots of the spinal nerve, the connecting branches. The nerve at the exit from the spinal canal in the intervertebral fissure does not have epineural and perineural layers, which contributes to easy penetration of the anesthetic.

In addition, penetration of the substance into neighboring spaces is possible: around the heads of the ribs, into the epidural cavity, on the nerve nodes and plexuses - this contributes to increased anesthesia.

Penetrating to the nerve fibers, the anesthetic depresses the excitability of receptors and nerve conduction.

Execution technique

The blockade, regardless of which department it is used for (lumbosacral, cervical, thoracic), is carried out in 2 stages: preparatory and the procedure itself.

Preparatory stage: the skin of the back is treated with antiseptics (iodine solution, ethyl alcohol).

Preliminary anesthesia: injections are made with a thin needle to anesthetize the skin at 4 points lateral to the spinous process (distance 2 cm from the midline).

The blockade procedure itself: with a thick needle more than 10 cm, you need to puncture the skin of the back at the previously anesthetized point, slowly move the needle perpendicular to the skin until there is a feeling of resistance, move the needle slightly towards you, insert it at an angle above the injection site, after which slowly inject the anesthetic in the required dose.

How is the procedure carried out?

To relieve pain in osteochondrosis of the cervical region, the patient is laid on his side or sat down, asking him to slightly bend his neck. The injection is carried out in the area of ​​​​the sixth cervical vertebra.

With osteochondrosis of the thoracic region, an injection is made between T4 and T9, but if osteochondrosis affects other departments, then the puncture is performed below T10 - up to L2.

A lumbar block differs from a thoracic block in that the needle passes over rather than under the transverse process of the lumbar vertebrae.

When performing an injection in the lumbar back, the agent is often injected into the area of ​​​​the interspinous and supraspinous ligaments for greater effectiveness.

It is better when nerve anesthesia is performed under radiological control (to avoid the risk of epidural injection due to needle insertion through the intervertebral space).

Used drugs

During the procedure, a local anesthetic is used (more often novocaine or lidocaine blockade is performed) to relieve pain.

The concentration and type of product is selected strictly individually. With intense pain, use the maximum allowable dose.

The main drugs: lidocaine, novocaine, trimecaine, bupivicaine, carbocaine.

In addition to the main analgesic effect, anesthetics also have vasodilating, reparative, resolving, relaxing (on smooth and striated muscles) effects. These properties are useful for osteochondrosis, hernias, diseases of the spine.

To prolong the effect of novocaine blockade, adrenaline is added to the anesthetic, which has vasoconstrictive activity and thereby reduces resorption and the toxic effect of the drug.

To increase the effectiveness of treatment, other drugs are added to the solution: corticosteroids for additional anti-inflammatory and anti-edematous action; B vitamins for trophic, antihistamine and vasodilating action.

Complications

Like any manipulation, the blockade has a number of possible complications.

Among them, the most important are:

• Toxic (when prescribing a large dose of anesthetic, improper execution technique and administration of the drug into the bloodstream).
• Allergic (both delayed type - skin manifestations / swelling, and immediate type - anaphylactic shock).
• Puncture of cavities (pleural, abdominal, spinal).
• Traumatic (damage by a needle to a vessel with the formation of a hematoma / bruising / bleeding, a nerve with a violation of sensitivity / motor function).
• Vegetative-vascular reactions (sympathetic due to the introduction of adrenaline, and vagotonic due to the rapid rise to the feet after the administration of the drug: tachycardia / bradycardia, increased / decreased pulse, etc.).
• Inflammatory processes (meningitis, osteoperiostitis due to manipulation in non-sterile conditions).

To prevent some complications, premedication with sleeping pills, antihistamines is carried out. To avoid toxic complications, it is necessary to correctly calculate the dose of the drug, inject adrenaline into the solution.

It is important to carry out the manipulation strictly according to all the rules of asepsis.

After the administration of the drug, the patient is assigned to bed rest in order to avoid orthostatic collapse.

It must be remembered that the method of paravertebral blockade of pain refers to symptomatic methods of treatment, and therefore is insufficient to combat the disease. The doctor must prescribe adequate etiological and pathogenetic treatment.

In the period of remission after pain relief, additional methods of therapy are massage, physiotherapy, physiotherapy.

Chondromarin: instructions, price, reviews

Every year, due to diseases such as deforming osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and others, thousands of patients are forced to undergo surgery. At best, they are offered minimally invasive interventions, and at worst, endoprosthetics.

The very acceptance of the fact that you have to lie on the operating table literally unsettles you. That is why patients are forced to seek help from traditional therapists, nutritionists, massage therapists, rehabilitation therapists, and more.

