1. Local anesthetic complications can arise from the drugs themselves or injection techniques. Soft tissue injury and sloughing of tissues from ischemia are complications of the drugs, while needle breakage, hematoma, and failure to achieve anesthesia can result from injection issues.
2. Proper administration techniques such as slow injection, aspiration, and choice of anesthetic agent and dose can help prevent complications. Monitoring for signs of excessive dosage or allergic reaction and having BLS protocols in place are also important for managing potential issues.
3. An understanding of anatomy, use of proper technique, and care in performing injections can help minimize risks. However, despite best efforts, complications may still occur rarely and require prompt treatment of symptoms
This document discusses complications of local anesthesia. It begins by defining local anesthesia and providing a brief history. It then discusses various local complications that can occur, such as needle breakage, prolonged anesthesia, facial nerve paralysis, and soft tissue injury. Causes of these local complications include needle trauma to nerves, intraneural injection, and hematoma formation around nerves. The document also discusses systemic complications like toxicity and allergic reactions. Prevention strategies aim to avoid nerve trauma during injection and proper use and handling of local anesthetic materials. Most local complications resolve on their own, but persistent cases may require reassurance and follow-up.
This document discusses complications that can occur from regional anesthesia. It classifies complications as primary or secondary, mild or severe, transient or permanent. It also discusses specific complications that can occur from local anesthetic absorption (toxicity, idiosyncrasy, allergy), needle insertion (syncope, trismus, pain, edema, infection), or post-procedure (hematoma, sloughing of tissues, intraoral lesions). For each complication, it describes potential causes and treatments or methods for prevention. The document provides an overview of potential anesthetic complications and strategies to avoid or address issues.
This document provides information on local anesthesia techniques. It begins with definitions of local anesthesia and contraindications. It then describes the basic injection technique in 19 steps, including using a sharp sterile needle, checking solution flow, warming cartridges if needed, positioning the patient, drying tissue, applying topical anesthetic, establishing a firm hand rest, making tissue taut, keeping the syringe out of view, slowly inserting and advancing the needle, slowly depositing solution, observing the patient, and documenting the injection. Finally, it discusses various regional anesthesia techniques for the maxilla and mandible, including infiltration, nerve blocks, and intraseptal injections.
This document discusses various local anesthesia techniques used in dentistry. It begins by introducing regional anesthesia techniques like field blocks, nerve blocks, and local infiltration. It then describes specific injection techniques for the maxilla including posterior superior alveolar nerve blocks, middle superior alveolar nerve blocks, anterior superior alveolar/infraorbital nerve blocks, nasopalatine nerve blocks, greater palatine nerve blocks, and maxillary nerve blocks. Mandibular injection techniques discussed include inferior alveolar nerve blocks and mental nerve blocks. The document provides details on appropriate needle size, insertion points, depths, and areas anesthetized for each technique.
This document provides information on local anesthesia. It defines local anesthesia and classifies local anesthetic agents into esters and amides. It describes the mechanism of action of local anesthetics in blocking nerve conduction and lists some commonly used local anesthetic agents like lidocaine, bupivacaine, and procaine. It also discusses vasoconstrictors that are often added to local anesthetics to prolong their duration of action and the composition, effects, administration and side effects of local anesthetic solutions.
This document provides information on local anesthesia. It begins with definitions and history, describing how local anesthesia was developed by Koller in 1884 using procaine. It then discusses the various methods of inducing local anesthesia and the neuroanatomy and electrophysiology of nerve conduction. The remainder of the document focuses on the pharmacology of local anesthetics, including theories of action, properties, classification, pharmacokinetics, composition, and maximum permissible doses. Specific local anesthetic techniques for the maxilla and mandible are also outlined.
The document discusses various regional anesthesia techniques including infiltration, field block, nerve block, and nerve blocks for specific nerves of the head and neck. It covers the basic injection technique, evaluation of patients, contents to be covered, and descriptions of different regional anesthesia methods with their indications, contraindications, techniques, and complications.
This document discusses techniques for mandibular anesthesia. It begins by noting the lower success rate of mandibular blocks compared to maxillary blocks, due to bone density and access to nerve trunks. It then reviews different types of mandibular nerve blocks and focuses on the inferior alveolar nerve block technique. This technique anesthetizes multiple nerves but has the highest failure rate. Proper deposition of local anesthetic solution within 1mm of the nerve trunk is needed for success. Precautions, alternatives, indications, contraindications and complications are also outlined.
This document discusses complications of local anesthesia. It begins by defining local anesthesia and providing a brief history. It then discusses various local complications that can occur, such as needle breakage, prolonged anesthesia, facial nerve paralysis, and soft tissue injury. Causes of these local complications include needle trauma to nerves, intraneural injection, and hematoma formation around nerves. The document also discusses systemic complications like toxicity and allergic reactions. Prevention strategies aim to avoid nerve trauma during injection and proper use and handling of local anesthetic materials. Most local complications resolve on their own, but persistent cases may require reassurance and follow-up.
This document discusses complications that can occur from regional anesthesia. It classifies complications as primary or secondary, mild or severe, transient or permanent. It also discusses specific complications that can occur from local anesthetic absorption (toxicity, idiosyncrasy, allergy), needle insertion (syncope, trismus, pain, edema, infection), or post-procedure (hematoma, sloughing of tissues, intraoral lesions). For each complication, it describes potential causes and treatments or methods for prevention. The document provides an overview of potential anesthetic complications and strategies to avoid or address issues.
