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LA Symposium > Overview of Local Anaesthetics > Flashcards

Overview of Local Anaesthetics Flashcards

1
Q

what do you consider when choosing your anaesthetic?

A

type (ester/amide), vasoconstrictor (adrenaline/felypressin), preservative (propylparabens/bisulphites)

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2
Q

who do you never give felypressin to?

A

pregnant women

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3
Q

where is LA deposited in infiltration techniques?

A

around terminal branches of nerves

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4
Q

what is infiltration used for?

A

anaesthetise soft tissues, produce pulpal anaesthesia where alveolar bone is thin, maxilla, lower anteriors

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5
Q

where is LA deposited in a block technique?

A

beside nerve trunk

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6
Q

what is block used for?

A

soft tissue anaesthesia, where bone too thick for infiltration, mandible

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7
Q

what tissues do you anaesthetise for tooth restorations?

A

dental pulp, soft tissues (matrix band/rubber dam placement, haemostatic management in fixed pros)

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8
Q

what tissues do you anaesthetise for extractions and surgical procedures?

A

pulp, gingiva and surrounding soft tissue

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9
Q

what tissues do you anaesthetise for scaling?

A

gingivae, pulp

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10
Q

in the maxilla what type of injection do you use to anaesthetise the pulp and buccal gingivae?

A

buccal infiltration

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11
Q

in the maxilla what type of injection do you use to anaesthetise the palatal gingivae?

A

palatal injection

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12
Q

for anaesthetising the pulp of lower molars and second premolar what injection is used?

A

IDB

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13
Q

for anaesthetising the pulp of lower premolars and canines what injection is used

A

mental (incisive) nerve block

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14
Q

for anaesthetising the pulp of lower canines and incisors what injection is used

A

buccal/labial infiltration

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15
Q

for anaesthetising buccal gingivae of lower molars and second premolar what injection?

A

long buccal infiltration

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16
Q

what injection for buccal gingivae of lower first premolar and canine?

A

infiltration or long buccal or mental nerve block

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17
Q

what injection for buccal gingivae of lower incisors and canines?

A

buccal/labial infiltration

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18
Q

how do you anaesthetise lingual gingivae?

A

either second part of IDB by pulling out 1-2mm and injecting again to numb lingual nerve or use a lingual infiltration

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19
Q

what makes up an LA needle?

A

syringe (and bung), needle (and barrel), cartridge of LA solution)

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20
Q

what is the aspirating technique

A

pull back on syringe handle to see if needle is sitting in a blood vessel

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21
Q

what is the bevel

A

the point or tip of needle

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22
Q

what is the gauge?

A

diameter of lumen of needle, smaller the number the greater the internal diameter

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23
Q

what do greater gauge needles result in?

A

less deflection so greater accuracy, reduces risk of breakage, easier for aspiration

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24
Q

what is the length of a short needle

A

20-25mm

25
Q

what is the length of a long needle and what is it used for?

A

30-35mm for IDB

26
Q

what part of the needle should never be inserted and why?

A

the hub as it is the weakest point and most likely to fracture here

27
Q

what is the first step of LA preparation

A

collect syringe handle and needles

28
Q

what is the second step of LA preparation

A

collect selected LA cartridges

check batch, expiry date and insert into notes

29
Q

what is the third step of LA preparation

A

unpack everything

lay out so you can see everything

30
Q

what is the fourth step of LA preparation

A

record details for decontamination, put everything in the notes that you unpackage and pull off

31
Q

what is the fifth step of LA preparation

A

make up syringe handle

thumb ring and finger rest, attach silicone ring (bung) place broader end towards handle

32
Q

what is the sixth step of LA preparation

A

load cartridge of local anaesthetic solution in needle barrel
place aluminium cap end into needle

33
Q

what is the seventh step of LA preparation

A

connect syringe handle and local anaesthetic needle with cartridge
rubber bung goes into cartridge end and clicks into place, check for attachment by tugging

34
Q

what is the eighth step of LA preparation

A

prepare needle for use

pull back safety sheath and remove cap then pull sheath down so it clicks once

35
Q

how do you prepare the patient

A

medical history, position in chair, dry mucosa, apply topical for 1-2mins, breathing exercise to reduce pain perception

36
Q

what is the infiltration technique

A

stretch mucosa, puncture quickly, position needle tip at the target point (apex of tooth), bevel of needle towards bone, aspirate, inject slowly (no less than 30 seconds)

37
Q

what does infiltration anaesthesia give?

A

pulpal anaesthesia to one or two teeth, soft tissue anaesthesia, supra-periosteal

38
Q

what is the limitations to an infiltration

A

infection can limit effect, dense bone may limit effect

39
Q

how do you do a buccal infiltration

A

stretch cheek, puncture mucosa, advance needle until over the apex of the tooth, aspirate, inject, remove syringe, click down once, massage LA into tissue, wait 2 mins

40
Q

how do you do a palatal infiltration?

A

use short needle, apply pressure behind injection site with mirror handle, insert needle at 45 degrees angle, inject small amount, blanching occurs

41
Q

what does a posterior superior alveolar nerve block achieve?

A

LA in first, second and third molars

42
Q

how do you perform a posterior superior alveolar nerve block?

A

insert needle mesio-buccally over maxillary 2nd molar,

43
Q

how do you perform a middle superior alveolar nerve block?

A

insert needle mesio-buccally over 2nd premolar

44
Q

what does a middle superior alveolar nerve block achiever

A

anaesthetic over 1st molar, premolars and canine

45
Q

what does an anterior super alveolar nerve block achieve?

A

anaesthesia of maxillary incisors and canine on side of delivery

46
Q

how do you perform anterior superior alveolar nerve block

A

mesio-buccal fold over 1st premolar

47
Q

what does the greater palatine nerve supply?

A

posterior portion of hard palate and overlying soft tissue from first premolar to midline

48
Q

what does the nasopalatine nerve supply?

A

anterior portion of hard palate bilaterally from 4-4

49
Q

how do you dispose of sharps

A

handle off, everything in box with needle double clicked, if cartridge still has LA then it goes into blue lid box

50
Q

where is the mental nerve?

A

between apices of lower premolars

51
Q

how do administer lower buccal infiltration

A

slightly distal to tooth to be treated

52
Q

what are the landmarks for IDB?

A

coronoid notch of mandibular ramus, posterior border of mandible, pterygomandibular raphe, lower premolar teeth of opposite side,

53
Q

where do you place your hands for an IDB?

A

finger of non-working hand on posterior border, thumb of non-working hand on coronoid notch

54
Q

where does the cartridge go when doing IDB?

A

over premolars on opposite side

55
Q

what is the limitations of IDB?

A

increased onset time, increased lingual nerve injury, no change in intravascular injection

56
Q

where do you inject with an IDB?

A

6-10mm above occlusal plane, inject halfway between ptergomandibular raphe and coronoid notch

57
Q

if you have no bone contact with IDB how do you reposition

A

distally over premolars

58
Q

if you have bone contact too soon with IDB how do you reposition

A

mesially over premolars

59
Q

how do you confirm anaesthesia

A

ask patient how it feels (rubbery, numb, tingly, swollen, fat)

LA Symposium (7 decks)

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