Dental Anaesthetic Procedures

Question 1

Local anaesthesia is defined as..

Answer 1

• loss of sensation
• in a circumscribed area of the body
• caused by depression of excitation in nerve endings
• or an inhibition of the conduction process in peripheral nerves
• reversibly

(Just understand)

Question 2

What are the 4 methods of LA administration?

Answer 2

1. Topical
2. Infiltration
3. Regional nerve block
4. Intra-ligamentary injection

Question 3

Role of LA (list)

Answer 3

1. Decrease intraoperative & postoperative pain
2. Decrease amt of general anaesthetics used in the operating theatre
3. Increase px cooperation
4. Diagnostic testing/examination

Question 4

What are the 3 branches of the trigeminal nerve?

Answer 4

V1: opthalmic
V2: maxillary (all sensory)
V3: mandibular (sensory & motor)

*think maxilla cannot move but mandibular can move

Question 5

How do you check that IDN block has worked?

Answer 5

Check the lip

Question 6

Significance of the pterygomandibular space and its relations.

Question 7

[T/F] IDN is a sensory nerve

Answer 7

false
- is a mixed nerve

Question 8

Why is Articaine preferred in paeds?

Answer 8

• kids have very porous bone
• articaine has better bone penetration
• good for infiltration

Question 9

Bupivacaine is preferred for

Answer 9

• post-operative care
• issa a long acting amide LA

Question 10

Amide LAs are metabolised in..

Answer 10

Liver

Question 11

Mepivacaine cannot be used in

Answer 11

Pregnant women
- ask for lidocaine instead
- mepivacaine is class C

Question 12

We dont rlly use ester LAs in clinics anymore cuz..

Answer 12

Allergic rxns

Question 13

What are the 3 main purposes of vasoconstrictors given w LA

Answer 13

1. Prolong length of action & increase depth of action of LA
2. Reduce toxicity of LA
3. Haemostatic effect (reduces bleeding)

(If there is bleeding, first thing to do is inject vasoconstrictor in the area)

^ need to know for MCQs!

Question 14

What does 1:50,000 relate to

Answer 14

Aka 1g/50,000ml
= 1000mg/50,000ml
= 0.02mg/ml

Question 15

What does % mean in maximum doses LA

Answer 15

% means g/dL

1%=1g/dL
1%=10g/L
1%=10mg/mL

Thus, 2%=20mg/mL

Question 16

Max dose (just look at slide & understand)

Answer 16

• 1 carpule = 1.8cc
• 1:100,000=.01mg/ml
• 0.01 X 1.8cc= 0.018mg
• 0.04/0.018=2.22carpules

^ calc will be tested in exam

Question 17

[T/F] the larger the gauge the smaller the internal diameter of the needle

Answer 17

True
- larger the number, thinner the needle

Question 18

Long vs short needles used for..

Answer 18

Long: used for blocks
Short: used for infiltration

• usually only short for maxilla
• unless its a 8 on maxilla, may give exceptions

Question 19

Aspiration is needed for infiltration or block?

Answer 19

• only needed for blocks, not for infiltration
• make sure u arent injecting into blood vessels into systemic

Question 20

‘Always go higher & posterior’ for nerve blocks

Answer 20

• cuz nerve comes from the back

Question 21

Which infiltration injection hurts the most?

Answer 21

Nasopalatine
- when u poke a nerve is damn pain (same as when u do mental block n u poke the nerve directly, damn pain, will cry)

(Then palatal)
- cuz no space for bolus to go