Local Anesthesia Complications Flashcards
How can we get nerve damage ?
Local anesthesia deposition into nerve bundle
Due to physical : needle placement
Chemical concentration
Which nerve more prone to damage ?
Lingual in regional IAN
Which nerve prone to paralysis and how ?
Facial nerve , injection into parotid gland.
Halsted method, when extend the nerve beyond ramus
Check if he blink
How can we get Trismus ?
Mainly in medial pterygoid , penetration cause minor bleeding
Lead to muscle spasm
Need week
Intravascular injection
Avoid by aspiration
Systemic complications
Hear loss
Hemiparesis
How to manage anaphylaxis?
Epinephrine
O2
IV anti-histamines , cortisone ( reduce inflammation, edema, in airways improve respiration).
Beta agonists , albuterol relief breathing symptoms
How can we get infection
Contaminated needle
Which patient should not take vasoconstriction?
Cardiovascular disease
2)Hyperthyroidism: Patients with hyperthyroidism may be more sensitive to the cardiovascular effects of vasoconstrictors.
3)Pregnancy: Vasoconstrictors should be used with caution in pregnant women, as they can cross the placenta and affect fetal blood flow.
4)Allergy to vasoconstrictors:
What’s lidocaine optimal dose in childrens ?
1-2 mg/kg, up to a maximum of 4.5 mg/kg.
For children under 3 years old, the maximum dose should not exceed
2 mg/kg.
Mepivacaine doses for children’s ?
1-3 mg/kg, up to a maximum of 4.5 mg/kg.
Bupivacaine doses for children’s ?
0.25-0.5 mg/kg, up to a maximum of 2 mg/kg.
Articaine dose for children’s ?
0.5-1 mg/kg, up to a maximum of 4.4 mg/kg.
What’s the doses of lidocaine adults ?
Without Epi , 300
With 500
Without 4.4mg/kg
With 7mg
What’s the doses of mepivacaine adults ?
375
400
4.4mg/kg
With 6.6mg
Bupivacaine adults ?
75,150
3mg with
2.5 without
