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BDS Finals > Local Anaesthetic > Flashcards

Local Anaesthetic Flashcards

1
Q

Types of LA

A

Ester
Amide

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2
Q

Vasoconstrictor options (3)

A
  1. Adrenaline
  2. Felypressin
  3. None
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3
Q

Preservatives (2)

A

Bisulphite
Propylparaben

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4
Q

Who should felypressin not be used on

A

Pregnant individuals
Labour could be induced

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5
Q

Where is anaesthetic deposited in infiltration (2)

A

Around terminal branches of nerves
Bone must be thin to allow infiltration

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6
Q

Where is anaesthetic deposited in blocks (2)

A

Beside the nerve trunk
Used where bone too thick to allow infiltration

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7
Q

How to anaesthetise palatal gingivae

A

Palatal injection

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8
Q

What teeth pulp does an IDB anaesthetise

A

Lower molars and second premolar

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9
Q

How to anaesthetise pulp of lower premolars and canine

A

Mental (incisive) nerve block

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10
Q

How to anaesthetise pulp of lower canine and incisors

A

Buccal/labial infiltration

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11
Q

How to anaesthetise buccal gingivae of lower molars and second premolar

A

Long buccal infiltration
Not going to get everything with IDB

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12
Q

How to anaesthetise buccal gingivae of lower first premolar and canine

A

Infiltration OR
long buccal OR
Mental nerve block

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13
Q

How to anaesthetise buccal gingivae of lower incisors and canines

A

Buccal/Labial infiltration

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14
Q

How to anaesthetise lingual gingivae in mandible

A

Secondary part of IDB
Lingual infiltration

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15
Q

Citanest - vasoconstrictor (2)

A

Does not contain adrenaline
Can come with no vasoconstrictor

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16
Q

What will make topical anaesthetic more effective

A

Dry mucosa

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17
Q

General injection technique (5)

A
  1. Stretch mucosa
  2. Puncture quickly
  3. Aspirate
  4. Inject slowly
  5. Ensure correct bevel of needle
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18
Q

Bevel of needle

A

Thinnest part of needle enters mucosa first

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19
Q

Infiltration bevel

A

Bevel away from bone so as not to penetrate periosteum

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20
Q

Limitations of infiltration (2)

A

Infection
Dense bone

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21
Q

Buccal Infiltration technique (5)

A
  1. Stretch cheek
  2. Puncture mucosa with correct bevel
  3. Advance needle until over apex of tooth
  4. If contact bone, withdraw slightly
  5. 45 degree angle to bone
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22
Q

Can needles be placed in the orange bin

A

Yes, if empty

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23
Q

Where should a mental block be administered

A

Between apices of lower premolars

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24
Q

Landmarks for IDB (4)

A
  1. Coronoid notch of mandibular ramus
  2. Posterior border of mandible
  3. Pterygomandibular raphe
  4. Lower premolar teeth of the opposite side
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25
What is in the area of the site for IDB deposition
Mandibular foramen
26
How much of the needle should be in tissue for an IDB
3/4
27
Injection technique for IDB (5)
1. Thumb at anterior notch 2. Needle entry junction of buccal pad of fat and pterygomandibular raphe 3. Syringe lies over contralateral 5/6 4. Advance to bony contact then retract 1mm 5. 1cm of needle visible
28
Bony contact too soon for IDB
Reposition syringe barrel mesially
29
Secondary part of IDB
For lingual anaesthesia withdraw while injecting last 1/3 of solution
30
How does LA stop nerve conduction
Blocking voltage gated Na channels
31
LA in myelinated axons
Multiple nodes of ranvier must be blocked or the current could be strong enough to flow past one blocked node
32
Types of Ester anaesthetic (3)
1. Benzocaine 2. Procaine 3. Cocaine
33
Amide anaesthetics (4)
1. Lignocaine 2. Prilocaine 3. Articaine 4. Bupivicaine
34
Felypressin (3)
Vasoconstrictor Synthetic vasopressin Also called octapressin
35
Adrenaline effect on cardiac output
Increases
36
Adrenaline effect on mean arterial BP
Little or no effect
37
Noradrenaline effect on mean arterial BP
Increases Can result in a decrease as body compensates
38
Where are amide anaesthetics broken down
In the liver by liver amidases
39
Where are ester anaesthetics broken down
In the tissue by tissue esterases
40
Concentration of adrenaline in lidocaine
1:80,000
41
Maximum dose of lidocaine
5mg per kg body weight
42
Maximum adrenaline dose
500 micrograms
43
How much adrenaline does a cartridge of lidocaine contain
27.5 micrograms
44
Complications of LA - Local (9)
1. Prolonged anaesthesia 2. Trismus 3. Haematoma 4. Intra-vascular injection 5. Facial paresis 6. Broken needle 7. Infection 8. Soft tissue damage 9. Contamination
45
Complications of LA - Systemic (6)
1. Psychogenic 2. Interaction with other drugs 3. Cross infection 4. Allergy 5. Collapse 6. Toxicity
46
Potential drug interactions with LA (5)
1. MAOI 2. Tri-cyclics 3. Beta blockers 4. Non-potassium sparing diuretics 5. Cocaine
47
If a patient faints during LA
Differentiate between just fainting or toxicity and fainting
48
What block will anaesthetise all upper teeth on one side
Posterior superior alveolar nerve block
49
Cause of trismus after IDB (2)
Damage to medial pterygoid Injection too low or too rapid
50
Facial palsy vs palsy after stroke
True facial palsy will affect the forehead as well whereas palsy after a stroke may only affect either the upper or lower half of the face
51
Facial palsy after IDB cause
LA into parotid gland Injection too far posteriorly
52
Onset of facial palsy after IDB
Within minutes
53
Onset of truisms after IDB
Within hours
54
Management of trismus after IDB (3)
1. Reassurance 2. Muscle relaxant? 3. Anti-inflammatory
55
Management of facial palsy after IDB (2)
Reassurance Cover eye with pad until blink reflex returns
56
When should sharps be disposed of
When the patient is still in the dental chair
57
Sharps - ARC
Are you injured? Remove your gloves Check the area carefully
58
Chasing injection
Start with buccal infiltration, then papilla between 4 and 5 which will numb some of palate. Then palate which has been anaesthetised
59
Intraligamental anaesthesia (3)
1. Not recommended free hand for restorative work 2. Peripress syringe 3. If easy to inject, probably in the wrong place
60
Peripress syringe
Produce more pressure
61
Intraosseus injection (3)
1. Stabident perforator 2. Done if cheek, tongue and lip are all numb but tooth is not (pulp hyperaemic) 3. Inject directly into cancellous bone
62
Stabident perforator (2)
Cuts hole through mucosa into cancellous bone Attaches to slow speed
63
Topical Jet Injector (3)
1. Can cause burns in mucosa 2. Basically a compressed air pistol 3. Expensive
64
Advanced La techniques
Gow Gates Akinosi Technique
65
Gow Gates (2)
1. Needle goes in very high 2. Aim for neck of condylar process
66
Akinosi Technique (2)
1. Closed mouth technique 2. Sometimes used as stepping stone to infiltration
67
Constituents of LA (5)
1. Base 2. Reducing agent 3. Preservatives 4. Fungicide 5. +/- vasoconstrictor

BDS Finals (22 decks)

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