This document provides information on local anesthesia techniques. It begins with definitions of local anesthesia and contraindications. It then describes the basic injection technique in 19 steps, including using a sharp sterile needle, checking solution flow, warming cartridges if needed, positioning the patient, drying tissue, applying topical anesthetic, establishing a firm hand rest, making tissue taut, keeping the syringe out of view, slowly inserting and advancing the needle, slowly depositing solution, observing the patient, and documenting the injection. Finally, it discusses various regional anesthesia techniques for the maxilla and mandible, including infiltration, nerve blocks, and intraseptal injections.
This document discusses various local anesthesia techniques used in dentistry. It begins by introducing regional anesthesia techniques like field blocks, nerve blocks, and local infiltration. It then describes specific injection techniques for the maxilla including posterior superior alveolar nerve blocks, middle superior alveolar nerve blocks, anterior superior alveolar/infraorbital nerve blocks, nasopalatine nerve blocks, greater palatine nerve blocks, and maxillary nerve blocks. Mandibular injection techniques discussed include inferior alveolar nerve blocks and mental nerve blocks. The document provides details on appropriate needle size, insertion points, depths, and areas anesthetized for each technique.
This document provides information on local anesthesia. It defines local anesthesia and classifies local anesthetic agents into esters and amides. It describes the mechanism of action of local anesthetics in blocking nerve conduction and lists some commonly used local anesthetic agents like lidocaine, bupivacaine, and procaine. It also discusses vasoconstrictors that are often added to local anesthetics to prolong their duration of action and the composition, effects, administration and side effects of local anesthetic solutions.
This document provides information on local anesthesia. It begins with definitions and history, describing how local anesthesia was developed by Koller in 1884 using procaine. It then discusses the various methods of inducing local anesthesia and the neuroanatomy and electrophysiology of nerve conduction. The remainder of the document focuses on the pharmacology of local anesthetics, including theories of action, properties, classification, pharmacokinetics, composition, and maximum permissible doses. Specific local anesthetic techniques for the maxilla and mandible are also outlined.
The document discusses various regional anesthesia techniques including infiltration, field block, nerve block, and nerve blocks for specific nerves of the head and neck. It covers the basic injection technique, evaluation of patients, contents to be covered, and descriptions of different regional anesthesia methods with their indications, contraindications, techniques, and complications.
This document discusses techniques for mandibular anesthesia. It begins by noting the lower success rate of mandibular blocks compared to maxillary blocks, due to bone density and access to nerve trunks. It then reviews different types of mandibular nerve blocks and focuses on the inferior alveolar nerve block technique. This technique anesthetizes multiple nerves but has the highest failure rate. Proper deposition of local anesthetic solution within 1mm of the nerve trunk is needed for success. Precautions, alternatives, indications, contraindications and complications are also outlined.
Local & systemic Complications of Local AnesthesiaIAU Dent
This document discusses local anesthesia (LA), including its mechanism of action, factors influencing injection discomfort and techniques to reduce discomfort, testing the success of LA, causes and management of failed LA, complications of LA including local and systemic complications, and management of specific complications like needle breakage, pain/burning on injection, persistent anesthesia, and trismus. It provides anatomical and technical details related to achieving successful LA and avoiding complications.
This document discusses local anesthetic complications from dental procedures. It begins by defining local anesthesia and describing common local complications like needle breakage and prolonged numbness. It then discusses potential systemic complications and treatments. Risk factors for specific issues like paresthesia and trismus are outlined. Throughout, it provides guidance on best practices to minimize complications and recommendations for managing issues if they occur.
This document provides an overview of local anesthesia. It discusses the historical background of local anesthetics beginning with cocaine in the 1860s. It defines local anesthesia and describes the mechanisms of action, desirable properties, and theories regarding how local anesthetics work. The document outlines the classification, mode of action, descriptions, and administration techniques of various local anesthetic agents. It also discusses complications and special patient groups.
This document provides information on surgical endodontics procedures performed by Dr. Osama Mushtaq. It discusses the reasons for endodontic treatment failure and describes objectives and indications for endodontic surgery, including managing periapical disease and lesions that cannot be treated via nonsurgical root canal treatment. The document outlines the surgical procedure, covering topics like flap design, root resection, root-end filling materials, and postoperative care. It also discusses factors associated with success and failure of periapical surgery, and indications and contraindications for corrective endodontic surgery to repair procedural errors or resorptive defects.
This document discusses various techniques for local anesthesia in the maxilla. It begins by defining local infiltration, field block, and nerve block injections. It then describes specific maxillary injections including supraperiosteal, intraligamentary, intrapulpal, intraosseous, intraseptal, and various nerve blocks of the anterior superior alveolar, middle superior alveolar, and greater palatine nerves. For each technique, it provides indications, contraindications, anatomy anesthetized, complications and failure causes. The anterior superior alveolar nerve block is described in detail as the most common and effective maxillary nerve block.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Local anesthetics work by blocking sodium ion channels in nerve cell membranes, preventing the rapid influx of sodium ions needed to generate nerve impulses. They bind preferentially to activated sodium channels, inhibiting nerve conduction and establishing a localized loss of sensation. The mechanism of action involves inhibiting nerve depolarization and propagation of impulses by reducing sodium ion influx, thereby preventing transmission of sensations like pain.
Management of patients with systemic diseaseSaleh Bakry
This document discusses the management of patients with systemic diseases for dental treatment. It covers the ASA classification system for determining medical risk levels from I to V. For each level, it provides guidelines on elective treatment, treatment modifications, and emergency care. It then discusses specific considerations and protocols for reducing risks when treating patients with conditions like congestive heart failure, angina, myocardial infarction, hypertension, and those at risk of infective endocarditis. Recommendations are provided for anesthesia, antibiotic prophylaxis, and handling medical emergencies during treatment.
