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BDS3 OSCE > IDB > Flashcards

IDB Flashcards

1
Q

Describe placing an IDB.

A
  • use thumb to retract patient’s cheek
  • palpate the coronoid notch with thumb
  • locate pterygomandibular raphe
  • pull the mucosa tight and ask patient to open as wide as possible
  • approach needle from contralateral premolars
  • insert needle 1cm above last molar, in the triangle created by the raphe and coronoid notch
  • advance needle until bone contacted
  • retract 1cm and aspirate
  • slowly deposit LA
  • inject 2/3 of cartridge before beginning to withdraw depositing last 1/3 as lingual block
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2
Q

How do you check for anaesthesia of IAN?

A
  • ask patient how their face feels on that side (numb, swollen)
  • for XLA probe PDLs and mucosa
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3
Q

What needle is used for an IDB?

A

Yellow (long)

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4
Q

What LA is contraindicated for IDB?

A

Articaine

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5
Q

What should you check prior to placing LA?

A
  • date
  • batch number
  • LA type
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6
Q

How do you dispose of an LA needle?

A
  • ensure needle is locked (double click)
  • separate needle from cartridge if possible
  • needle placed in orange sharps bin
  • cartridge placed in blue sharps bin
  • if unable to separate, place everything into blue sharps bin
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7
Q

When is an IDB contraindicated?

A
  • absence of anatomical landmarks
  • infection in path of needle
  • bleeding disorder
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8
Q

When is prilocaine contraindicated?

A

When the patient is pregnant, and the solution contains felypressin

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9
Q

When is articaine contraindicated?

A

Preferably not used for IDBs

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10
Q

When is lidocaine contraindicated?

A

Liver disease (instead patients should be treated with articaine as it is metabolised in the plasma)

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11
Q

When is lidocaine with adrenaline contraindicated?

A
  • uncontrolled/unstable hypertension
  • cardiac disease (ie unstable rhythm)
  • advanced diabetes
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12
Q

What is the safe LA to give to renal patients?

A

Lidocaine

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13
Q

What is the safe LA to give to liver patients?

A

Articaine

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14
Q

What LA should be administered for XLA of lower teeth?

A
  • IDB
  • lingual
  • long buccal block (if posterior)
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15
Q

How do you administer a long buccal block?

A
  • retract cheek and pull tissues taught
  • insert needle parallel to occlusal plane, disto-buccal to the 7
  • advance needle 3-4mm
  • aspirate and deposit 1/4 cartridge
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16
Q

What LA should be administered for a restoration of a molar?

A

IDB

17
Q

What LA should be administered for a restoration with a matrix band of a molar?

A
  • IDB
  • lingual
  • long buccal block
18
Q

What needle is used for a long buccal block?

A

Yellow (long)

19
Q

What LA is indicated for a patient with hypertension or CV disease?

A
  • plain lidocaine
  • prilocaine
20
Q

What LA is indicated for a patient on beta blockers?

A

Prilocaine

21
Q

What LA is indicated for a patient on tricyclic antidepressants?

A

Lidocaine with adrenaline (2 max)

22
Q

What LA is indicated for a patient with a latex allergy?

A

Prilocaine

23
Q

What LA is indicated for a patient with controlled hypertension?

A

Lidocaine

24
Q

What LA is indicated for a patient on MAOIs?

A

Prilocaine

25
Q

What LA is indicated for a patient non-potassium sparing diuretics?

A

Prilocaine

26
Q

What LA is indicated for a patient who uses cocaine?

A

Prilocaine

27
Q

What is the first line LA?

A

2% lidocaine with 1:80,000 adrenaline

28
Q

What are common causes of allergies with LA?

A
  • latex bung
  • preservative
  • hypersensitivity to amides
29
Q

What is the max dose of lidocaine?

A

4.4mg/kg = 44mg/10kg
1 cartridge contains 44mg
=> 1 cartridge per 10kg

30
Q

What is the max safe dose of prilocaine?

A

6mg/kg = 60mg/10kg
1 cartridge contains 66mg
=> 1 cartridge per 10kg

31
Q

What is the max safe dose of articaine?

A

7mg/kg = 70mg/10kg
1 cartridge contains 88mg
=> 1 cartridge per 8kg

32
Q

What is the standard preparation of lidocaine?

A

2.2ml 2% lidocaine with 1:80,000 adrenaline

33
Q

What is the standard preparation of prilocaine?

A

2.2ml 3% prilocaine with felypressin 0.03units/ml

34
Q

What is the standard preparation of articaine?

A

2.2ml 4% articaine with 1:100,000 adrenaline

BDS3 OSCE (28 decks)

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