local anesthetis how and why Flashcards
uses for LA
1) prevention of pain during treatment
2) relief of post surgical or other acute pain
3) localisation of pain for diagnosis
4) reduction of surgical haemorrhage (due to the vasoconstrictor found in LA)
general anasthetci
greater risk
contraindicated in patietns with underlying medical problems
LA
safe easy to use economical long operating time haemostasis
contra inducations for LA
unmangable patietns
injections into acute infections
possible risk of bleeding with IA block
types of LA procedures
surface
infiltrations
blocks
surface LA
- 5% lidocanine ointment
- 10% lidocaine spray
- ethyl chloride can also be used as it is very cold
infiltrations LA
usually between mucosa and periosteum
- effective with thin alveolar bone and vascular channels, and bone is porous so the anaesthesia can diffuse towards the pulp
block LA
required in md due to thick cortical bone with no vascular channels
equipment
asprirating needel
cartridge
types of needles
27 guage for blocks
30guage for infiltrations
nerves in the mx
branches of mx nerve plexus surroduning the bone on the buccal aspect innervte the teeth
- posterior superior alveolar nerve
- anterior supereior alveolar nerve
- middle superior alveolar nerve
palate nereves
anterior greater palatine nerves
nasopalatine nerevs
postiero superior dental nerve
block
rarelry necessary unless fialure of iniltration
insert adjacent to 8
infra orbital nerve blokc
block from just unde the orbit - LA diffuses into canal to anterior and middle superior alveolar nerves Intraoral - IO foramen palpated with finger - lip reflected with thumb
intrafilamentary injections
- use 30 guage needles, special short syringe (pistol or pen type)
- antiseptic to gingival crevise
- insert approx 2mm along PDL of each root
- inject slowly 0.2ml per 30 secs, max 0.4ml per root (must feel resistance)
- fast onset, high success rate