This document provides information on various local anesthesia techniques used in dentistry. It begins with an introduction to regional anesthesia, including field blocks, nerve blocks, and local infiltration. It then describes different local anesthesia injection techniques such as supraperiosteal, intraligamentary, intraosseous, and intraseptal injections. The document proceeds to explain specific maxillary and mandibular injection techniques including posterior superior alveolar nerve block, anterior superior alveolar nerve block, greater palatine nerve block, and others. It concludes with a brief section on recent advancements in local anesthesia.
This document summarizes recent advances in local anesthesia for dentistry. It discusses newer local anesthetic drugs like articaine and centbucridine that are equally or more effective than lignocaine. It also describes new delivery systems for local anesthesia like computer-controlled local anesthesia delivery systems, jet injectors, and iontophoresis that reduce injection pain and improve patient comfort. Devices like CCLADs allow controlled infusion of anesthetic for more precise needle insertion and placement.
This document discusses complications associated with local anesthesia. It describes local complications such as needle breakage, persistent anesthesia, facial nerve paralysis, and trismus. It also covers systemic complications including allergic reactions, toxicity from overdose, and idiosyncratic reactions. Prevention and management strategies are provided for various complications. The document emphasizes the importance of proper technique and avoiding overdose when administering local anesthesia.
Complications of Local anesthesia (part I) for B.D.S & M.D.S bhavana valvi
This document discusses various local complications that can arise from local anesthetic injections. It describes complications such as needle breakage, prolonged anesthesia, facial nerve paralysis, trismus, soft tissue injury, hematoma, pain on injection, infection, and edema. For each complication, it discusses causes, problems associated with the complication, prevention strategies, and management approaches. The document provides detailed information on injection techniques and protocols to minimize risks of various local complications.
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
This document provides information on local anesthetics used in dentistry. It discusses the components of the local anesthetic armamentarium including syringes, needles, and cartridges. It describes different types of syringes and needles and their appropriate uses. It also discusses the components and handling of local anesthetic cartridges. The document outlines the mechanisms of local anesthetics and vasoconstrictors as well as considerations for maximum safe dosing.
This document summarizes various local complications that can occur from local anesthesia administration and their prevention and management. It discusses complications such as needle breakage, paresthesia, facial nerve paralysis, trismus, hematoma, infection, and post-anesthetic intraoral lesions. For each complication, it outlines potential causes, problems associated with the complication, ways to prevent the complication, and how to manage it if it occurs. The document emphasizes using proper techniques, aseptic protocols, and treating any issues that arise.
Complications occur During Dental Extraction and their ManagementIraqi Dental Academy
This simplified lecture explain briefly the Complications occur During Dental Extraction and their Management.
It is presented to the level of mind of undergraduate students
Local and systemic complications of local anesthesiamohamed ali
Local and systemic complications of local anesthesia administration in dentistry
contents :
Introduction
Types of complications
Localized complications with their management
Generalized complications with their management
Technique of maxillary anesthesia which includes Greater Palatine Nerve Block and Incisive Nerve Block. The reference is of LA Book by Malamed.
Hope you find it useful.
Please like and share.
Local anesthetics,drugs, doses,theories, mechanismsMayank Chhabra
Local anesthesia is a transient loss of sensation in a localized area caused by blocking nerve conduction without loss of consciousness. It works by binding to receptor sites on nerve membranes and blocking sodium channels, preventing the transmission of nerve impulses. Common local anesthetics are lidocaine, prilocaine, mepivacaine and bupivacaine. Vasoconstrictors like epinephrine are often added to prolong the effects and reduce systemic absorption. Proper dosage calculation and contraindications must be considered for safe administration of local anesthesia.
This document outlines local and systemic complications that can occur from dental injections. It discusses various local complications including paresthesia, needle breakage, hematoma, pain on injection, facial nerve paralysis, infection, trismus, soft tissue injury, and edema. It also discusses rare ocular complications that can occur from inadvertent injection into blood vessels supplying the eye. Prevention and management strategies are provided for each complication. Systemic complications from overdose or allergy are also briefly covered. Predisposing factors that can increase risks of complications are outlined.
1. Epilepsy is a chronic neurological disorder characterized by recurrent seizures. Seizures occur due to abnormal electrical activity in the brain and their signs and symptoms depend on their location in the brain.
2. A first seizure should be thoroughly evaluated to determine its cause, risk of recurrence, and need for anti-seizure medication. The chance of recurrence is greatest within the first two years and treatment may reduce this risk.
3. Common anti-seizure medications include phenytoin, diazepam, lorazepam, valproate, and levetiracetam. Their dosages and monitoring vary depending on factors like administration route and patient characteristics.
Pharmacotherapy of Local anaesthetic drugsManoj Kumar
Local anesthetics are drugs that reversibly block sensation, especially pain, in a localized area without loss of consciousness or control of vital functions. They can be administered topically, via injection, or infiltration. The ideal local anesthetic has rapid onset, sufficient duration, is potent, stable in solutions, and does not interfere with tissue healing or cause toxicity. Common techniques for local anesthesia include infiltration, field block, nerve block, spinal anesthesia, epidural anesthesia, and intravenous regional anesthesia. Proper administration and monitoring can prevent potential toxic effects on the central nervous system and cardiovascular system.
Local & systemic Complications of Local AnesthesiaIAU Dent
This document discusses local anesthesia (LA), including its mechanism of action, factors influencing injection discomfort and techniques to reduce discomfort, testing the success of LA, causes and management of failed LA, complications of LA including local and systemic complications, and management of specific complications like needle breakage, pain/burning on injection, persistent anesthesia, and trismus. It provides anatomical and technical details related to achieving successful LA and avoiding complications.
This document discusses local anesthetic complications from dental procedures. It begins by defining local anesthesia and describing common local complications like needle breakage and prolonged numbness. It then discusses potential systemic complications and treatments. Risk factors for specific issues like paresthesia and trismus are outlined. Throughout, it provides guidance on best practices to minimize complications and recommendations for managing issues if they occur.
