LOCAL ANAESTHETIC OSCE Flashcards
how do local anaesthetics work?
LA stops nerve conduction by blocking the voltage gated sodium channels
what can local anaesthetic molecules cause in the body?
badycardia and hypotension
what are some examples of ester LAs?
benzocaine
what are some examples of amide LAs?
- lignocaine
- prilocaine
- articaine
- bupivicaine
are LAs vasodilators or vasoconstrictors?
vasodilators
what other substances are usually found in LA solutions? give examples?
vasoconstrictors
- adrenaline
- felypressin
what are the Lignocaine preparations for dental injections?
- 2% lignocaine HCL
- 2% lignocaine HCL + 1:80000 adrenaline
what are the typical prilocaine preparations for dental injections?
- 4% prilocaine HCL
- 3% prilocaine HCL + felypressin (0.03U/ml)
who is felypressin not suitable for?
pregnant women (may infuce labour)
what are the two types of LA administrative techniques used in dentistry?
- inflitration
- block
how can the deposition of the local anaesthetic be desribed in the infiltration technique ?
LA solution deposited around terminal branches of nerves
how can the deposition of the local anaethstic be described in block techniques?
LA solution desposited around the nerve trunk
if you are restoring a tooth, what tissues should be anaesthetised?
- dental pulp
- soft tissues
if you are providing anaesthesia to the maxillary teeth dental pulp, what LA technique would be used?
buccal infiltration
if you are aiming to anaesthetise the maxillary teeth buccal ginigivae, what LA technique would be used?
buccal infiltration
if you are aiming to anaesthetise the maxillary palatal gingivae of a tooth, what LA technique would be used?
palatal injection
when would a mandibular dental block injection be used? (IDB/IAN)
to anaesthetise the pulp of the lower molars and second premolar
when would a mental nerve block techique be used?
when providing dental pulp anaesthetic to the lower premolars and canine
what LA technique is used to provide anaesthesia to the lower canine and insisors pulp?
buccal/labial infiltration
when providing anaesthesia to the buccal gingivae of the lower molars & second premolar, what LA technique is used?
long buccal infiltration
what LA techniques would be used to probvide anaesthetic to the buccal gingivae of the lower premolars and canine?
- infiltration
- long buccal infiltration
- mental nerve block
how would you anaesthetise the buccal gingivae of lower canines and incisors?
provide LA via buccal/labial infiltration
how is a lingual nerve block provided?
when performing an IDB/IAN, on removal of the needle the remaining LA solution is deposited as the needle is withdrawn to provide anaesthetic to the lingual nerve
how can the lingual gingivae of the mandibular arch be anaesthetised?
- lingual nerve block
- lingual infiltration
how would you perform LA on a patient who is nervous?
- relaxation techniques such as deep breathing/playing music
- distraction techniques (pressing another area of the mouth with back of mirror, wiggling toes, talking to them etc.)
- apply topical anaesthetic to the area to reduce pain
what are the steps of actually injecting the patient? (injection technique)
- position patient in chair
- dry mucosa & apply topical 1-2 minutes (pea sized)
- stretch mucosa and position needle at target point
- bevel of needle should be towards bone
- puncture mucosa quickly
- aspirate
- inject SLOWLY (no less than 30s)
why is it important to aspirate when providing local anaesthetic to the patient?
to ensure you arent injecting into a blood vessel
patient is booked for an extraction of their 14, what LA technique would you use?
- infiltration technique
What LA is CITANEST?
Prilocaine HCL 3%
- amide type LA
- comes in plain or with FELYPRESSIN 1.2 micrograms
What LA techniques would CITANEST be suitable for?
- infiltrations
- blocks
Who is CITANEST not suitable for?
Pregnant women
what is the max safe dose per kg for Lidocaine 2% plain/with epinephrine?
4.4mg/kg
what is the max safe dose for prilocaine 4% plain/3% with felypressin?
6.0mg/kg
what is the max safe dose per kg for Mepivicaine 3% plain/2% with epinephrine?
4.4mg/kg
what is the max safe dose per kg for Articaine 4% with epinephrine?
7.0mg/kg
what is the Max Safe Dosages equation for LAs?
(weight of person x dose) divided by mg per cart
how many mg of anaesthetic are in a 2% strength LA?
44mg of LA
how many mg of anaesthetic are in a 3% strength LA?
66mg of LA
how many mg of anaesthetic are in a 4% strength LA?
88mg of LA
