LA complications

Question 1

how may allergy affect LA administration?

Answer 1

allergy is rare but can occur

should send for patch testing

often was from the latex bung in the LA, often allergy is now the antioxidant in the LA.

Question 2

what neurological side effects may occur from LA administration? How would this be dealt with?

Answer 2

Psychogenic / stress

Light headedness, paleness and sweating,
Bradycardia and nausea
Pupil dilation

To help this, lay flat and raise legs, loosen clothing around the neck too

Question 3

how can LA toxicity occur? what might occur? how treated?

Answer 3

when too much local is given.

fainting or collapse
convulsions
respiratory depression
circulatory depression

give BLS

Question 4

what other issues (non allergy or toxicity related) may arise from LA? how may be avoided?

Answer 4

haematoma (bleed) and trismus (muscle spasm and contraction)

infection

prolonged anaesthesia (from injection right into nerve or from many injections)

get injection in right place!

ASPIRATE!

Question 5

what issues may arise from the vasoconstrictor?

Answer 5

sympathetic cardiac issues such as tachycardia

coronary dilation and muscle dilation of vessels

Issues with cardiac patients

Question 6

what is trismus, how may it occur and what should be done should it arise?

Answer 6

trismus is severe restriction of opening the mouth and may last weeks or months

caused by injecting directly into the nerve or many local injections

prescribe muscle relaxant (valium) and inflammatory meds.

Question 7

how can a stroke be identified vs facial palsy from local

Answer 7

local anaesthesia induced facial palsy - patients wont be able to utilise upper facial muscles whereas a stroke victim would.

Question 8

What should be a contra indication for epinephrine in patients?

Answer 8

Heart disease

Uncontrolled diabetes

Uncontrolled hyperthyroidism

Untreated or uncontrolled hypertension

Question 9

What is a contraindication of articane

Answer 9

Nerve blocks, not enough literature to back the safety / unsafeness of it

Question 10

What are possible side fx of local anaesthesia and its symptoms?

How would you treat this

Answer 10

Psychogenic stress

Pupil dilation, light-headedness, pallor, scratching, nausea, bradycardia.

Lay them flat with legs elevated, loosen clothing around the neck, maybe provide a sweet drink

Question 11

What may occur if too much LA is given?

What are the symptoms?

How treat?

Answer 11

LA toxicity

Convulsions, respiratory depression, lack of consciousness

Start BLS