LA Paeds Seminar Flashcards
La complacency
Which patients is fenypressin used in
Cardiac pt
With heart conditions / cant have adrenaline
LA techniques
- topical
- infiltration
- intrapapillary
- indirect palatal
- IDB
- intraligamental
Topical LA
20% benzocaine
Different flavours / allow plenty of time
If allergy to benzocaine
Ethyl chloride - very cold + can cause burn
Intrapapillary suitable for
Suitable for palatal analgesia for
- matrix bands
- rubber dam
- stainless steel crowns
- removal primary incisors and canines
Intrapapillary
- penetrate interdental papilla to depth 1-2mm
- needle and syringe are parallel to occlusal plane
- inject slowly
- advance needle slowly
Inject until blanching of palate observed
Repeat on other side
Indirect palatal
For removal of maxillary molars
Similar to intrapapillary but needle angled upwards
Can reinforce with direct palatal
IDB -adds
Mandibular foramen in child lower and deeper on internal surface
occlusal plane lower
Risk of trauma on lip for child - they start chewing
Intraligamental
- wand or extra short needle
Indications
- for XLA
- adjunct to failed IDB
- alternative to IDB
- bleeding disorder instead of IDB - avoid hitting artery / vein = haematoma
Intraligamental
Contra indications
- children at risk from bacteraemia - infective endocarditis risk
- cardiac arrhythmias / hypertension (for sol containing adrenaline)
Intraligamental technique
- give infiltration
- introduce needle into periodontal sulcus of mesial surface
- advance until resistance felt
