2. Overview of LA Techniques Flashcards Preview

BDS2 CDS LA Symposium > 2. Overview of LA Techniques > Flashcards

Flashcards in 2. Overview of LA Techniques Deck (30):
1

Function of LA

To prevent pain

2

Definition of pain

An unpleasant sensory and emotional experience associated with actual or potential tissue damage

3

Function of vasoconstrictors in LA (2)

Increase length of action of LA
Encourage haemostasis

4

What is usually the source of LA allergy

Preservatives

5

Types of LA injections (2)

Infiltration
Nerve block

6

Process of LA infiltration

LA solution deposited around the terminal branches of nerves

7

Functions of LA infiltration (2)

Used to anaesthetise soft tissues
Used to produce plural anaesthesia where alveolar bone is thin

8

Process of LA nerve block

LA deposited beside nerve trunk

9

Functions of LA nerve block (3)

Abolishes sensation distal (more terminal) to site
Used to produce soft tissue anaesthesia
Used where bone is tooth thick to allow infiltration

10

Types of anaesthesia in the maxilla (3)

Anaesthesia of pulp - buccal infiltration
Anaesthesia of buccal gingiva - buccal infiltration
Anaesthesia of palatal gingiva - palatal injection

11

Types of anaesthesia in the mandible (3)

Anaesthesia of pulp - 6-8 (IDB), 3-5 (mental nerve block), 1-3 (buccal/labial infiltration)
Anaesthesia of buccal gingiva - 6-8 (long buccal infiltration), 3-5 (infiltration/long buccal/mental nerve block), 1-3 (buccal/labial infiltration)
Anaesthesia of lingual gingiva - secondary part of IDB if given/infiltration

12

The tissues to be anaesthetised depends on the procedure (3)

Restoration - dental pulp
Extraction - pulp/gingiva
Scaling - gingiva or pulp/gingiva

13

Types of syringe barrels and LA uses (2)

Infiltration - short 25mm 30G
IDB - long 30mm 27G

14

Important cartridge checks (2)

Check expiry date
Check batch number

15

Preparation of patient (4)

Check MH
Position in chair
Dry mucosa
Apply topical anaesthesia for 3-4mins

16

Types of topical anaesthetic (2)

2% lignocaine (minty)
20% benzocaine (bubblegum)

17

Injection technique (5)

Stretch mucosa
Puncture mucosa quickly (use distraction)
Position needle tip at target point
Aspirate
Inject slowly (no less than 30s)

18

Function of the bevel

To provide a cutting surface that offers little resistance to mucosa as the needle penetrates and withdraws from the tissue

19

Correct bevel orientation

Bevel towards operator during needle placement will leave the lumen unobstructed

20

Infiltration needle position (3)

Bevel away from bone
If bevel is towards bone, edge of the needle is likely to penetrate the periosteum
Periosteal injections are more likely to evoke a painful response

21

Definition of aspiration

Blood in cartridge

22

Importance of aspiration

Allows operator to check if they have perforated a BV (which would cause systemic effects)

23

Features of infiltration anaesthesia (2)

Pulpal anaesthesia limited to one/two teeth
Soft tissue anaesthesia

24

Advantages of infiltration anaesthesia (2)

High success rate
Technically easy
Atraumatic

25

Disadvantages of infiltration anaesthesia (3)

Infection
Dense bone (mandible)

26

Blocks in the maxilla (3)

PSA
MSA
ASA

27

Sharps disposal (5)

Needle is double clicked to prevent reuse and removed from handle
Needle and sliding sheath are placed in sharps bin (orange bin)
LA cartridge placed in blue bin
Bung is removed from handle and placed in clinical waste (orange stream waste)
Handle and tag are kept to be decontaminated (in dirty room/box)

28

Important landmarks for IDBs (5)

Coronoid notch of mandibular ramus
Posterior border of mandible
Pterygomandibular raphe
Lower premolar teeth of opposite side
Site of anaesthetic deposition is in the region of the mandibular foramen

29

Limitations of an inferior position of IDB (3)

Increased onset time
Increased lingual nerve injury
No change in intravascular injection

30

Confirming anaesthesia tips (3)

Ask how it feels (rubbery, numb, swollen/fat)
For IDB - tongue/lip to midline should feel numb
Consider testing with probe