Local Anaesthetic Flashcards
Failure of anaesthesia may be due to patient variation what is this referring to?
size of the patient local anatomy accessory nerve supply drug metabolism speed of diffusion
Why might injecting into muscles lead to failure of anaesthesia?
By injecting into a muscle you increase the diffusion distance and barrier, making anaesthetic time and success more variable
During an ID block if there is no bone contact where may the needle lie?
In the medial pterygoid muscle
Why can infected areas lead to failure of anaesthesia?
The tissues tend to be a lower pH, the LA solution is consequently less effective.
There is also greater tissue vascularity, so more LA is taken away from the site it is needed.
Why is it important to inject into a site slowly?
As rapid injection and tissue expansion causes pain and could potentially lacerate the periosteum
What could laceration of a vein cause?
Rapid swelling
If LA is deposited into the parotid gland this could lead to facial paralysis how do you manage this?
Reassure the patient it will last 2-3 hours
Give Eye patch if the patient is unable to close their eye
What is trismus and how could this happen when giving LA?
Spasms of jaw muscles
Could be caused by a vascular bleed caused by the needle
Why should injecting into an infected area be avoided?
As infection can be spread into adjacent spaces
If a patient faints what should be your plan of action?
Make sure patient is supine to recover
What is the maximum dosage per kg for lidocaine?
4.4mg/kg
What is the maximum dosage per kg for articaine?
7mg/kg
What does the posterior superior alveolar nerve supply?
1st, 2nd & 3rd Molars
What does the middle superior alveolar nerve supply?
1st Molar & premolars
What does the anterior superior alveolar nerve supply?
Canines and incisors
What does the greater palatine nerve supply?
Palatal mucosa
What does the lesser palatine nerve supply?
Soft palate & uvula
What does the nasopalatine nerve supply?
Palatal mucosa
What does the inferior alveolar nerve supply?
All lower teeth
What does the mental nerve supply?
Buccal mucosa anterior to premolars and lower lip
What does the lingual nerve supply?
Anterior 2/3 tongue
What does the Mylohyoid nerve supply?
Lower molars
What does the long buccal nerve supply?
Buccal gingiva and mucosa opposite molars
Where is the point of entry for a IANB?
Midway between the internal oblique ridge and the pterygomandibular raphe
