Maxillary Anesthesia Flashcards
What nerve supplies the upper anteriors and the gingiva?
3-3 supplied by anterior superior alveolar nerve
What nerve supplies the premolars and the gingiva?
Middle superior alveolar nerve
What nerve supplies the molars and the gingiva?
Posterior superior alveolar nerve.
BUT
Mesiobuccal cusp of upper 6 supplied by middle superior alveolar nerve
What nerve supplies the maxillary sulcus?
Long buccal nerve
What nerve supplies the palate around the anterior?
3-3 supplied by incisive branch of nasopalatine nerve
What nerve supplies the rest of the hard palate?
Greater palatine nerve
What nerve supplies the soft palate?
Lesser palatine nerve
What is an advantage of blocks rather than infiltration regarding infection?
- An advantage of regional block is that because it anesthetizes a larger area, you can deposit it away from site of infection to reduce the chance of spreading the infection
How is a greater palatine nerve block given?
Given 1cm medial and adjacent to maxillary second molar.
When is greater palatine nerve block indicated?
When you have to do extensive palatal soft tissue surgery (reduces dose and more comfortable than multiple palatal infiltrations.
What is the concentration of lidocaine and adrenaline in lignospan?
20mg/mL lidocaine, 12.5micrograms/mL adrenaline.
What does a 2.2mL cartridge of lignospan special 2% contain?
44mg lidocaine, 27.5 micrograms adrenaline.
What are two anesthetics without a vasoconstrictor?
mepivicaine, prilocaine PLAIN
For what condition would it be good practice to reduce dose?
- Most drugs are broken down in liver via amidases. IN LIVER DISEASE, PATIENT WONT EFFECTIVELY BREAK THE DRIG DOWN AND YOU MAY GET HIGHER CIRCULATING DOSES. HENCE GOOD PRACTICE TO REDUCE DOSE.
What is the half life of articaine? Where is it broken down?
- Articaine broken down in PLASMA AND LIVER.
- 0.5 hours.
What should be avoided in pregnancy?
Articaine, felypressin (vasoconstrictor).
What are 3 advantages of vasoconstrictors?
- increase speed of onset
- extend duration of anesthesia (because it is taken up more slowly in the blood)
- lower blood levels of LA
What is the maximum dose of lidocaine?
4.4mg/kg up to a MAX OF 300mg.
A CARTRIDGE PER 10 KG, MAXIMUM OF 7.
When should lidocaine with adrenaline not be used?
- Severe cardiac dysrhythmia
- unstable angina
What is the concentration of articaine and adrenaline in septanest?
4%
40mg/mL 1:100,000 OR 1:200,000 adrenaline
Contents of a 2.2mL cartridge of 4% septanest?
88mg articaine in a 2.2mL cartridge.
Maximum dose of septanest 4%?
7mg/ kg up to a MAX OF 300mg.
4 indications to reduce anesthetic dose
- Liver disease (impaired metabolism)
- Calcium channel blockers
- Beta blockers
- Drug abuse