But behind the banal fear lies the enormous harm that is done to health. After all, there are radiological criteria, indications and, in the end, protocols by which the progression of the disease can be restrained.
And then, as if by magic, you find the drug Chondromarin. Its name speaks for itself, and the effects are simply amazing: a complete cure for hernias, articular pathology and inhibition of oncological processes. Below we will consider Chondromarin, reviews about it, compare prices, and also study the instructions.

Panacea for patients: what kind of medicine is Chondromarin

With enviable frequency, the names of new medicines appear on the network, which are supposedly designed to make your life easier, get rid of "all" diseases, and even more - save you from surgery. But all this is lyrics, and we love naked facts.

So, Chondromarin is a biologically active agent that has a complex composition, and is also characterized by a chondroprotective, regenerative, and anti-oncogenic effect.

Consider the composition of Chondromarin:

• salmon milt nucleic acids (DNA);
• active ingredients from salmon cartilage;
• chondroitin;
• glucosamine;
• enzymes;
• trace elements.

It is specified that all active ingredients are fixed on a carrier (polyethylene oxide), which delivers the agent directly to the small intestine.

Nanomedicine: how Chondromarin components work

As specified on the official website, Chondromarin Cryptos helps with a number of diseases:

1) deforming osteoarthritis;
2) osteoporosis;
3) ankylosing spondylitis;
4) reactive arthritis;
5) chondrodysplasia;
6) oncological diseases;
7) intervertebral hernia.

You will learn all the details about the drug Chondromarin from the video:

The emphasis is on the fact that the components are delivered unchanged to the bloodstream due to the fact that they have a micromolecular structure.

After that, the substances are delivered directly to chondro- and osteocytes, supplying them with the necessary plastic material and stimulating regeneration.

In addition, the drug has a powerful anti-inflammatory effect, which is identified with the action of NSAIDs.
Another interesting effect is the inhibition of neoangiogenesis (vascular formation), which is important for the treatment of tumors of various origins. Moreover, patients with intervertebral hernias are promised a complete cure within 1-2 courses.

Course without surgery: how to take Chondromarin

Periodic or persistent pain, impaired mobility and decreased vitality - this is not the whole range of indications for the use of Chondromarin. The average course of treatment is 2-3 weeks.
After a short break, it can be repeated.
So, the price of Chondromarin currently fluctuates around $60.
In one package there are 70 capsules, which are most often taken according to this scheme (instructions for the use of Chondromarin):

• in the first 3 days, 1 capsule 2 times a day (drink plenty of water before meals);
• in the following days, take 2 capsules 2 times a day (for patients over 60, it is recommended to take 1 capsule a day).

Comparison with analogues, their price, composition and effectiveness

One package of Teraflex (120 caps) will cost you 1,500 rubles, 3-4 packages are needed for a full course of treatment, Teraflex should be taken for at least 3 months, otherwise the effect cannot be expected.

The drug has almost the same composition (chondroitin sulfate and glucosamine), many patients have already proven the effectiveness of the composition, only the number of capsules per course of treatment is embarrassing - about 400!

In turn, Don's course of treatment will cost about 4000-4500 rubles, but it contains almost 2 r more glucosamine.
The drug has a regenerative effect on cartilage tissue. If Chondromarin uses active substances from salmon fish and DNA, then Dona contains glucosamine, similar in composition to human.

In the vastness of the global network, there are quite conflicting reviews regarding the use of Chondromarin.
On the official website you can find information about the following positive aspects:

• pain reduction;
• restoration of cartilage structure;
• elimination of inflammatory reactions;
• improved calcium delivery;
• normalization of biological parameters of blood;
• low price of Chondromarin in comparison with analogues.

It is also specified that Chondromarin is an innovative drug that contains nanoparticles, due to which all components enter the bloodstream unchanged.

It should be noted that the drug has also passed clinical trials, the results of which go beyond conventional medicine.

So, after passing several courses of treatment with Chondromarin, a complete remission of diseases of the musculoskeletal system may occur.

Criticism: reviews of doctors

“There are no complaints about dietary supplements that were, are and will be on our market. But a serious problem is that patients are abandoning the main line of treatment in favor of a product containing substrates from fish cartilage, ”says a rheumatologist of the highest category.

The fact is that, taking only chondroprotective drugs, the patient loses valuable time, complex treatment is necessary.

“If the anti-inflammatory effect of Chondromarin can be explained, then there are many questions regarding its regenerative capabilities.

So, the ability to restore cartilage tissue is lost after 20-24 years, moreover, the drug is in a meager concentration in the synovial fluid, since the cartilage does not have its own blood supply.

I need more proof."

Moreover, there have been no official clinical trials and no FDA approval, which casts doubt on the effectiveness of the remedy.
Please note that today in medicine effective protocols are used to quickly diagnose and prescribe medication.