Anesthesia Armamentarium

Question 1

what is the local anesthetic armamentarium?

Answer 1

syringe
needle
cartridge (aka carpule)

Question 2

what criteria does the ADA require for syringes?

Answer 2

1. durable and withstand multiple sterilizations
2. accept wide variety of cartridges and needles
3. inexpensive, simple to use with one hand
4. effective aspiration, blood easily seen in cartridge

Question 3

what are the types of nondisposable syringes?

Answer 3

breech-loading metallic, aspirating
breech-loading metallic self-aspirating
breech-loading plastic, aspirating
pressure syringe for PDL injection
jet injector (needleless)

Question 4

what is the most commonly used syringe in dentistry?

Answer 4

breech-loading, metallic, cartridge, aspirating

Question 5

what are the advantages of the PDL syringe?

Answer 5

mechanical advantage - easier to administer
trigger permits measured dose
cartridge protected (cartridge break/shatter)

Question 6

where is the needle weakest?

Answer 6

at the hub

Question 7

as the gauge ________ the needle lumen diameter _________

Answer 7

decreases, increases
OR
increases, decreases

Question 8

what’s the main advantage of a smaller gauge needle?

Answer 8

less deflection (greater accuracy)

Question 9

what did the unpublished study by Monheim show regarding the gauge of needle with positive aspirations

Answer 9

25 - 100% positive aspirations achieved (preferred in high risk aspiration area)
27 - 85% positive aspirations
30 - 2% positive aspirations

Question 10

what length is the long needle?

Answer 10

32mm

Question 11

what length is the short needle?

Answer 11

20mm

Question 12

what length is the ultra-short needle?

Answer 12

10mm

Question 13

what are the two recapping options?

Answer 13

scoop technique
needle holder

Question 14

T/F you shouldn’t bend needles

Answer 14

True

Question 15

upon insertion the needle will dull after __________ penetrations

Answer 15

3-4

Question 16

how does the needle length affect deflection?

Answer 16

longer needle = higher deflection

Question 17

how does the angel of the bevel affect deflection?

Answer 17

greater angle = greater defelection

Question 18

what is the capacity for a cartridge or carpule?

Answer 18

1.8 (usual) or
1.7 (actually 1.76 mL)

Question 19

what does the aluminum cap of the carpule do?

Answer 19

hold diaphragm in place

Question 20

why should you not use carpule warmers?

Answer 20

breaks down epinephrine and it doesn’t work as well

Question 21

what should you do if the plunger is even or beyond the rim of the carpule?

Answer 21

discard it!

Question 22

a pt present to your office with a latex allergy and wants to make sure there isn’t any latex used for the dental procedure. you know that there is latex present on the anesthetic carpule so you __________

Answer 22

administer the anesthetic as usual. there are no reported/documented allergic reaction in studies or articles

Question 23

what are the contents of the cartridge?

Answer 23

local anesthetic drug
sodium chloride
sterile water
vasopressor (except in carbocaine)
sodium bisulfite
methylparaben (no longer, people had allergic reactions)