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YR 3 - CSB > ORAL SURG - Complications of Extractions > Flashcards

ORAL SURG - Complications of Extractions Flashcards

1
Q

2 types of pain.

A

neuropathic
inflammatory

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2
Q

anxiety and bone removal .. pain

A

increases

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3
Q

what can be taken to prevent pain?

A

paracetamol
non-steroidal anti-inflammatories
opioids
steroids

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4
Q

what are analgesias?

A

AKA painkillers

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5
Q

what analgesias are recommended for extraction WITHOUT bone removal?

A

1g paracetamol every 6 hours
maximum 4grams/24 hours

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6
Q

what analgesias are recommended for extractions WITH bone removal?

A
  • 400mg ibuprofen every 6 hrs

if not enough

  • 1g paracetamol w/ 60mg codeine every 6 hours
  • max 4g paracetamol/24 hrs
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7
Q

what analgesias are recommended for complex surgeries - e.g. multiple tooth removal?

A

IV morphine
goes by patients verbal pain rating

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8
Q

what should the patient take for any mild pains?

A

paracetamol or ibuprofen

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9
Q

what should the patient take for mild-moderate pain?

A

paracetamol and ibuprofen

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10
Q

what should the patient take for moderate to severe pain?

A

paracetamol and ibuprofen and opioid

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11
Q

describe the post-op extraction swelling.

A

up to 72 hours
depends on procedure and on the patient

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12
Q

what should be asked in regards to bleeding?

A
  • any conditions underlying bleeding issues
  • pregnancy
  • tonsil issues
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13
Q

what conditions are at risk when there is bleeding?

A
  • liver disease
    -idiopathic thrombocytopenia purpura (ITP)
  • haematological malignancy
  • chronic renal failure
  • heart failure leads to liver failure
  • coagulation disorders
  • chemotherapy
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14
Q

which medications cause risk when bleeding? (4)

A
  • antiplatelets - aspirin and clopidrogel
  • anti-coagulants - warfarin, dabigatran, apixaban
  • cytotoxic drugs
  • NSAIDS
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15
Q

what should be the expected bleeding post-op?

A

minimal
- pressure for 30 mins with wet gauze
- wait for definitive clot formation
if there is bleeding after 12 hours = excessive

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16
Q

what can be done if there is a capillary bleed?

A

apply pressure

17
Q

what can be done if there is an arterial bleed?

A

apply pressure and consider cautery

18
Q

what if there is a bony bleed?

A

consider bone wax

19
Q

what is there is continuous bleeding and no haemostasis being achieved?

A

continue added pressure
contact local unit for advice

20
Q

which 6 groups might there be risk of post-op infection?

A
  • smokers
  • extreme age
  • inexperienced operators
  • poor OH
  • the type of surgery
  • immunocompromised patients
21
Q

5 signs of inflammation

A

heat - calor
redness - rubor
swelling - tumor
pain - dolor
loss of function - function leasa

22
Q

what can be 4 systemic signs of an infection?

A
  • tachycardia - more beats than usual
  • lymphadenopathy - swelling of the lymph nodes
  • pyrexia - fever
  • blood picture - assess the blood and if there are any abnormalities
23
Q

what is sepsis?

A

an life-threatening response to infection

24
Q

describe the acronym SEPSIS for the sepsis signs and symptoms

A

S - slurred speech
E - extreme shiver or muscle pain
P - passing no urine in a day
S - severe breathlessness
I - it feels like you’re going to die
S - skin mottled or discoloured

25
Q

what is alveolar osteitis?

A

dry socket, inflammation of alveolar bone
- when there is premature disintegration of the clot in the extraction socket

26
Q

what are the risk factors for alveolar osteitis?

A
  • surgical trauma
  • smokers
  • oral contraceptive pill
  • experience of the operator
  • prev history of dry socket
  • nutrient deficient
  • increased local fibrinolysis
27
Q

symptoms of alveolar osteitis

A
  • post op pain inside/around site of extraction
  • pain increases
  • disintegrated blood clot
  • may have halitosis
28
Q

how is alveolar osteitis managed?

A
  • confirm diagnosis
  • NSAIDS or paracetamol
  • irrigate with saline
  • dress with Alvogyl
29
Q

what is alvogyl? what is it combined with?

A

a dressing is used to help control hemostasis, foster healing

combine with a fern plant from Sumatra
- anti-septic properties

30
Q

describe the 3 ingredients of Alvogyl.

A
  • Iodophorm - antimicrobial
  • Butamben - anaesthetic
  • Eugenol - analgesic
31
Q

how do you reduce the risk of having extraction complications? (7)

A
  • knowledge of anatomy
  • discuss the risks and benefits
  • know LA technique to avoid nerve damage
  • informed consent
  • post op phone calls
  • post op advice
  • appropriate referrals if necessary

YR 3 - CSB (38 decks)

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