This document provides an overview of local anesthesia. It discusses the historical background of local anesthetics beginning with cocaine in the 1860s. It defines local anesthesia and describes the mechanisms of action, desirable properties, and theories regarding how local anesthetics work. The document outlines the classification, mode of action, descriptions, and administration techniques of various local anesthetic agents. It also discusses complications and special patient groups.
This document provides information on surgical endodontics procedures performed by Dr. Osama Mushtaq. It discusses the reasons for endodontic treatment failure and describes objectives and indications for endodontic surgery, including managing periapical disease and lesions that cannot be treated via nonsurgical root canal treatment. The document outlines the surgical procedure, covering topics like flap design, root resection, root-end filling materials, and postoperative care. It also discusses factors associated with success and failure of periapical surgery, and indications and contraindications for corrective endodontic surgery to repair procedural errors or resorptive defects.
This document discusses various techniques for local anesthesia in the maxilla. It begins by defining local infiltration, field block, and nerve block injections. It then describes specific maxillary injections including supraperiosteal, intraligamentary, intrapulpal, intraosseous, intraseptal, and various nerve blocks of the anterior superior alveolar, middle superior alveolar, and greater palatine nerves. For each technique, it provides indications, contraindications, anatomy anesthetized, complications and failure causes. The anterior superior alveolar nerve block is described in detail as the most common and effective maxillary nerve block.
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Local anesthetics work by blocking sodium ion channels in nerve cell membranes, preventing the rapid influx of sodium ions needed to generate nerve impulses. They bind preferentially to activated sodium channels, inhibiting nerve conduction and establishing a localized loss of sensation. The mechanism of action involves inhibiting nerve depolarization and propagation of impulses by reducing sodium ion influx, thereby preventing transmission of sensations like pain.
Management of patients with systemic diseaseSaleh Bakry
This document discusses the management of patients with systemic diseases for dental treatment. It covers the ASA classification system for determining medical risk levels from I to V. For each level, it provides guidelines on elective treatment, treatment modifications, and emergency care. It then discusses specific considerations and protocols for reducing risks when treating patients with conditions like congestive heart failure, angina, myocardial infarction, hypertension, and those at risk of infective endocarditis. Recommendations are provided for anesthesia, antibiotic prophylaxis, and handling medical emergencies during treatment.
This document provides information on various local anesthesia techniques used in dentistry. It begins with an introduction to regional anesthesia, including field blocks, nerve blocks, and local infiltration. It then describes different local anesthesia injection techniques such as supraperiosteal, intraligamentary, intraosseous, and intraseptal injections. The document proceeds to explain specific maxillary and mandibular injection techniques including posterior superior alveolar nerve block, anterior superior alveolar nerve block, greater palatine nerve block, and others. It concludes with a brief section on recent advancements in local anesthesia.
This document summarizes recent advances in local anesthesia for dentistry. It discusses newer local anesthetic drugs like articaine and centbucridine that are equally or more effective than lignocaine. It also describes new delivery systems for local anesthesia like computer-controlled local anesthesia delivery systems, jet injectors, and iontophoresis that reduce injection pain and improve patient comfort. Devices like CCLADs allow controlled infusion of anesthetic for more precise needle insertion and placement.
This document discusses complications associated with local anesthesia. It describes local complications such as needle breakage, persistent anesthesia, facial nerve paralysis, and trismus. It also covers systemic complications including allergic reactions, toxicity from overdose, and idiosyncratic reactions. Prevention and management strategies are provided for various complications. The document emphasizes the importance of proper technique and avoiding overdose when administering local anesthesia.
Complications of Local anesthesia (part I) for B.D.S & M.D.S bhavana valvi
This document discusses various local complications that can arise from local anesthetic injections. It describes complications such as needle breakage, prolonged anesthesia, facial nerve paralysis, trismus, soft tissue injury, hematoma, pain on injection, infection, and edema. For each complication, it discusses causes, problems associated with the complication, prevention strategies, and management approaches. The document provides detailed information on injection techniques and protocols to minimize risks of various local complications.
Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
This document provides information on local anesthetics used in dentistry. It discusses the components of the local anesthetic armamentarium including syringes, needles, and cartridges. It describes different types of syringes and needles and their appropriate uses. It also discusses the components and handling of local anesthetic cartridges. The document outlines the mechanisms of local anesthetics and vasoconstrictors as well as considerations for maximum safe dosing.
This document summarizes various local complications that can occur from local anesthesia administration and their prevention and management. It discusses complications such as needle breakage, paresthesia, facial nerve paralysis, trismus, hematoma, infection, and post-anesthetic intraoral lesions. For each complication, it outlines potential causes, problems associated with the complication, ways to prevent the complication, and how to manage it if it occurs. The document emphasizes using proper techniques, aseptic protocols, and treating any issues that arise.
Complications occur During Dental Extraction and their ManagementIraqi Dental Academy
This simplified lecture explain briefly the Complications occur During Dental Extraction and their Management.
It is presented to the level of mind of undergraduate students
Local and systemic complications of local anesthesiamohamed ali
Local and systemic complications of local anesthesia administration in dentistry
contents :
Introduction
Types of complications
Localized complications with their management
Generalized complications with their management
Technique of maxillary anesthesia which includes Greater Palatine Nerve Block and Incisive Nerve Block. The reference is of LA Book by Malamed.
Hope you find it useful.
Please like and share.
