local infiltrated analgesia Flashcards
what are the cartridge contents?
Local anaesthetic agent
vasoconstrictor
Reducing agent: prevent oxidation of vasoconstrictor by competing with adrenaline for oxygen.
Preservative (without shelf life= 18-24mnths)
Fungicide (thymol)
Carrier solution (modified ringers lactate solution adjusted for biocompatible ph.)
name 4 analgesics
lidocaine, prilocaine, mepivicaine, articaine
describe lidocaine
2% soloution dissolved as hydrochlorite salt
Epinephrine 1:80000 concentration ~1hr
Plain soloution ~ 20 mins
Topical/injectable
describe prilocaine
3% soloution with octapressin
4% plain soloution
Less effective in controlling haemorrhage
Slight vasoconstriction
describe mepivicaine
2% with 1:100000 epinephrine
3% plain soloution
describe articaine
4% soloution + 1:1000000 or 1:2000000 epinephrine
Quickly metabolised.
describe epinephrine
More profound analgesia, longer lasting, haemostasis
Usually 1:8000
Naturally occurring hormone
describe felypressin
Similar to vasopressin
Comes in concentrations of 0.03iu/ml.
Not as effective.
precautions with LA
Prescription must be written and signed
Treatment plan must be up to date
Dentist must be on premises for IDB
contraindications to constituents of LA
Analgesics
Vasoconstrictors
Drug interactions
what can cause unwanted side affects
physical trauma inappropriate deposition toxicity underlying medical conditions felypressin and pregnancy drug interactions
explain inappropriate deposition of LA
Intravascular (epinephrine increases heart rate)
Intramuscular – trismus
Too fast- haematoma
explain toxicity with LA
Excitable tissues
Enough LA in cartridge to produce toxic levels of agent in CNS of children and small adults.
explain LA allergy
Rashes/diffivulty breathing
Latex- plunger
describe problems with medical conditions and LA
Liver disease- risk toxicity due to impaired metabolism
Cardiac disease- epinephrine avoided felypressin preferred
