Anesthesiology Flashcards
T or F: All local anesth. are weak bases
T
All local anesth. are synthetic except
Cocaine “Erythrocylon Coca”
All local anesth. are vasodilators except
Cocaine = Constriction
All local anesth are CNS, CVS depressant except?
Cocaine = stimulant -> sympathetics
Myelin sheath in CNS is produced by
OLIGODENDROCYTES
Myelin sheath in PNS is produced by
SCHWANN CELLS
if a patient is allergic to AMIDE and ESTER, administer:
1% Diphenhydramine
local anesth. Longest duration of action
BUPIVACAINE (Marcaine)
Anesth. used for patient with heart problems, hyperthyroid, vasoconstrictor is contraindicated
MEPIVACAINE (Carbocaine)
- vasoconstrictor: Levonordefrin
Amide with ester characteristic local anesth
Articaine (Septocaine)
most common adverse reaction of lidocaine (Xylocaine)
Syncope
1st management for syncope
Trendelenburg Position then Oxygen (O2)
local anesth that Causes ortho-tuludine -> methemoglobinemia
PRILOCAINE (Citanest)
Prilocaine metabolized in
Kidney and Lungs
Longest acting, longest duration, slow metabolism used for patients with trigeminal Neuralgia and contraindicated to pedo patient
BUPIVACAINE (Marcaine)
most potent vasodilator
PROCAINE (NOVOCAINE)
Duration of Local Anesth. Ultra-short acting
Procaine <30minutes
SHORT ACTING 45-75 minutes
2% Lidocaine with 1:100,000 Epinephrine
2% Mepivacaine with 1,20,000 Levonordefrin
Best topical Local Anesth.
Benzocaine
Tetracaine
Lidocaine
in a carpule of 2% lidocaine with 1:100,000 epinephrine, how many MG of Lidocaine and epinephrine would 1 carpule has?
2% Lidocaine: 36mg
1:100,000 Epinephrine: 0.018mg
ALWAYS REMEMBER! FORMER BOARDS.
Most commonly used syringe in dentistry
Metallic, Breach-loading, Aspirating
syringe forced through small openings
Jet injector
Most common area of breakage in needle
Hub
Adult IAN needle
G27 32MM Long needle
Pedo IAN needle
G27 20mm short needle
Intraligamentary needle
G30 15mm ultra-short needle
Glass tube with 1-2mm bubbles is normal because of?
Nitrogen
Glass tube with 4mm of bubbles is not to be used because of?
OXYGEN or Oxidized/Expired
Antioxidant/Preservative of local anesth
Sodium Bisulfite
Preservative of developer and fixer in roent.
Sodium Sulfite
what is the mechanism of .2MG citric acid in local anesth?
Stabilizer
Vasoconstrictor to the body, prolongs the effect of local anesth.
Epinephrine
What is the effect of Epinephrine in the BODY?
VASOCONSTRICTOR
What is the effect of Epinephrine in Local Anesth?
PROLONGS THE EFFECT OF LA
most commonly used vasoconstrictor in dentistry?
EPINEPHRINE
Mepivacaine contains?
Levonordefrin
Maximum dose of Vasoconstrictors to Healthy patients?
0.2 mg, 11 Carpules!
Maximum dose of vasocons. to CV patients?
0.04mg, 2 Carpules!
Temporary loss of pain sensation in a particular part of the body
Regional Anesthesia
Target of topical anesthesia
Free nerve endings
- sensory receptor for pain - present in PULP
Flooding the small terminal nerve endings
Local Infiltration “Paraperiosteal”
Close proximity to larger terminal nerve branches, common in maxillary. ASAN-MSAN-PSAN
Field block
Intraligamentary into the periodontal membrane space, common in children, complication of intraligamentary technique is?
Avulsion
technique into thin porous interseptal bone
Interseptal tech
Osseous structure: INTRAOSSEOUS
Into the pulp: INTRAPULPAL
ASAN blocking is common to cause
Ecchymosis
REMEMBER!
PSAN blocking is common to cause
HEMATOMA
remember please!
Penetrates posterior fiber of buccinator muscle / trumpeters muscle
PSAN!!! “TUBEROSITY BLOCK/ZYGOMATIC BLOCK”
Incisive papilla, central incisor landmark is
Nasopalatine nerve
nerve block for the extraction of 1st molar?
PSAN, MSAN, GREATER PAL/ANT. Pal. N.
most common location of mental foramen
Apical of mandibular 2nd PREMOLAR
most common supplemental blocking technique in mandible
Long buccal nerve technique
Highest degree of anesthetic failure
Standard/Classic IAN
target: Near mandibular foramen
location of needle: 6-10mm above occlusal plane.
Depth: 20-25mm depth
Bone Contact
Bone contact hit too soon, the tip of needle is located at?
Ant. of Ramus
No bone contact, the tip of needle is located at?
Parotid Gland
- will suffer facial paralysis (CN 7)
True mandibular technique is also called
Gow-Gates technique
- supine
common use for trismus, limited jaw opening, tmj prob..
Vazirani-akinosi technique also known as
Closed mouth technique
- semi-supine position
- most common cause of facial paralysis
most common cause of hyperventilation
Anxiety -> CARPOPEDAL SPASM
burning on injection is caused by
rapid injection
needle breakage is associated with this technique and 30 gauge needle
IAN technique
most common breakage - HUB
trismus upon IAN blocking
Internal pterygoid muscle
Infratemporal fossa - can cause trismus
prolonged anesthesia causes
Paresthesia
- nerve trauma: IAN
Transient cerebral hypoxia is known as?
Syncope
- most common cause of loss of consciousness in dental clinic
Carotid sinus syncope is common in?
Elderly
Most common type of syncope, triggered by dehydration, emotion, injection
Vasovagal Syncope/Reflex/Neurally Mediated
immediate management for syncope
Trendelenburg Position
Easiest to prevent complication
Needle breakage