Local anesthetics,drugs, doses,theories, mechanismsMayank Chhabra
Local anesthesia is a transient loss of sensation in a localized area caused by blocking nerve conduction without loss of consciousness. It works by binding to receptor sites on nerve membranes and blocking sodium channels, preventing the transmission of nerve impulses. Common local anesthetics are lidocaine, prilocaine, mepivacaine and bupivacaine. Vasoconstrictors like epinephrine are often added to prolong the effects and reduce systemic absorption. Proper dosage calculation and contraindications must be considered for safe administration of local anesthesia.
This document outlines local and systemic complications that can occur from dental injections. It discusses various local complications including paresthesia, needle breakage, hematoma, pain on injection, facial nerve paralysis, infection, trismus, soft tissue injury, and edema. It also discusses rare ocular complications that can occur from inadvertent injection into blood vessels supplying the eye. Prevention and management strategies are provided for each complication. Systemic complications from overdose or allergy are also briefly covered. Predisposing factors that can increase risks of complications are outlined.
1. Epilepsy is a chronic neurological disorder characterized by recurrent seizures. Seizures occur due to abnormal electrical activity in the brain and their signs and symptoms depend on their location in the brain.
2. A first seizure should be thoroughly evaluated to determine its cause, risk of recurrence, and need for anti-seizure medication. The chance of recurrence is greatest within the first two years and treatment may reduce this risk.
3. Common anti-seizure medications include phenytoin, diazepam, lorazepam, valproate, and levetiracetam. Their dosages and monitoring vary depending on factors like administration route and patient characteristics.
Pharmacotherapy of Local anaesthetic drugsManoj Kumar
Local anesthetics are drugs that reversibly block sensation, especially pain, in a localized area without loss of consciousness or control of vital functions. They can be administered topically, via injection, or infiltration. The ideal local anesthetic has rapid onset, sufficient duration, is potent, stable in solutions, and does not interfere with tissue healing or cause toxicity. Common techniques for local anesthesia include infiltration, field block, nerve block, spinal anesthesia, epidural anesthesia, and intravenous regional anesthesia. Proper administration and monitoring can prevent potential toxic effects on the central nervous system and cardiovascular system.
General anesthesia involves making a patient unconscious through the use of drugs that bind to receptors in the brain, brainstem, and spinal cord. It has five main components: unconsciousness, amnesia, analgesia, immobility, and attenuation of stress responses. Anesthesiologists evaluate patients before surgery to determine their medical history and create an anesthetic plan tailored to the procedure and individual. During surgery, they monitor the patient and administer anesthetic drugs and oxygen to maintain unconsciousness and stable vital signs, emerging the patient once surgery is complete and extubating once safe criteria are met.
General anesthesia involves using drugs to induce a reversible loss of consciousness during surgery, while local anesthesia inhibits nerve impulses in a restricted area to reduce pain from procedures. The main types of general anesthetics are inhalational gases like nitrous oxide and volatile liquids like halothane administered by an anesthesiologist, and intravenous drugs used for induction and maintenance like thiopental and propofol. Anesthesia works through various stages from analgesia to unconsciousness and involves theories of action on lipid membranes or specific membrane proteins. Choice of agent depends on properties like safety, potency, and ease of administration and recovery.
This document discusses systemic complications that can arise from local anesthesia. It begins by introducing local anesthesia and defining complications. It then covers the history of local anesthesia, focusing on the discovery of cocaine. The main types of complications are categorized as local complications, systemic complications, allergic reactions, and overdose reactions. Risk factors for overdose reactions and treatments for overdose are outlined. The document also discusses principles of safe drug use and differentiating between allergic reactions and overdoses.
231125 Group 6 Sedation and Regional Anesthesia.pptxDakaneMaalim
The document discusses sedation and regional anesthesia. It begins by introducing sedation as a continuum between consciousness and general anesthesia, allowing patients to maintain protective reflexes and respond to stimuli. It then describes the levels of sedation from minimal to general anesthesia. Regional anesthesia techniques are also discussed, including neuraxial methods like epidural and spinal anesthesia, as well as peripheral nerve blocks and topical anesthesia. Specific drugs, procedures, indications, contraindications and complications are outlined for both sedation and regional anesthesia.
The document discusses local anesthesia and its potential complications. It defines local anesthesia and lists local and systemic complications. It discusses the principles of drug toxicity and the role of the user in potential toxicity. It describes overdose reactions involving the central nervous system and treatments. It provides guidelines for safe administration of local anesthesia and managing complications like overdose reactions and allergic responses.
Local anesthetics work by reversibly blocking nerve conduction. They alter the nerve membrane potential and decrease nerve firing and depolarization rates. Local anesthetics are classified as esters, amides, or ketones. After injection, esters are quickly broken down while amides have longer half-lives and their toxicity is more likely if liver function is impaired. The onset and duration of local anesthetics are affected by tissue pH, concentration, and lipid solubility, with pH being most important. Adding epinephrine decreases systemic toxicity and increases duration by reducing absorption. Local anesthetic toxicity can cause CNS stimulation or depression as well as cardiovascular effects.
Sk. Saleha Begum, a 37-year-old female, was admitted to the hospital for seizures. She has a history of two grand mal seizures in the past 6 months and weakness in her lower limbs for 6 months. Her neurological exam was normal. She was diagnosed with seizures and her management included anti-seizure medications, lifestyle modifications, and patient education on seizure first aid and management. Her prognosis depends on treatment response and number/type of seizures.
This document provides an overview of adverse effects of antipsychotics. It begins with an introduction and outlines the presentation scheme. Neurological side effects are discussed first, including neuroleptic induced movement disorders such as acute syndromes like dystonia, pseudoparkinsonism, and akathisia as well as tardive syndromes. Non-neurological side effects affecting endocrine, sexual, metabolic, cardiovascular, hematological, gastrointestinal, hepatic, dermatological and ophthalmological systems are also reviewed. Management strategies for different adverse effects are provided.
