LA in kids Flashcards
dosage of lidocaine
4.4mg/kg
mepivacaine (scandonest): 4.4mg/kg
bupivacaine: 1.3mg/kg
articaine: 7mg/kg- not used in children below 3 (too well, too effective soft tissue, child confused and bite, dont use blocks cos higher chance of nerve damage)
remember 1 carpule how much LA
1 carpule 10kg
how much is 1%
10mg/ml
what is topical anaesthetic
benzocaine 20% gel but lidocaine (got added toxicity) Tac-20: 20% lidocaine, 4% tetracaine, 2% phenylephrine (compounded but cos lidocaine so we not good enough)
how to know topical works
dry mucous (later slide down throat), small amount, wait for 1min to achieve profound anaesthesia, wrinkling of mucosa
how to place child
supine
chin up (syringe out of childs line of vision
children eyes closed
assistant lean across chair or parent hold child hands
where to give buccal infil
give at mucogingival junction, not at attached gingiva
IDN block for kids
ramus under developed, give at occlusal plane
if you doing pulpot, give full cartridge
complications for LA
1:1200000 for smaller % LA
1:500000 for four % LA
soft tissue trauma are self limiting and heal wo complication, warn parents to stop them from chewing
use phentolamine mesylate injection to reverse LA in patients over 6 or at least 15kg, reduces effect of local
What is buffering LA
LA is weak acid, need to cross membrane then bind again
you can buffer a bit right before
computer assisted delivery
controlled delivery of LA with low and constant pressure
where to put cotton roll
buccal max and man, lingual,
2 for lower 1 for upper
cotton roll better or rubber dam better
rubber damn feels better?
can clamp before RD easy to see
clamp and RD useful for posterior molar
secure rubber dam with elasticity of rubber dam or floss
what rubber dam clamp
W2 for most primary teeth
12A and 13A for permanent molars (bigger side for buccal)
secure w floss the paeds way
what is isolite system
combine suction with cheek deflector and light, just costly
