Local Anaesthetic Techniques Flashcards
What are he two groups of local anaesthetics? Which is most commonly used?
Amide *** common
Ester
In terms of local anaesthetics with vasoconstrictors, what are the options?
None
Adrenaline
Felypressin
What are the two preservatives used in local anaesthetic?
Bisulphite
Propylparaben
What are the advantages of using a local anaesthetic with a vasoconstrictor?
Prolongs the effects of the anaesthetic by constricting the tissues and keeping it localised.
Allows a lower volume of LA to be used
Manages bleeding tissues - constricts the vessels and reduced blood flow to the area.
When should felypressin not be used and why?
In pregnant ladies - induces labour.
What component of local anaesthetic causes the most problems with allergy?
Preservative - propylparaben
What are the two types of injection using in local anaesthetics?
Infiltration
Block
Where is local anaesthetic deposited in a infiltration injection?
Around nerve terminals
Where is local anaesthetic deposited in a block injection?
Around nerve trunks
What does an infiltration injection anaesthetise?
Soft tissues
Pulp/teeth that are surrounded by thin alveolar bone.
e.g. lower anterior teeth and maxillary teeth.
What are the limitations of infiltration injections?
Only anaesthetise 1 or 2 teeth around the injection site
Cannot be used when infection is present.
What are the benefits of infiltration injections?
Easy techniques
Atraumatic to the tissues
In what medically compromised patients can infiltration injections be used?
haemophiliacs
What does an block injection anaesthetise?
soft tissue
pulp/teeth surrounded by thick alveolar bone;
i.e. posterior mandibular teeth and maxillary molars.
What injections are carried out to anaesthetise teeth in the maxillary arch (both infiltration and block) ?
Infiltration:
Buccal
Block:
Posterior superior alveolar block - all molars
Middle superior alveolar block - 1st molar, premolars and canine.
Anterior superior alveolar block - canine and incisors on the same side as the injection.
What injections are carried out to anaesthetise soft tissue in the maxillary arch ?
Buccal infiltration
Palatal infiltration
Where do you insert the needle in a palatal infiltration?
The midpoint between the gingival margin and the greatest depth of the palatal vault.
What injections are carried out to anaesthetise teeth in the mandibular arch (both infiltration and block) ?
Inferior alveolar nerve block - Molars and 2nd premolar
Mental/incisive nerve block - premolars and canine
Buccal/labial infiltrations - incisors and canine
What injections are carried out to anaesthetise soft tissue in the mandibular arch ?
Long buccal infiltration
labial infiltration
Mental nerve block
2nd half of the IDB - retract needle 2-3mm to anaesthetic the lingual nerve.
What size and colour of needle is used for an infiltration injection?
Short 25mm blue
What size and colour of needle is used for an block injection?
Long 35mm yellow
What landmarks are used when carrying out an IDB (Inferior alveolar nerve block)?
Coronoid notch of mandibular ramus
Posterior border of the mandible
Lower premolars of the opposite side
Pterygomandibular raphe.
In an IDB where should the needle be inserted in relation to the lower molar?
1cm above
6 -10 mm
In an IDB once the needle has been correctly positioned how much of the needle should be visible?
1cm
What should you always check before assembling the injection?
The date and batch on the cartridge!!!
Record both in patient notes.