This document discusses the assessment and treatment of aggression and agitation in emergency psychiatry. It covers the neurochemistry and contributing factors to impulsive aggression. Initial approaches to agitated patients include ensuring safety, assessing the environment, and using verbal de-escalation techniques. Non-pharmacological interventions are preferred but chemical restraint may be necessary in crisis situations. Common medications used for acute aggression include benzodiazepines and antipsychotics, which can have side effects requiring monitoring. Differential diagnoses and treatment approaches are provided for conditions that can present with agitation such as alcohol withdrawal, delirium, and neuroleptic malignant syndrome.
Acute dystonic reactions and tardive dyskinesia are medication-induced movement disorders. Acute dystonic reactions typically develop within hours of a trigger like medication and involve involuntary muscle contractions. Tardive dyskinesia results from prolonged use of dopamine-blocking medications and causes abnormal movements in the face and limbs. Risk factors include prolonged antipsychotic use, older age, and female sex. Treatment focuses on minimizing triggering medications and using anticholinergic drugs or VMAT2 inhibitors.
This document discusses the nervous system and provides information on epilepsy and multiple sclerosis. It defines epilepsy as recurrent seizures caused by abnormal electrical activity in the brain. Epilepsy is classified as focal or generalized. Multiple sclerosis is a demyelinating disease of the central nervous system characterized by patches of demyelination in the brain and spinal cord. Common symptoms include sensory and motor issues. Diagnosis involves clinical evaluation and MRI imaging. Treatment aims to modify the disease course and manage symptoms.
Seizures and epilepsy are defined. Seizures are caused by sudden surges of electrical activity in the brain that affect how a person feels or acts for a short time. Epilepsy is a condition involving the central nervous system that requires a person to have had at least two seizures not caused by a known medical condition. Diagnosing seizures involves considering witness accounts, symptoms, and test results like EEGs and neuroimaging. Treatment involves identifying seizure types and potentially using anti-seizure medications or surgery to control seizures.
This document defines seizures and epilepsy, describes different types of seizures, and outlines evaluation and treatment approaches. It summarizes that seizures are caused by sudden bursts of electrical activity in the brain, epilepsy is defined as two or more unprovoked seizures, and evaluation involves medical history, physical exam, EEG, and sometimes neuroimaging to classify seizures and determine underlying causes and treatment.
This document defines seizures and epilepsy, describes different types of seizures, and outlines evaluation and treatment approaches. It summarizes that seizures are caused by sudden bursts of electrical activity in the brain, epilepsy is defined as two or more unprovoked seizures, and evaluation involves medical history, physical exam, EEG, and sometimes neuroimaging to classify seizures and determine underlying causes and treatment.
The document discusses the history and development of the field of neuroanesthesia, covering topics like common complications during neurosurgery and recommendations for different anesthetic regimens and agents based on patient conditions like Alzheimer's, Parkinson's, or epilepsy. It also examines complications that can occur from regional anesthesia techniques and recommendations to reduce risks from anticoagulation in patients undergoing regional blocks.
The document summarizes potential complications from local anesthetic administration, including both local and systemic complications. Local complications include needle breakage, facial nerve paralysis, and soft tissue injury. Systemic complications can include adverse drug reactions such as overdose, allergy, or idiosyncrasy. Overdose is the most common adverse reaction and can cause signs like talkativeness or hypotension. Allergic reactions range from mild skin issues to life-threatening laryngeal edema. Proper patient evaluation, slow injection, and immediate treatment of reactions can help manage complications.
Complications of wisdo removal neurological mangment .pdfIslam Kassem
1. The document provides information about impacted wisdom teeth and their treatment, including alternatives to removal, principles of surgery, and complications.
2. Key points discussed include evaluation of impaction patterns, lingual splitting surgical technique, laser therapy benefits, and management of dry socket and nerve injuries.
3. Post-extraction healing processes and potential complications are outlined, along with prevention strategies and treatment approaches.
This document provides information about Dr. Islam Kassem and his team who perform salivary gland surgery. It lists some of Dr. Kassem's publications on topics like parotitis related to Covid 19. The document then gives advice on oral diagnosis and the diagnostic sequence which involves detecting and examining lesions, examining the patient, developing differential diagnoses, and making a final diagnosis. It also provides details on various aspects of history taking and physical examination for oral diagnosis.
This document provides information about bone grafts and grafting procedures in dentistry. It defines different types of grafts including autografts, allografts, xenografts, and alloplastic grafts. It describes the properties of osteoinduction, osteoconduction, and osteogenesis. It discusses various graft materials like human bone, allogeneic grafts, bone substitutes, and their advantages and disadvantages. The document also outlines objectives and techniques of bone grafting as well as factors affecting the fate of graft materials.
Preoperative Evaluation and Investigations for Maxillofacial Surgery 1.pdfIslam Kassem
The document provides guidelines for preoperative evaluation, admission notes, operative notes, and postoperative care of patients undergoing maxillofacial surgery. It discusses the purpose and key contents of admission notes, preoperative notes, informed consent processes, surgical site marking, brief operative notes, full operative reports, immediate postoperative notes, progress notes, postoperative orders, and discharge summaries. The guidelines aim to ensure thorough documentation and communication between healthcare providers regarding patient care.
Blood glucose monitoring helps identify patterns in fluctuations and better manage diabetes. It plays a vital role in self-management education and treatment. Regular monitoring through intermittent glucometers or continuous monitors allows for individualized control and adjustment of medications. The frequency of monitoring depends on the treatment regimen but commonly includes before meals and at bedtime. Both methods have advantages and disadvantages such as cost and reliability. Laboratory testing also evaluates long-term control through A1C levels. Maintaining stable blood glucose through effective self-monitoring and medical consultation can reduce risks of short and long-term complications.
