Chapter 41
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Created by:
twu_dental_hygiene on November 3, 2009
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26 terms
Terms | Definitions |
|---|---|
 Allergic Reactions to Esters | Occur in response to the PABA by-product and not to the anesthic drug |
| Esters | Procaine, Tetracaine, Benzocaine |
| Benzocaine | most widely used topical in dentistry, 10% and 20% gel soluntion |
| Amides | Lidocaine, Mepivacaine, Prilocaine, Bupivacaine, Articaine |
| Dyclonine | ketone topical local anesthetic; onset up to 10 minutes; duration up to 1 hour; 0.5% and 1% liquid soln |
| Lidocaine w/o vasoconstrictor | vasodilating properties, which limit duration of action |
| Lidocaine w/ vasoconstrictor | restricts blood flow into the area of injection and therefore reduces the rate of absorption, prolonging the duration of action: 1 hr pulpal anesthesia, 3 to 5 hrs soft tissue |
| Mepivacaine | slight vasodilation; 2% w/ vasoconstrictor provides adequate depth and duration of pain control for most procedures; 3% w/o vaso is used for short procedures/no allergic rxns documented |
| Prilocaine | less toxic than Mepivacaine and Lidocaine; should not be administered to patients with any condition in which problems with oxygenation may be critical; 4% w/ epi: 1:200,000, 4% w/o vasoconstrictor |
| Bupivacaine | stronger vasodilating properties than all other amides; produces prolonged anesthesia for lenthy dental procedures requiring pulpal anesthesia longer than 90 minutes; 0.5% soln w/ 1:200,000 epi |
| Epinephrine | vasoconstictor used in local anesthetics that stimulate beta receptors of the myocardium, resulting in an increase in the force of contraction and an increased heart rate. |
| 32mm Needle | typically used when deposition site is a significant distance from the penetration site; as in case of mandibular block |
| 20mm Needle | used in areas where the nerve is a short distance from the penetration site |
| Gauge of the Needle | refers to the diameter of the lumen; most common widths in dentistry are 25, 27,and 30 |
| Carpule | single-unit, glass cartridge filled with the anesthetic solution that permits observation of aspirated blood |
| Syringes | aspirating sterilizable stainless steel |
| Hazard of intraoral anesthesia | inadvertent intravascular injection, check for this by creating negative pressure in the cartridge |
| scoop technique | requires that the operator slide the uncapped needle into the needle cap while it is lying on the instrument tray or table. |
| topical anesthetics | higher concentration of anesthetics leading to greater potential of local and systemic toxicity |
| Positive Aspiration | DO NOT deposit the anesthetic drug if this occurs, prevents the deposition of the drug directly into the bloodstream |
| Important facts on delivering Local Anesthetics | dry site w/ 2X2, topical used on delivery site for 1 minute prior to injection, slow pace of delivery, communicate with the patient, |
| documentation of local anesthetic usage | date, type of drugs used, # of injections, volume of drug, results of aspirations(+, -), gauge of needles used, pre- and post- blood pressure and if any complications/rxns to the drug |
| Local Actions/Complications of Anesthetics | trismus, paresthesia, needle breakage, facial nerve paralysis, ulcerations and edema, hematoma, and infection |
| Topical adverse reactions | redness, pain, swelling, necrosis, and sloughing |
| infiltration | shallow injection for soft tissue procedures |
| Nerve Block | involves anesthesia of the nerves of several teeth including pulps of these teeth innervated by specific nerves |
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