Local Anesthesia Fundamentals

Question 1

What are the various types of topical anesthesias? What is the most common topical used?

Answer 1

Benzocaine

Spray, patches, liquids, gels, secondary syringe applicators, Oraqix gel

Question 2

What class of drug is benzocaine?

Answer 2

Ester

Question 3

What class of drug is lidocaine?

Answer 3

Amide?

Question 4

What are contraindications for local anesthetics?

Answer 4

Lactation, ester allergies, methemoglobinemia (blood oxygen disorder)

Question 5

What must be done to prep an area for local anesthesia?

Answer 5

Area must be dried

Question 6

How long do we wait for the topical to take effect?

Answer 6

1-2 minutes for lidocaine, minimum 1 minute for benzocaine

In lab we wait 1 minute, remove excess with cotton prior to injection

Question 7

What is the most common reason for topical anesthesia failure?

Answer 7

Insufficient time allowed for the topical to take effect

Some take 30 seconds, others can take several minutes

Question 8

What is an adverse reaction that can occur from topical anesthesia?

Answer 8

Localized edema following application of benzocaine

Question 9

What are the items in your armamentarium?

Answer 9

Syring, needle, cartridge, 2x2’s, mirror, cotton swab, topical

Question 10

What are the parts of a syringe?

Answer 10

Thumb ring
Finger grip
Spring
Guide bearing
Piston
Harpoon
Barrel
Needle adaptor

Question 11

What is the standard of care for dental syringes?

Answer 11

Aspirating
Breech loading
Metallic
Cartridge-type syring

Question 12

What is the purpose of a dental aspirating syring?

Answer 12

Permits ability of aspirating blood

Helps determine if the tip of the needle is located intravascularly

Question 13

How are needles generally categorized?

Answer 13

Length and diameter

Question 14

What are the three lengths of needles?

Answer 14

Long (32mm), short(20mm), ultra short (12mm)

Question 15

What are the needle components?

Answer 15

Needle shaft with beveled tip
Penetrating end
Syring adaptor
Needle cap

Question 16

Which way should the needle bevel be facing?

Answer 16

Toward the bone

Question 17

What are the most commonly used needle gauges?

Answer 17

25, 27 and 30. We use 25 and 27

Question 18

Needle cap colors can very between manufacturers and do not indicate length, but they will be color coded for gauge size, how do they code them?

Answer 18

Red= 25 gauge
Yellow= 27 gauge
Blue= 30 gauge

Question 19

Components of an anesthetic cartidge

Answer 19

Cylindrical gass tube
Stopper
Aluminum cap
Diaphragm

Question 20

Which vasopressor is used in local anesthetics and why?

Answer 20

Epinephrine, extends the working period of the drug

Question 21

What is included in a cartridge?

Answer 21

Vasopressor drug
Antioxidants as preservative
Sodium chloride- makes solution isotonic
Distilled water- dilutes and adds fluid volume

Question 22

What information is on the cartridge labels?

Answer 22

Trade and generic drug names
Drug concentrations
Dilutions of vasoconstrictors
Name of manufacturer
Expiration date

Color bands identify each drug

Question 23

What are the 3 anesthetics we use at CCP and their concentrations?

Answer 23

Articaine 4% w/ Epi 1:100,000-GOLD
Lidocaine 2% w/ Epi 1:100,000- RED
Mepivicaine 3% plain- TAN