This document contains information about Islam Kassem, an oral and maxillofacial surgeon, including his educational background and credentials. It also lists other doctors in the maxillofacial department and discloses no conflicts of interest. The rest of the document discusses topics related to scar management, including different types of skin, ideal patients for peels, goals of conditioning skin, and depths of peels.
This document discusses impacted and unerupted teeth, with a focus on impacted wisdom teeth. It provides information on:
- The frequency of tooth impactions, with wisdom teeth and maxillary third molars being most common.
- Factors to consider when deciding whether to remove impacted wisdom teeth, including development stages, potential risks like infection, and possible benefits like occlusion.
- Surgical principles for removing impacted teeth, including flap design, suturing techniques, and managing complications like nerve injury.
- Alternatives to surgical removal like restoration and the optimal timing for prophylactic removal of wisdom teeth between ages 15-18.
This document discusses dentoalveolar trauma, including diagnosis, clinical examination, radiographic examination, classification, and treatment. It covers obtaining a thorough history of the trauma and examining the soft tissues, teeth, and bone clinically and radiographically. Ellis' classification of dental injuries is described. Treatment depends on the class of injury and may include splinting, stabilization, root canal treatment, or referral for surgery. Low-level laser therapy can aid in healing. Management aims to reduce complications and promote healing of injured tissues.
This document discusses the use of dental lasers and their advantages. It provides information on different types of lasers and their wavelengths. Lasers can provide benefits like greater patient satisfaction, less bleeding and shorter procedure times compared to traditional techniques. The document discusses laser safety and appropriate eyewear. Lasers have various applications in dentistry such as incisions, hemostasis and treating conditions like gingival enlargement and snoring.
This document provides information about Islam Kassem, an oral and maxillofacial surgeon, including his qualifications and specializations. It then outlines a 3 day course covering topics like impacted teeth, lasers, trauma, piezosurgery, sinus implications, complications, and more. The document also discusses the importance of oral diagnosis and clinical pathology. It provides details on the diagnostic sequence including detection, examination, classification, differential diagnosis, and treatment planning. Key aspects of history taking like chief complaints, medical history, and physical examination are also summarized.
Local anesthesia interrupts nerve transmission by blocking sodium channels and preventing the propagation of action potentials along nerve fibers. The ideal local anesthetic has rapid onset, prolonged duration, is reversible, selectively acts on sensory nerves, is water soluble, non-irritating, stable, and has no systemic side effects. Complications from local anesthesia can arise from the drugs, injection techniques, or both. Common complications include soft tissue injury, tissue necrosis, needle breakage, hematoma, and failure to achieve anesthesia. Proper injection technique and use of medications can help reduce complications.
This document discusses tooth extraction, including indications, contraindications, techniques, and complications. It provides details on:
1. Indications for tooth extraction such as non-restorable caries, pulpitis, periodontal disease, fractures, bony lesions, impacted teeth, and orthodontic reasons.
2. Contraindications including certain medical conditions, medications, pregnancy, infections, and uncooperative patients.
3. Techniques for simple extractions using forceps with different types for various tooth positions, and trans-alveolar extractions for difficult cases.
4. Potential complications from the procedure or analgesia like fracture, nerve damage, bleeding, pain, or displacement of the tooth
This document provides information about dento-alveolar trauma. It begins with the speaker's credentials and declarations of no conflicts of interest. The learning objectives are listed as diagnosis, first aid treatment, in-office treatment, maxillofacial trauma signs, biostimulation use, and complications of improper management. Diagnosis involves history, clinical examination including vitality tests, and radiographic examination. Treatment depends on factors like stage of root formation and presence of fractures. Splinting may be used for alveolar fractures or displaced teeth. Laser biostimulation is discussed as a potential alternative or addition to endodontic treatment. References are provided.
This document discusses temporomandibular joint (TMJ) pathology and occlusion. It begins by defining key occlusion terms like centric occlusion, centric relation, and anterior guidance. It describes the importance of occlusion in diagnosis, treatment planning, and minimizing failure. Ideal occlusion provides comfort and function through features like anterior guidance, posterior stability, and lack of interferences. The document discusses how anatomic factors like condylar guidance, incisal guidance, and overlap influence occlusion and posterior tooth morphology. Finally, it examines how occlusion impacts mastication and bite force.
This document provides an anatomical overview of structures related to the temporomandibular joint (TMJ) including:
- Bones such as the mandible, maxilla, zygomatic, and hyoid bones
- Muscles like the masseter, temporalis, and lateral and medial pterygoid muscles
- The TMJ itself, which consists of the condylar process, disc, and articulation with the temporal bone
- Normal TMJ function involves initial rotation followed by translatory motion as the disc and condyle move together
This document provides information about a two-day course on temporomandibular joint (TMJ) disorders presented by Dr. Islam Kassem. The course will cover the surgical anatomy of the TMJ, different treatments for TMJ pathology, and complications of TMJ treatment on Day 1. Day 2 will focus on medical management of temporomandibular disorders, laser biostimulation, neurotoxins, and complications of TMJ treatment. The course aims to help distinguish between muscular and joint disorders of the TMJ and properly diagnose and treat these conditions.
1. This document discusses techniques for maxillary anesthesia including local infiltration, field blocks, and nerve blocks. It describes specific techniques such as the posterior superior alveolar nerve block, middle superior alveolar nerve block, and greater palatine nerve block.
2. Each technique is indicated for anesthetizing certain areas like the maxillary molars, premolars, canines, and incisors as well as associated gingiva and bone. Landmarks, needle position, aspiration, and volume of local anesthetic solution are outlined.
