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2e. BDS2 CDS LA Symposium > L115. An Overview of LA Techniques > Flashcards

L115. An Overview of LA Techniques Flashcards

(55 cards)

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1
Q

L115: What is pain?

A

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

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2
Q

L115: Why do we administer LA?

A

To manage pain

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3
Q

L115: What are the three main components of a LA?

A
  • LA;
  • Vasoconstrictor;
  • Preservative.
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4
Q

L115: What are the two major types of LAs and of these, which ones are mainly used now?

A

Esters and amides

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5
Q

L115: What are the two major vasoconstrictors used in LAs?

A
  • Adrenaline;
  • Felypressin.

(or none!)

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6
Q

L115: What are the advantages of LAs containing vasoconstrictors?

A
  • LA will stay in the area for a longer time;
  • Controlled bleeding;
  • Contributes to maintaining homeostasis;
  • Bloodless field to work in.
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7
Q

L115: Which vasoconstrictor tends to be more effective for prolonging the LA at site?

A

Adrenaline

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8
Q

L115: What vasoconstrictor should be avoided if patients are pregnant or have heart conditions?

A

Felypressin

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9
Q

L115: What are the two major preservatives used in LAs?

A
  • Bisulphite;

- Propylparaben.

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10
Q

L115: What are the advantages of LAs containing preservatives?

A

Prolonged shelf life

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11
Q

L115: Which LA preservative do people more commonly have an allergy to?

A

Propylparaben

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12
Q

L115: For patients with a true allergy to LA, where should they be treated?

A

Referred to anaphylactic clinic

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13
Q

L115: What are the two types of LA injections?

A
  • Infiltration;

- Nerve block.

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14
Q

L115: How and where do infiltration LAs work?

A
  • Used for pulpal anaesthesia where alveolar bone is thin;
  • e.g. maxilla, lower anteriors and soft tissues;
  • LA deposited around terminal branches of nerves.
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15
Q

L115: How and where do nerve block LAs work?

A
  • Used for pulpal anaesthesia where alveolar bone is too thick to allow infiltration technique of LA administration;
  • e.g. mandible, multiple teeth and large areas;
  • LA deposited beside nerve trunk.
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16
Q

L115: When administered, nerve block LAs anaesthetise all nerve fibres x, to it?

A

Distal

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17
Q

L115: In the maxilla, pulpal anaesthesia is achieved by what type of LA injection?

A

Buccal infiltration

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18
Q

L115: In the maxilla, buccal gingivae anaesthesia is achieved by what type of LA injection?

A

Buccal infiltration

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19
Q

L115: In the maxilla, palatal gingivae anaesthesia is achieved by what type of LA injection?

A

Palatal injection

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20
Q

L115: In the mandible, anaesthesia of the molars ( + second premolar) is achieved by what type of LA injection?

A

Inferior dental block (IDB/ IAN)

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21
Q

L115: In the mandible, anaesthesia of the premolars ( + canine) is achieved by what type of LA injection?

A

Mental (incisive) nerve block

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22
Q

L115: In the mandible, anaesthesia of the canines and incisors is achieved by what type of LA injection?

A

Buccal/ labial infiltration

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23
Q

L115: In the mandible, buccal gingivae anaesthesia of the molars ( + second premolar) is achieved by what type of LA injection?

Study These Flashcards
A

(Long) buccal infiltration

24
Q

L115: In the mandible, buccal gingivae anaesthesia of the premolars ( + canine) is achieved by what type of LA injection?

