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BDS2 LA Symposium > LA in Children > Flashcards

LA in Children Flashcards

1
Q

why is LA used in children?

A
  • operative pain control
  • haemorrhage control
  • diagnostic tool
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2
Q

what is meant by surface anaesthesia?

A

anaesthesia of the surface tissues (e.g skin or mucous membranes)

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3
Q

what are the uses of surface anaesthesia?

A
  • to reduce pain of LA injection
  • to reduce discomfort of venipuncture
  • for superficial soft tissue manipulation
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4
Q

what are the two types of surface anaesthesia?

A
  • physical

- pharmacological

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5
Q

what is physical surface anaesthesia?

A
  • ‘refrigeration anaesthesia’

- reduces the temperature

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6
Q

what is meant by pharmacological anaesthesia?

A

topical anaesthesia

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7
Q

how deep do topical anaesthesias work?

A

2-3mm depth of tissue

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8
Q

what is the typical technique for applying topical anaesthesia?

A
  • dry area
  • apply over limited area (cotton wool)
  • apply for 2 mins
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9
Q

what are some commonly used intraoral topical anaesthetics?

A
  • lidocaine

- benzocaine

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10
Q

when is intra-oral topical anaesthesia used?

A
  • pre-injection
  • rubber dam clamp
  • placing matrix band
  • scaling
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11
Q

what are some means of non-pharmacological pain control?

A
  • TENS (transcutaneous electrical nerve stimulation

- Hypnosis

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12
Q

what does a TENS machine do?

A

blocks large myelinated nerve fibres and closes the gate to central transmission of smaller unmyelinated pain fibres

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13
Q

what is hypnosis?

A

an altered state of mine such that suggestions are accepted more readily and acted upon more powerfully

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14
Q

what are some common LA solutions?

A
  • lidocaine 2% with 1:80000 adrenaline
  • lidocaine 2% plain
  • prilocaine 3% with felypressin
  • articaine 4% with 1:100000 adrenaline
  • mepivicaine 3% plain
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15
Q

what is the usual half life of lidocaine?

A

1.5-2hrs

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16
Q

what type of LA is lidocaine appropriate for?

A
  • infiltration
  • block
  • surface anaesthesia
17
Q

what is the purpose of adding adrenaline/epinephrine to LA solutions?

A
  • adrenaline vasoconstricts arteries
  • reducing bleeding
  • delays the resorption of anaesthesia
  • doubles the duration of anaesthesia
18
Q

in what case would the use of Lidocaine not be advised?

A
  • patients with heart block & no pace maker
  • allergy to LA
  • hypotension
  • impaired liver function
19
Q

what is the half life of articaine?

A

20 mins

20
Q

why is the risk of systemic toxicity lower with articaine compared to other LAs?

A

it is hydrolysed by blood quicker

21
Q

what type of infiltration is Articaine more effective compared to lidocaine?

A

mandibular infiltrations

22
Q

in what cases should Articaine be avoided as a local anaesthetic?

A
  • sickle cell patients

- haemoglobinpathies

23
Q

what needle sizes (and their use) are used in LA for children?

A
  • ultra-short (infiltration)
  • short (infiltration)
  • long (ID block)
24
Q

when performing an intraligamental injection, what needle is used in children?

A

ultra short 32 gauge needle

25
Q

what is important to remember about the mandibular foramen in children compared to adults?

A

the mandibular foramen is LOWER in children than in adults

26
Q

if high levels of LA reach the cardiovascular system, what might occur?

A

circulatory collapse

27
Q

if large amounts of LA reach the CNS what might occur?

A

unconsciousness and respiratory arrest

28
Q

what is the maximum safe dose for Lidocaine 2% (plain/epinephrine)?

A

4.4mg/kg

29
Q

what is the maximum safe dose for Prilocaine 4% plain / Prilocaine 3% w felypressin?

A

6.0mg/kg

30
Q

what is the maximum safe dose for Mepivicaine 3% plain / 2% w epinephrine?

A

4.4mg/kg

31
Q

what is the maximum safe does for Articaine 4% with epinephrine?

A

7.0mg/kg

32
Q

what would a dentist do if they suspected LA overdose in a child?

A
  • stop dental treatment
  • provide BLS
  • call for medical assistance
  • protect patient from injury
  • monitor vital signs
33
Q

what are some LA complications that can occur post-procedure?

A
  • self-inflicted trauma (ulceration)
  • long lasting anaesthesia
  • trismus
  • infection
34
Q

why is it important to avoid IDB anaesthesia in patients with bleeding disorders?

A

can cause haematoma in the retromolar and pterygoid area (LIFE THREATENING if unnoticed)

35
Q

in terms of behaviour management, what is an important aspect that the dentist should AVOID?

A
  • bribing
  • coaxing
  • shouting
    etc.
36
Q

what behaviour management techniques are used in the clinic when administering LA to a child?

A
  • positive reinforcement
  • tell, show, do
  • distraction
  • voice control

BDS2 LA Symposium (5 decks)

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