Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

24 Anesthesia and Pain Control > LA complications > Flashcards

LA complications Flashcards

1
Q

___________ anesthesia involves the deposition of local anesthetic solution into the cancellous bone that supports the teeth

A

intraosseous anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T/F a PDL injection will utilize the traditional syringe with a long needle

A

false. special syringe and a 27g short needle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what injection is useful for perio curettage and flap procedures

A

intraseptal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what angle is the needle inserted for an intraseptal

A

90 degrees to tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T/F you can make a small hole in the cortical bone and give local anesthetic to a given area

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

where will you inject for an intrapulpal injection?

A

inject into tooth (pulp chamber/canal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

if a mandibular infiltration is given; who will it work better in: children or adults? why?

A

children, cortical bone is less thick and more porous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what injection can you use for a troublesome mand. 1st molar

A

mylohyoid injection (~100% effective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some complications with intraosseous anesthesia?

A

Needle breakage
Facial nerve paralysis (CN VII)
Soft tissue injury
Hematoma
Nerve injury (CN V)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what do you run the risk of if you bend the needle?

A

breaking the needle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

if a needle will break where will it break?

A

at the hub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

if a needle breaks in the hard tissues or it’s hard to locate, what should you do?

A

refer
precedent to leave if retrieval appears difficult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

which nerve will be affected if local anesthetic is injected into parotid capsule?

A

hemifacial paralysis (VII)
V3 normal sensation
inability to voluntarily close eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what can happen if you give repeated palatal injections with vasoconstrictors?

A

prolonged ischemia to tissues/ tissue sloughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the post-anesthetic lesions that are usually secondary to trauma?

A

-Recurrent aphthous ulcer
-Herpes simplex
-Duration: 7-10 days regardless of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what should you remind the pt to avoid while numb?

A

not to bite lip/tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how does a hematoma occur?

A

nicking vessel during injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the most common hematoma sites?

A

PSA – visible extra-orally
IAN – visible intra-orally
Bleeding into surrounding tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what doe you do for management of a hematoma

A

Direct pressure
Tissue pressure (hematoma) on vessel
Ice to face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

with an IAN hematoma where should you put pressure

A

pressure to medial aspect of ramus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

with an ASA hematoma where should you put pressure

A

pressure over infra-orbital foramen

22
Q

with an mental hematoma where should you put pressure

A

pressure over mental foramen

23
Q

with an Long buccal or palatal hematoma where should you put pressure

A

direct pressure over inject site

24
Q

with an PSA hematoma where should you put pressure

A

more difficult management due to location of pterygoid plexus, posterior superior alveolar artery
-Located posterior, superior and medial to tuberosity
-Pressure – mucobuccal fold as far distally as possible
-Ice to face (heat causes vasodilation = bleeding)

25
Q

what is the most common cause of a lawsuit with anesthesia?

A

persistent paresthesia or anesthesia

26
Q

how can a local anesthesia solution become contaminated?

A

-Carpule sitting in alcohol – diaphram semi-permeable
-Alcohol -> neurolytic

27
Q

what happens if a pt feels an “electric shock”?

A

needle grazes sheath
could cause injury to nerve

28
Q

can local anesthesia itself cause persistent paresthesia or anesthesia?

A

yes

29
Q

can parasthesia or dysthesia go away?

A

it can

30
Q

what systemic complications can happen with anesthetic?

A

local anesthetic overdose
allergic reaction

31
Q

what are the predisposing factors for a local anesthetic overdose?

A

Age
Weight
Comorbid diseases
Other medications
Genetics - biotransformation

32
Q

what are the most common ages for anesthetic overdose?

A

extremes of age: youngest/oldest

33
Q

what is the rule of thumb of ~70kg refer to?

A

refer to how a susceptible a pt is to overdose on anesthetic

34
Q

what comorbid diseases make the pt more likely to overdose

A

Cardiac:
Congestive heart failure: decreased liver perfusion
Hepatic: biotransformation to inactive form
Renal: ESRD can lead to inadequate clearance

35
Q

what drug factors affect overdosing?

A

Vasoactivity/presence of vasoconstrictors
Concentration
Dose
Route of administration
Rate of injection
Vascularity of injection site

36
Q

if vasodiliators are present what will happen with anesthetic?

A

shorter duration

37
Q

how will the route of administration affect predisposing factors for overdose

A

-Intravascular injection
-High levels reached in short period of time = potential overdose
-Aspirate, aspirate, aspirate (ex)aspirating redundency

38
Q

what happens if too much benzocaine (hurricane) is used?

A

risk of methemoglobinemia: suspect if pulse oximeter is ~85% and not responsive to 100% oxygen

39
Q

T/F with methemaglobinemia the blood will go from Fe 3+ to Fe 2+

A

false
2 is us (ferrus), 3 is a crowd
from 2+ to 3+

40
Q

what is the tx of methemaglobinemia

A

Slow IV infusion of 1% Methylene Blue (1.5mg/kg) q4h if cyanosis is persistent or returns

41
Q

T/F local anesthetics exert a depressant effect on all excitable membranes

A

true

42
Q

what’s the first CNS step of someone who’s going into an overdose?

A

Excitability: talkative, irritable, agitated
Inhibitory impulse is depressed more than the excitatory impulse

43
Q

what’s the second CNS step of someone who’s going into an overdose?

A

seizure activity

44
Q

what’s the last CNS step of someone who’s going into an overdose?

A

generalized depression
Respiratory center in medulla oblongata - brainstem
Respiratory depression and resp arrest

45
Q

what happens to the cardiovascular system during an overdose?

A

-myocardium depression (shutdown of electrical activity)
-peripheral vasculature (hypotension)

46
Q

what’s the different levels of cardiovascular overdoses?

A

Overdose levels
Profound hypotension caused by decreased:
Contractility, cardiac output and peripheral vascular resistance

Lethal levels = cardiovascular collapse
Massive vasodilation, decreased contractility and heart rate (profound bradycardia)
In addition, Marcaine overdose may precipitate Ventricular Fibrillation (fatal V. fib)

47
Q

Overdose to the cardio-respiratory centers in the __________ will cause _____________ and (secondarily) ______________.

A

medulla oblongata, respiratory arrest, cardiac arrest

48
Q

what is present in anesthetic solutions that a pt can be allergic to?

A

ester, amides

49
Q

what is used as an antioxidant for vasopressors that pt’s can be allergic to?

A

sodium bisulfite

50
Q

what was removed form dental carpules, but is in multidose vials that pt’s may be allergic to?

A

methylparaben

51
Q

what is an allergy that can’t occur in humans

A

epinephrine (like being allergic to air)

24 Anesthesia and Pain Control (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions