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FreakinLOCALanesthesia!!! > Day 3 - Local Anesthesia Complications > Flashcards

Day 3 - Local Anesthesia Complications Flashcards

1
Q

What is usually the cause of Facial Nerve (VII) paralysis? How can it be avoided?

A

introduction of LA into parotid gland posterior of ramus….CONTACT bone to prevent!

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2
Q

What is the duration of VII paralysis?

A

the duration of the soft tissue anesthesia

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3
Q

What are the 4 injection types at greatest risk for a hematoma?

A

1.IANB 2.Mental NB 3.IO NB 4.PSA NB

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4
Q

What is the best and IMMEDIATE mgmt of a hematoma?

A

pressure at the site for 2 min with ice

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5
Q

What do you avoid in the Tx of a hematoma? How long will it probably last?

A

avoid using HEAT on the area for 4-6 hrs…It should resolve in 7-14 days

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6
Q

What is PROLONGED anesthesia and a tingling/itching sensation?

A

PAR-esthesia

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7
Q

What is Painful sensation to non-noxious stimuli?

A

DYS-esthesia

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8
Q

What is Increased sensitivity to noxious stimuli?

A

HYPER-esthesia

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9
Q

What is a main concern of paresthesia (esp in kids)?

A

self-inflicted injury (biting)

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10
Q

Which nerve paresthesia would cause impaired taste via the lingual nerve?

A

CHORDA TYMPANI

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11
Q

Paresthesia: ______ gauge needles almost never totally sever a nerve….only damage a small portion of fibers

A

SMALL

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12
Q

Paresthesia: Pressure or chemically induced injury to nerve may develop from injection within the neural ______

A

sheath

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13
Q

Paresthesia: __% LA solutions have an increased incidence of paresthesia. Two examples are: ________ and ______

A

4%….prilocaine and articaine

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14
Q

MOST paresthesia develops in the ________

A

mandible (IA, lingual nerves) (so avoid using 4% prilocaine or articaine in the mandible)

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15
Q

“Electric shock” impingement on nerve by needle

􏰀 felt along peripheral distribution of nerve…_______ slightly before depositing solution

A

withdraw

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16
Q

Paresthesia: Explain that paresthesia normally persists for at least _______

A

2 months

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17
Q

Paresthesia: If present after _______ with little/no improvement, consider referral to oral maxillofacial surgeon, neurologist

A

3 months

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18
Q

_________: Motor disturbance of the trigeminal nerve, especially spasm of the muscles of mastication

A

Trismus

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19
Q

A possible cause of Truisms is Trauma to blood vessels of the ____________

A

infratemporal fossa

20
Q

_______: Limitation of mandibular opening, usually mild but may become chronic and severe

A

Trismus

21
Q

Trismus mgmt: Management: See patient and Prescribe:
􏰀 _____ therapy, analgesics, muscle _______ as needed,􏰀 exercise (open/close + lateral excursions) chewing ____, tongue depressors, Record in chart

A

heat….relaxants…GUM

22
Q

How long does Truisms usually last?

A

resolves in 48 hrs.

23
Q

What do you do if Truisms symptoms last longer than 48 hrs?

A

Consider an infection in the area and Rx antibiotics

24
Q

What do you do if all of your Truisms tx fail with in 1 week?

A

Refer to OMFS

25
Q

What is the key instrument to manage a needle break?

A

Hemostats or cotton pliers

26
Q

When would a Tonic clonic seizure typically occur after direct intravenous injection? When should it resolve?

A

5 seconds to get to brain…resolve in 30sec

27
Q

__________ should ALWAYS be included in local anesthetics unless there is a compelling reason to exclude them

A

Vasopressors

28
Q

To obtain full mouth anesthesia in the primary dentition, fewer than ___ cartridges of LA need be administered

A

2

29
Q

What is the safest anesthetic in pediatric dentistry? What is the maximum dose?

A

2% lidocaine with 1:100,000 epinephrine…Max dose: 1 cartridge/ 20 lbs body weight

30
Q

What is the acronym for managing a dental emergency/LA overdose? What does each letter mean?

A

P A B C D…..Position, Airway, Breathing, Circulation, Definitive care

31
Q

Without proper airway space, the pt cannot breathe and therefore becomes _______ (acidotic/alkalytic). What does this do to the amount of LA needed in blood to cause a seizure?

A

acidotic…DECREASES amount of blood needed to cause a seizure, so the next one is more intense

32
Q

There is NO _____, _____, or _______ justification for a dental doctor not being able to manage emergency situations which might arise during a patients treatment

A

moral, ethical or legal

33
Q

The most common cause of cardiac arrest in healthy children is ___________ or ______

A

AIRWAY OBSTRUCTION or apnea

34
Q

Irreversible CNS damage develops with anoxia in ___ minutes*

A

3 minutes

35
Q

IN GENERAL: are the signs of a MILD LA overdose typically more of a SNS response or PNS response?

A

More of a Sympathetic NS response: increased BP, HR,Resp, sweating, excitability

36
Q

IN GENERAL: are the signs of a MODERATE to HIGH overdose typically more of a SNS or a PNS response?

A

More of a Parasympathetic NS response: decrease BP, HR, Resp…general CNS depression

37
Q

Which has a greater risk for OD: Esters or Amides?

A

AMIDES (metabolized in Liver instead of blood, and therefore is in body longer)

38
Q

How much ug/mL of LA in blood is needed for Tonic-clonic seizure?

A

7.5-10ug/mL

39
Q

How do we prevent PAIN/Burning on injection?

A

Technique dawg! (pH of solution-go slower)

40
Q

What are two ways we can help prevent cheek/lip biting in kiddos after LA?

A

Anchor cotton rolls to their shirt and put them in their mouth..or OraVerse!

41
Q

What are the TWO LA’s that are category B in Pregnancy and are therefore safer to use? (the rest are C)

A

1.Lidocaine 2.Prilocaine

42
Q

What are the two LA’s with UNKNOWN crossing into mothers milk? What is the ONLY LA drug that is NOT SAFE during breast feeding?

A

Unknown: 1.Articaine 2.Prilocaine…NOT SAFE: Epinephrine-definitely travels to milk

43
Q

What is a NORMAL ASA status for a pregnant woman? What are risk factors for the higher ASA status woman?

A

ASA II is standard, no risks….ASA III for pregnant women with diabetes, previous miscarriages, spontaneous abortions

44
Q

How long does a methodoglobinemic take to have BROWN BLOOD post injection?

A

about 90 minutes

45
Q

In methemoglobinemia you inject a _____ drug into a _____ patient to make them turn ______….. What is the name of the drug, what does it do?

A

blue….blue….pink….methylene blue IV (1.0 to 1.5 mg/kg)…..converts methemoglobin to oxyhemoglobin

FreakinLOCALanesthesia!!! (11 decks)

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