Chapter 37: Anesthesia & Pain control Flashcards
The term used for temporary loss of feeling or sensation
anesthesia
the drugs that produce the temporary loss of feeling or sensation.
anesthetics
Methods of pain control used in dentistry to alleviate or reduce anxiety and pain include the following:
• Topical anesthesia
• Local anesthesia
• Inhalation sedation
• Antianxiety agents
• Intravenous (IV) sedation
• General anesthesia
• Mind-body medicine
provide a numbing effect in a specific area where an injection is to take place.
provide a temporary numbing effect on nerve endings located on the surface of the oral mucosa
topical anesthesia
The active ingredient in topical anesthetic
benzocaine or lidocaine
For today’s products, a gel type of topical anesthetic is to remain on the site of injection for a minimum of __ to __ seconds with a maximum of __ - __minutes to have optimum effectiveness.
15-30
1-2
agents that are applied to larger surface areas of the oral tissues. This type of anesthetic is useful when applied at the back of the throat in patients with a strong gag reflex
spray topical anesthetics
It should be noted that topical sprays can pose a potential danger if too much is administered.
t or f
true
(anesthetic would be absorbed into the bloodstream, possibly causing an irregular heartbeat and respiratory failure.)
most frequently used form of pain control in dentistry.
local anesthetic agents
is obtained by injecting an anesthetic solution near the nerve where treatment is to take place.
local anesthesia
The action of local anesthesia becomes reversed as the ______ carries away the solution, causing the patient to lose numbness in the area.
bloodstream
Local anesthetic solutions for dental use come under two chemical groups:
amides and esters.
Amide local anesthetics are metabolized by the ___,
ester local anesthetics are metabolized primarily in the ____.
liver
plasma
the length of time from injection of the anesthetic solution to complete and effective conduction blockage.
induction
the length of time from induction until the reversal process is complete
duration
• A short-acting local anesthetic agent can last approximately __ minutes.
30
An intermediate-acting local anesthetic agent lasts approximately __ minutes.
Mostly used for general dental procedures.
60
A long-acting local anesthetic agent lasts approximately __ minutes.
90
an agent that when combined with the anesthetic slows down the uptake of an anesthetic agent into the bloodstream and increases the duration of action.
vasoconstrictor
Types of vasoconstrictors used with local anesthetic agents include
epinephrine, levonordefrin, and Neo-Cobefrin
With the concentration levels of a vasoconstrictor, the smaller the ratio, the ___ the percentage of vasoconstrictor.
higher
the use of an anesthetic solution without a vasoconstrictor is recommended for patients with a history of _______
heart diseases
Three major types of local anesthetic injections are applied for the maxillary arch:
Local infiltration
field block
Nerve block
Local anesthesia injection techniques differ from mandibular approaches because of the
____ nature of alveolar cancellous bone in the ____.
porous
maxilla
completed by injecting the anesthetic directly into the soft tissue area of the nerve endings affecting a specific area;
local infiltration
refers to injecting the anesthetic near a larger terminal nerve branch affecting a larger surface area of the operative field. When two or three teeth are being restored, a ____ _____ is indicated.
field block
occurs when local anesthetic is deposited close to a main nerve trunk. This type of injection is indicated for quadrant dentistry.
nerve block
may be necessary for procedures that involve the soft tissues of the palate
local anesthesia in the palatal area
the type of injection that is frequently required for most mandibular teeth
block anesthesia
Inferior alveolar nerve block, often referred to as mandibular nerve block
the shorter end of the needle.
cartridge end of the needle
t is common practice for the _____ short needle to be used for infiltration anesthesia and the 1 5/8 -inch long needle used for block anesthesia
1 inch
1 5/8
the hollow center of the needle through which the anesthetic solution flows.
lumen
refers to the thickness or size of the needle.
gauge
The larger the gauge number, the ___the needle.
The smaller the gauge number, the ____the needle.
thinner
thicker
The most frequently used gauge numbers are :
25, 27, and 30.
are the single greatest risk for transmission of a blood-borne infection to a dental healthcare provider
Needle stick injuries
dentist will always
_____ before injecting any local anesthetic solution
This creates a negative pressure within the anesthetic cartridge.
aspirate
The effects of a local anesthetic agent may be delayed or even prevented if injected into an area of infection, such as an ____
abscess
Even slight contact with solutions that contain local anesthetic agents can cause____________, which is an inflammation of the tissues caused by an allergic reaction to the anesthetic solution.
contact dermatitis
a condition in which numbness lasts after the effects of local anesthetic solutions have worn off.
paresthesia
Inhalation sedation, also referred to as nitrous oxide/oxygen (N2O/O2)
______ , is a safe and effective sedation method used in dentistry for pain and anxiety
anelgesia
N2O/O2 analgesia is usually administered to a pregnant patient only after the first trimester and only with the permission of her obstetrician.
t or f
true
Any type of nasal obstruction, such as a head cold or allergies, can prevent the patient from breathing in and out normally and not be able to obtain the benefit of N2O.
t or f
true
N2O, chemical name
dinitrogen monoxide,
safest maximum allowable amount of N2O in the dental environment is :
50 parts per million (ppm
N2O/O2 sedation should begin with the administration of:
100% O2
The N2O/O2 analgesia should end with the administration of 100% ___ for 3 to 5 minutes.
O2
The N2O/O2 system must be equipped with a _______The use of this system reduces the N2O released into the treatment room, which escapes into the atmosphere and is then inhaled
scavenging system.
Drugs that are administered for the relief of anxiety are termed:
antianxiety drugs, or anxiolytics.
results in a minimally depressed level of consciousness.
IV conscious sedation
is a controlled state of unconsciousness characterized by loss of protective reflexes, including the ability to maintain an airway independently and respond appropriately to physical stimulation or verbal command.
General anesthesia
General anesthesia is most safely administered in a _____________ or ________ with the necessary equipment for administration and management of an emergency.
hospital setting or at outpatient surgical setting
a method of reducing anxiety and pain through different nonpharmacologic techniques
mindbody medicine
4 stages of anesthesia
- anelgesia
2.excitement
3.general anesthesia
4.respiratory failure/cardiac arrest
