13. Local anesthesia in children and inflammatory diseases in the maxillofacial area.

Question 1

Increased potential risks associated with sedating pediatric patients for maxillofacial procedures

Answer 1

• Airway Susceptibility:
• Ventilatory Reserve: => less ventilatory reserve, leading to more rapid oxygen desaturation.
• Hypoxia and Bradycardia:
• Parasympathetic Innervation: => a quicker onset of bradycardia
• Cardiovascular Compensation: have less cardiovascular compensatory ability=> hemodynamic instability

Question 2

Why pediatric airway more susceptible to obstruction

Answer 2

• Anatomically smaller more reactive =>
• Swelling, secretions, or positioning

Question 3

Less ventilatory reserve in the context of pediatric patients

Answer 3

• Limited ability to increase their ventilation in response to hypoxia or hypercapnia=>
• Quicker oxygen desaturation during respiratory distress

Question 4

How rapid oxygen desaturation affects the pediatric patient

Answer 4

Lead to hypoxia=> bradycardia.

Question 5

Role of increased parasympathetic innervation in pediatric patients undergoing sedation

Answer 5

• More rapid onset of bradycardia
• Triggered indirectly by respiratory impairment or directly by the effects of sedative drugs

Question 6

How less cardiovascular compensatory ability affects pediatric patients during sedation

Answer 6

• More prone to hemodynamic instability=>
• CVS less capable of maintaining stable blood pressure and adequate perfusion =>
• When faced with stressors such as sedation

Question 7

Measures that should be taken to manage these risks in pediatric patients undergoing maxillofacial procedures

Answer 7

• Careful monitoring of the airway and breathing
• Use of appropriate sedative dosages
• Continuous monitoring of oxygen saturation and heart rate.
• Preparedness to manage airway obstruction and cardiovascular instability
• Adequate training for practitioners

Question 8

Maximum dose per kilogram of Procaine

Answer 8

• Children 7mg/kg
• Adults 10mg/kg

Question 9

Maximum dose per kilogram of lidocaine

Answer 9

• Children 4.4mg/kg
• Adults 7mg/kg

Question 10

Maximum dose per kilogram of Articaine (Ubistesin)

Answer 10

• Children 5mg/kg
• Adults 7mg/kg

Question 11

Maximum dose per kilogram of Mepivacaine (scandonest)

Answer 11

• Children 4mg/kg
• Adults 6.6mg/kg

Question 12

Maximum dose per kilogram of Bupivacaine

Answer 12

Adults 2.2mg/kg

Question 13

Maximum dose per kilogram of Procaine (Novocaine)

Answer 13

• Children 7mg/kg
• Adults 10mg/kg