Local Anaesthetics in dentistry Flashcards
What does analgesia ?
The reduction or elimination of pain in a conscious patient
What do local anaesthetics do?
They eliminate sensations, especially pain, in one part of the body by the topical application or regional injection of a drug
Are local anaesthetics reversible?
YES they are reversible lockings of nerve conduction
What do local anaesthetics block?
They block entry of sodium ions into cells
What are the 3 types of local anaesthetics?
- Ester based – largely superseded (Procaine)
- Amino-amides
- Articaine
Give some examples of amino amide local anaesthetics
(lidocaine, Mepivocaine, Prilocaine, Bupivocaine
What is the most common local anaesthetic we administer and what is the dosage we give?
Lidocaine 2% plain or with epinephrine 1:80,000
Describe the effect of Mepivacaine 3% plain 2% with epinephrine
It is plain and very short acting
How are local anaesthetics metabolised excreted?
- Amino amides are metabolised by the liver
2. Excreted via the kidneys
What advise do manufacturers say about the use of lidocaine?
manufacturers advise caution in patients with liver disease
Who should we avoid giving Felypressin?
Avoid in pregnancy
Who should we taken caution in giving Adrenalin / Epinephrine?
Care in ischaemic heart disease, hypertensives, unstable angina
What do Vasoconstrictors increase in local anaesthetics?
Vasoconstrictors increase duration and depth of anaesthesia and reduce local blood flow
How can the operator reduce the chances of getting a needle stick injury?
Do not re-sheath or re-use
Use safety-plus system
What are some reasons local anaesthetic might fail?
- Insufficient solution injected
- Inaccurate placement
- Intravascular injection
- Biological variation
- Anatomical variation
- Some teeth more difficult than others (lower laterals)
- Infection or inflammation
How can patients have an allergy local cal anaesthetics?
Usually due to preservative
Was more common to ester-type (benzocaine, cocaine procaine)