Local Anaesthetic Techniques

Question 1

What are he two groups of local anaesthetics? Which is most commonly used?

Answer 1

Amide *** common

Ester

Question 2

In terms of local anaesthetics with vasoconstrictors, what are the options?

Answer 2

None

Adrenaline

Felypressin

Question 3

What are the two preservatives used in local anaesthetic?

Answer 3

Bisulphite

Propylparaben

Question 4

What are the advantages of using a local anaesthetic with a vasoconstrictor?

Answer 4

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.

Question 5

When should felypressin not be used and why?

Answer 5

In pregnant ladies - induces labour.

Question 6

What component of local anaesthetic causes the most problems with allergy?

Answer 6

Preservative - propylparaben

Question 7

What are the two types of injection using in local anaesthetics?

Answer 7

Infiltration

Block

Question 8

Where is local anaesthetic deposited in a infiltration injection?

Answer 8

Around nerve terminals

Question 9

Where is local anaesthetic deposited in a block injection?

Answer 9

Around nerve trunks

Question 10

What does an infiltration injection anaesthetise?

Answer 10

Soft tissues

Pulp/teeth that are surrounded by thin alveolar bone.
e.g. lower anterior teeth and maxillary teeth.

Question 11

What are the limitations of infiltration injections?

Answer 11

Only anaesthetise 1 or 2 teeth around the injection site

Cannot be used when infection is present.

Question 12

What are the benefits of infiltration injections?

Answer 12

Easy techniques

Atraumatic to the tissues

Question 13

In what medically compromised patients can infiltration injections be used?

Answer 13

haemophiliacs

Question 14

What does an block injection anaesthetise?

Answer 14

soft tissue

pulp/teeth surrounded by thick alveolar bone;
i.e. posterior mandibular teeth and maxillary molars.

Question 15

What injections are carried out to anaesthetise teeth in the maxillary arch (both infiltration and block) ?

Answer 15

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.

Question 16

What injections are carried out to anaesthetise soft tissue in the maxillary arch ?

Answer 16

Buccal infiltration

Palatal infiltration

Question 17

Where do you insert the needle in a palatal infiltration?

Answer 17

The midpoint between the gingival margin and the greatest depth of the palatal vault.

Question 18

What injections are carried out to anaesthetise teeth in the mandibular arch (both infiltration and block) ?

Answer 18

Inferior alveolar nerve block - Molars and 2nd premolar

Mental/incisive nerve block - premolars and canine

Buccal/labial infiltrations - incisors and canine

Question 19

What injections are carried out to anaesthetise soft tissue in the mandibular arch ?

Answer 19

Long buccal infiltration
labial infiltration
Mental nerve block

2nd half of the IDB - retract needle 2-3mm to anaesthetic the lingual nerve.

Question 20

What size and colour of needle is used for an infiltration injection?

Answer 20

Short 25mm blue

Question 21

What size and colour of needle is used for an block injection?

Answer 21

Long 35mm yellow

Question 22

What landmarks are used when carrying out an IDB (Inferior alveolar nerve block)?

Answer 22

Coronoid notch of mandibular ramus

Posterior border of the mandible

Lower premolars of the opposite side

Pterygomandibular raphe.

Question 23

In an IDB where should the needle be inserted in relation to the lower molar?

Answer 23

1cm above

6 -10 mm

Question 24

In an IDB once the needle has been correctly positioned how much of the needle should be visible?

Answer 24

1cm

Question 25

What should you always check before assembling the injection?

Answer 25

The date and batch on the cartridge!!!

Record both in patient notes.