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1. Instruments and
Materials
Required for
Local Anesthesia

2. Topical /Surface anaesthesia
Topical/ Surface anesthesia
1. Xylocaine ointment
2. Flavoured Xylocaine gel
3. Lignocaine Spray
4. Ethyl Chloride Spray

3. Topical/Surface anaesthesia
Xylocaine ointment
Xylocaine/ Flavoured Xylocaine/ Lignocaine Spray/ Ethyl Chloride Spray
• Contains 5% lidocaine hydrochloride
• Benzocaine may be added to produce fast
anaesthesia
• Used to anaesthetize the mucosa before injection
• How to apply:
1) Put a small amount at the end of a cotton roll
2) Apply to spot where injection is to be done
3) Wipe off excess ointment on the mucosa

4. Topical/Surface anaesthesia
Xylocaine ointment
Xylocaine/ Flavoured Xylocaine/ Lignocaine Spray/ Ethyl Chloride Spray
• Contains 5% lidocaine hydrochloride
• On set 2-3 minutes and duration 5-7 minutes
• Flavour is added to appeal to children
• Indication: Anesthetising mucosa before injection
• How to apply:
1) Put a small amount at the end of a cotton roll
2) Apply to spot where injection is to be done
3) Wipe off excess ointment on the mucosa

5. Topical/Surface anaesthesia
Lignocaine Spray
Xylocaine/ Flavoured Xylocaine/ Lignocaine Spray/ Ethyl Chloride Spray
• 10% lidocaine hydrochloride in water based
• Aerosol container
• 1 minute to produce surface anaesthesia and lasts
about 10 minutes
• Not necessary to prepare the mucose due to antiseptic
effect
• Used in extraction of very mobile primary teeth
• How to apply:
1) Spray directly to the mucosa of the tooth
2) Use a gauze to prevent excess from getting to other
parts of the mouth

6. Topical/Surface anaesthesia
Ethyl Chloride Spray
Xylocaine/ Flavoured Xylocaine/ Lignocaine Spray/ Ethyl Chloride Spray
• Produces surfaces anaesthesia by freezing the
tissue
• Instant effect
• Lasts as long as the tissue is frozen
• Used in the extraction of very mobile teeth
• Also used to test vitality of the tooth
• How to apply:
1) Either spray directly
2) Use gauze with ethyl chloride and then wrap
the gauze over the tooth and the gum

7. Local Anaesthetic solution used for
Local anaesthetic solution used for
injection
Local anesthetic solution contained in a glass
cartridge. The cartridge contains 2.2 ml of local
anesthetic solution
• Xylocaine
• Citanest
injection

8. Local Anaesthetic solution used for
injection
Xylocaine/ Citanest
Local Anaesthetic
Agent
Vasoconstrictor Reducing agent
Contains 2% lignocaine
which produces an
anesthetic effect
Stabilizes the
vasoconstrictor
Contains adrenaline which
constricts blood vessels
and reduce rate of
solution being removed

9. Local Anaesthetic solution used for
injection
Xylocaine/ Citanest
Fungicide Preservative Vehicle
Prevents
fungal growth
Increases
shelf life
Salt solution
which “carries”
the other
solutions

10. Local Anaesthetic solution used for
injection
Xylocaine/ Citanest
• Active ingredient 3% prilocaine
• Vasoconsrictor – fely pressin
• Used for patients with
hypertension
• Does not contain adrenaline
which causes tachycardia
• Felypressin does not cause
tachycardia

11. Equipment in Infiltration and Regional
Anesthesia
• Needle
• Cartridge of local anesthetic solution
• Syringe

12. Equipment in Infiltration and Regional
Anesthesia
Size Gauge Use
Long needle 38mm G27 Block
techniques
Short needle 25mm G23 Infiltration
techniques
Needle/ Cartridge/ Syringe

13. Equipment in Infiltration and Regional
Anesthesia
Needle/ Cartridge/ Syringe

14. Equipment in Infiltration and Regional
Anesthesia
Needle/ Cartridge/ Syringe
• Gauge number tells us the bore of the needle.
• Larger number – finer needle
• Double ended with a plastic hub
• Hub attaches end of syringe
• Shorter end penetrates rubber diaphragm of
LA cartridge
• Longer end penetrates tissue

15. Equipment in Infiltration and Regional
Anesthesia
Needle/ Cartridge/ Syringe
• Stored in sterilized plastic containers
which are made in 2 parts: body &
cap
• Seal around area where body and
cap are joined
• Before removing cap, check that
seal is intact
• If not intact, needle should be
discarded

16. Equipment in Infiltration and Regional
Anesthesia
Needle/ Cartridge/ Syringe
Recapping the needle
• “Scoop” technique
• Body of plastic container placed at edge of
tray
• Uncapped needle slid into it
• Operator scoops body of container up
• Presses it firmly onto the hub

17. Equipment in Infiltration and Regional
Anesthesia
Needle/ Cartridge/ Syringec
• glass cylinder containing pre-filled local anesthetic solution
• Can hold up to 2.2ml of solution

18. Equipment in Infiltration and Regional
Anesthesia
Needle/ Cartridge/ Syringe

19. Equipment in Infiltration and Regional
Blister pack stored in
room temp
NO Alcohol swabbing of
rubber diaphragm
NO Autoclaving of
cartridge
Anesthesia
Needle/ Cartridge/ Syringe

20. Equipment in Infiltration and Regional
• *Bubble in the cartridge
• *Extruded stopper
• *Burning on injection
• Corroded/rusted cap
• Leakage during injection
• Broken cartridge
Bubble in cartridge
Excessive force exerted resulting in
broken cartridge
Anesthesia
Needle/ Cartridge/ Syringe

21. Equipment in Infiltration and Regional
• Non-aspirating syringe (most common)
– Consists of stainless steel metal barrel with large window
– Enables operator to see contents of LA
• Aspirating syringe (harpoon and thumb ring)
Aspirating Syringe
Non-Aspirating Syringe
Anesthesia
Needle/ Cartridge/ Syringe

22. Equipment in Infiltration and Regional
Anesthesia
• Allows operator
to aspirate
• Connected to
rubber end of
cartridge
• Allows operator
to aspirate and
apply force during
injection
Needle/ Cartridge/ Syringe
Aspirating Syringe

23. THTHAANNKK YYOOUU