Overdose, children and LA Flashcards Preview

Year 1 Sem 2 Local Anaesthesia > Overdose, children and LA > Flashcards

Flashcards in Overdose, children and LA Deck (3)
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1
Q

Brief the difference between infiltration and nerve blocks

A

An infiltration is injecting local to site being numbed. to numb only the end of the nerve branch which is supplying that single tooth. So you can give a buccal infiltration in the maxillary region, and the anaesthetic will penetrate the bone (as it is quite thin) and numb that region.

A nerve block is when you inject much further up the nerve branch and anaesthetise more of the nerve.

2
Q

State how LA toxicity is reduces in adults.

A

LAs preferentially binds to α-1 acid glycoprotein (AAG) found in plasma.

3
Q

State how LA toxicity is induced in children

A

AAG Levels:

  • Levels in neonates are 20-40% % than in adults
  • Low AAG levels lead to higher levels of unbound LA

Metabolism and excretion:
* Infants have decreased clearance and longer elimination 1⁄2 life

Myelination:

  • Myelination not complete until 12 years of age
  • Incomplete myelination= better penetration into nerve fibres
  • Therefore reduced doses can provide complete block

Anatomy:
* Loose fascial attachments around nerves facilitate spread of LA