Study These Flashcards
A

Infiltration or long buccal or mental nerve block

25
L115: In the mandible, buccal gingivae anaesthesia of the canines and incisors is achieved by what type of LA injection?
Buccal/ labial infiltration
26
L115: In the mandible, lingual anaesthesia is achieved by what type of LA injection?
Secondary part of IDB, lingual infiltration
27
L115: If carrying out a restoration of a tooth, what type of LA is required?
Pulpal
28
L115: If carrying out an extraction of a tooth, what type of LA is required?
Pulpal and gingivae
29
L115: If scaling teeth, what type of LA is required?
- Gingivae; - Pulpal; - Both. (depends on procedure!)
30
L115: What equipment is required to administer a LA?
- Syringe handle and bung; - Syringe barrel and needle; - LA cartridge.
31
L115: What are the two lengths of needles used in LAs?
- Short (25mm); | - Long (35mm).
32
L115: What must you check before using an LA cartridge?
Expiry date (record in notes along with batch number)
33
L115: In the UK, what is the typical volume of solution in one LA cartridge?
2.2mL
34
L115: In the UK, what is the typical ppm of adrenaline in one LA cartridge?
1 in 80,000
35
L115: In the UK, what are the three main LAs used in dentistry?
- Lignocaine (lidocaine); - Articaine; - Prilocaine.
36
L115: Which LA has been clinically shown to have increased ability to diffuse through bone?
Articaine
37
L115: Which LA is typically mixed with felypressin (vasoconstrictor), instead of adrenaline?
Prilocaine
38
L115: When checking a medical hx, what medical condition means that a patient cannot receive an IDB injection?
Haemophilia
39
L115: How should topical LA be applied?
- Dry mucosa (so that LA doesn't dilute); | - Pea sized amount on cotton wool for 1-2 minutes.
40
L115: Why is it important to relax the patient and manage their anxiety?
- If stressed, more likely to feel pain; | - Breathing techniques and muscle relaxation can help to reduce the perception of pain.
41
L115: What typical injection technique should be used to administer a LA?
- Stretch mucosa; - Puncture mucosa quickly; - Position needle tip at target point; - Aspirate; - Inject slowly (min. 30 secs).
42
L115: Why is it important to aspirate?
To check whether you have entered a blood vessel or not, do not want to inject LA into blood vessel as will affect heart.
43
L115: Why must you inject LA slowly?
- To reduce pain; - Too quick = high pressure; - Can also cause damage to tissues.
44
L115: What are the limitations of infiltration anaesthesia?
- Pulpal anaesthesia limited to one or two teeth; | - Presence of dense bone/ infection may reduce the effectiveness.
45
L115: What are the positives of infiltration anaesthesia?
- High success rate; - Technically easy; - Atraumatic.
46
L115: What are the different parts of the alveolar nerve in the maxilla?
- PSA: posterior superior alveolar; - MSA: middle superior alveolar; - ASA: anterior superior alveolar.
47
L115: What sharps bin should an empty LA cartridge be discarded into?
Orange
48
L115: What sharps bin should an LA cartridge containing solution be discarded into?
Blue
49
L115: When administering an IDB, what landmarks do you use to identify the site of injection?
- Coronoid notch of the mandibular ramus; - Posterior border of the mandible; - Pterygomandibular raphe; - Lower premolars of the opposite side.
50
L115: What is the pterygomandibular raphe?
Skin and connective tissue
51
L115: Why is it beneficial to ask the patient to open wide when administering an IDB?
- Tissue becomes taught; | - Can identify landmarks more easily.
52
L115: Describe the stages of administering a LA.
- Thumb on coronoid notch; - Fingers on posterior border of the mandible; - 3/4 of the way back between thumb and raphe; - Advance needle until bone is contacted; - 3/4 of needle should go in; - Withdraw needle 1mm; - Aspirate (check for blood); - If negative, deposit 3/4 of cartridge; - Retract 2-4mm of needle, deposit remaining 1/4 for lingual anaesthesia.
53
L115: If bone is not contacted when advancing the needle, what has most likely happened?
Needle positioned too posterior (reposition before injection)
54
L115: If you contact bone before 3/4 of the needle is advanced, what has most likely happened?
Needle positioned too anterior (reposition mesially before injection)
55
L115: What words can be used to describe a patient's sensations when anaesthetised?
- Rubbery; - Numb; - Tingly; - Swollen/ fat. (with an IDB, this should extend to tongue and lower lip)

2e. BDS2 CDS LA Symposium (1 decks)

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