LA complications

Question 1

Why should oxtapressin be avoided with pregnancy

Answer 1

Has the potential to induce labour

Question 2

What is the max recommended dose of LA for adults (70kg)

Answer 2

Mepivicaine 3% - 6 cartridges
Plain​

Lignocaine 2% - 7 cartridges
Adr 1:80,000​

Articaine 4% - 5 cartridges
Adr 1:100,000​

Prilocaine 3% - 8 cartridges
octapressin

Question 3

How is Maximum dose (safe) calculated for adults

Answer 3

LIGNOCAINE 2%​

​

Max Dose (mg) = Weight (kg) x MRD (mg/kg)​
= 70 x 4.5​
= 315mgs​

Volume (ml) = Max Dose / Concentration (mg/ml)​
= 315 / 20*​
= 15.75ml​
= 7 cartridges​

*2% solution = 20mg/ml

Question 4

Whta is the first line LA used in GDH

Answer 4

Lidocaine 2% with adrenaline

Question 5

What is the presentation of trismus

Answer 5

Difficulty opening mouth/moving jaw within a few hours of ID Block. May severely restrict opening and may last for weeks​

Question 6

What causes trismus

Answer 6

Probably damage (spasm or haematoma) to medial Pterygoid injection is too low OR too rapid​

Question 7

What is facial palsy

Answer 7

UNILATERAL MOTOR NERVE PARALYSIS WITHIN MINUTES OF INF. DENTAL BLOCKS

Question 8

What causes facial palsy

Answer 8

LOCAL INTO PAROTID GLAND INJECTION TOO FAR POSTERIORLY.​

Question 9

What complications can arise with intra-vascular injections

Answer 9

1. SKIN BLANCHING​
2. VISUAL DISTURBANCE​
3. AURAL DISTURBANCES

Question 10

What are systemic complications of LA

Answer 10

Psychogenic​

Interaction with other Drugs​

Cross infection​

Allergy​

Collapse​

Toxicity

Question 11

What are local complications of LA

Answer 11

Failure to achieve anaesthesia
Prolonged anaesthesia
Pain during or after injection
Trismus
Haematoma
Intra-vascular injection
Blanching​
Facial paresis
Broken needle​
Infection​
Soft tissue damage​
Contamination​