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BDS 2: Local Anaesthetic > Block Injections > Flashcards

Block Injections Flashcards

1
Q

What guides the decision for use of block or infiltration techniques on the mandible? (3)

A
  • Age of patient
  • Tooth of interest
  • LA agent being used
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2
Q

Where is anaesthetic deposited in the block technique?

A

Close to main nerve trunk

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3
Q

When is the block technique used? (3)

A
  • Alveolar bone is too thick to permit infiltration anaesthesia
  • Wider area of anaesthesia required with one injection
  • When its necessary to avoid area of infection
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4
Q

Which of the mandible or maxilla is more successful in anaesthesia

A
  • Maxilla more successful

- 1 in 5 Mandibular needs re-injection

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5
Q

Why is the success rate of inferior alveolar nerve blocks lower? (3)

A
  • Anatomical considerations in mandible
  • Greater depth of soft tissue penetration necessary
  • Administration must accurately deposit solution to within 1mm of target nerve
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6
Q

What do we need to do before a block technique procedure? (3)

A
  • Check medical history
  • Prepare correct equipment
  • Know anatomy of area
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7
Q

What is the needle dimensions in an inferior alveolar nerve block?

A
  • Long needle

- 27 Gauge

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8
Q

What position would you want your patient to be in for a block technique?

A
  • Slightly inclined

- Mandibular occlusal plane almost horizontal

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9
Q

What are the 6 steps in finding the Pterygomandibular space?

A
  • Locate the coronoid notch
  • Palpate the internal oblique ridge
  • Identify the pterygomandibular raphe
  • Locate the surface triangle
  • Locate the nerve
  • Pull back injection after hitting bone
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10
Q

What is the coronoid notch?

How do we locate it?

A
  • Greatest concavity on anterior border of ramus

- Using thumb of non dominant hand

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11
Q

How can you correctly angle a block injection to target the nerve in the pterygomandibular raphe?

A

By introducing the needle from over the premolars on the opposite side

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12
Q

What is the appropriate volume of solution to deliver for an inferior alveolar nerve block?

A

2ml

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13
Q

What are the 6 steps of an inferior alveolar nerve block?

A
  • Apply topical anaestehtic
  • Identify intraoral landmarks
  • Correctly position syringe
  • Needle entry and bony contact
  • Aspiration and delivery
  • Withdraw needle
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14
Q

Generally what is used for an inferior alveolar nerve block?

A
  • 27 Gauge
  • Long needle
  • 2% lidocaine (1:80000)
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15
Q

What can aid a block technique needle entry?

A

Stretching mucosa

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16
Q

During block technique needle entry what depth of needle is inserted?

A

15-25 mm

17
Q

What is the rate at which solution should be deposited in a block injection?

A

2ml over 60 seconds

18
Q

What could happen if your block needle is not angled enough? (over the incisors)

What do you do?

A
  • Lead to no bone contact
  • Might be in parotid gland
  • Take out and try again
19
Q

What do you do if your block needle is too angled? (Hits bone early)

A
  • You can keep needle in tissue but realign more posteriorly
    (Indirect technique)
20
Q

How can you check if an inferior alveolar nerve block is successful?

A

Ask the patient if their lip is numb

21
Q

What type of inferior alveolar nerve blocks should you avoid?

A

Bilateral IANBs

22
Q

Suggest how appointments involving inferior alveolar nerve blocks can be scheduled for full mouth root surface debridement (2)

A
  • 4 appointments for each quadrant (preferred)

- 2 appointments for each side

23
Q

What type of technique is an articaine infiltration?

What does it replace?

A
  • Supracrestal injection

- Replacement of inferior alveolar nerve blocks by buccal infiltration

24
Q

What needle is used for articaine infiltrations?

A
  • 27 Gauge

- Short needle

25
Q

Where is an articaine infiltration inserted?

A
  • 5mm below top of papilla

- 3mm away from gingival margin

26
Q

In a long buccal infiltration where is solution deposited?

A

In buccal sulcus distal to tooth of interest

27
Q

In a true long buccal block where is solution deposited?

A

Solution deposited at anterior aspect of mandibular ramus

28
Q

Where is solution deposited in a mental nerve block?

What encourages anaesthesia?

A
  • At mental foramen (between premolar apices)

- Massaging tissues

29
Q

How much solution is deposited in a mental nerve block?

A

1.5ml

30
Q

What does a greater palatine nerve block anaesthetise?

A

Hard palate from 3rd molar to canine region

31
Q

Where is the great palatine foramen located?

A

Palatally to distal aspect of upper second molar

32
Q

How much solution is deposited in a greater palatine nerve block?

A

0.2ml

33
Q

Where does the needle enter in a nasopalatine nerve block?

A

Near incisive papilla

34
Q

How much solution is deposited in a nasopalatine nerve block?

A

<0.2ml

BDS 2: Local Anaesthetic (5 decks)

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