3. Advantages include high success rates and being technically easy. Risks include hematoma and failure to adequately anesthetize if proper technique is not followed
This document provides information on mandibular anesthesia techniques. It discusses:
1. The lower success rate of mandibular anesthesia compared to maxillary anesthesia, around 80-85%, due to bone density and less access to nerve trunks.
2. The various mandibular nerve blocks including inferior alveolar, mental, buccal, lingual, and Gow-Gates techniques. The inferior alveolar nerve block is the most commonly performed but has the highest failure rate of 15-20%.
3. Details of performing the inferior alveolar nerve block including target area, landmarks, technique, areas anesthetized, indications, contraindications, and complications.
4
This document provides an anatomy overview of the trigeminal nerve (nervus trigeminus), which contains both motor and sensory fibers. It describes the locations and functions of the trigeminal ganglion and nuclei, as well as the three main divisions of the trigeminal nerve - the ophthalmic, maxillary, and mandibular nerves. It then provides detailed information on the branches and innervation territories of the ophthalmic and maxillary nerves.
This document provides information on local anaesthesia techniques and armamentarium. It discusses various topics such as:
- Types of pain fibers and how local anaesthesia works to block pain transmission
- Different types of local anaesthetic syringes including reusable, disposable, and safety syringes as well as their advantages and disadvantages
- Local anaesthetic needle features like gauge, length, and proper handling techniques
- Local anaesthetic cartridge contents and potential problems that can occur with cartridges
- Maintenance of syringes, needles, and cartridges
- Selection of local anaesthetic drugs for different medical conditions
- Record keeping requirements for sedation methods
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
24. Minimal to Moderate
Signs (cont.):
Elevated BP Sweating
Elevated heart rate Nausea/vomiting
Elevated resp. rate Disorientation
Failure to follow commands / reason
Lack of response to painful stimuli
26. Minimal to Moderate
Symptoms (cont.):
Light-headed and dizzy
Drowsy and disoriented
Losing consciousness
Sensation of twitching (before actual
twitching is observed)
27. Moderate to High
Generalized tonic-clonic seizure activity
followed by
Generalized CNS depression
Depressed BP, heart rate
Depressed respiratory rate
31. Mild Reaction -slow onset
Reassure patient
Administer O2
Monitor vital signs
Consider IV anticonvulsant
Allow recovery or get medical help prn
Get medical consultation, esp. if possibility
of metabolic or renal dysfunction
32. Severe Reaction - rapid onset
Stop all treatment
Place patient in supine position, feet up
Establish airway, give O2 (BLS)
If convulsions, protect patient
Summon emergency medical help
Consider anticonvulsant drugs, vasopressors
33. Severe Reaction - slow onset
Stop all treatment
Establish airway, give O2 (BLS)
Administer anticonvulsant
Summon emergency medical help
Consider vasopressors
Get medical consultation, esp. if possibility
of metabolic or renal dysfunction
37. Management - v/c overdose
Stop dental treatment
Sit patient up
Reassure patient, administer O2
Monitor BP and pulse until fully recovered
38. Allergic Reactions
Type Mechanism Time Clinical Example
I Antigen induc. sec/min Angioedema,
Anaphylaxis
IV Cell mediated 48 hrs Contact
dermatitis
39. Allergens in Local
Esters - usually to the Para-amino-
benzoic-acid product
Na bisulfite or metabisulfite - found in
anesthetics as perservative for
vasoconstrictors
Methylparaben - no longer used as
perservative in dental cartridges
40. Management of Allergy Pts.
If the patient gives a history of allergy to
local anesthetics - Assume that an
allergy exists
Elective procedures
Postpone until work-up is completed
41. Management of Allergy Pts.
Emergency treatment
Protocol #1 - no invasive treatment ( I&D,
analgesics, antibiotics)
Protocol #2 - use general anesthesia
Protocol #3 - Histamine blocker (Benadryl)
Protocol #4 - Others: electronic dental
anesthesia, hypnosis, adjunctive N2O
45. Management of Reactions
Delayed skin reaction
Benadryl - 50 mg stat & Q6H X 3-4 days
Immediate skin reaction
Epinephrine 0.3 mg IM or SC
Benadryl - 50 mg IM
Observation, medical consultation
Benadryl - 50 mg Q6H X 3-4 days
46. Management of Reactions
Bronchial constriction
Semi-erect position, O2 - 6 L/min
Inhaler or Epinephrine 0.3 mg IM or SC
Benadryl - 50 mg IM
Observation, medical consultation
Benadryl - 50 mg Q6H X 3-4 days
47. Mangement of Reactions
Laryngeal edema
Place supine, O2 - 6 L/min
Epinephrine 0.3 mg IM or SC
Maintain airway
Benadryl - 50 mg IV or IM
Hydrocortisone - 100 mg IV or IM
Perform Cricothyrotomy
48. Management of Reactions
Anaphylaxis
Place supine, on flat surface
ABCs of CPR, call for medical help
Epinephrine 0.3 mg IV or IM (Q 5 mins)
O2 - 6 L/min, monitor vital signs
After clinical improvement,
Benadryl and Hydrocortisone
51. Prior to Treatment
Complete review of medical status
(including vital signs)
Anxiety / Fear should be assessed and
managed before administering anesthetic
52. Administration of Anesthetic
Place pt. supine or semi-supine position
Dry site, apply topical X 1 min
Select appropriate drug for treatment (time)
Vasoconstrictor unless contraindicated
53. Administration (cont.)
Weakest anesthetic in the minimum volume
(compatible with successful anesthesia)
Inject slowly (minimum of 60 sec / 1.8 ml)
Continually observe -
Never leave patient alone after injection
54. Administration (cont.)
Use only aspirating syringe
Aspirate in two planes, before injecting
Use sharp, disposable needles of adequate
diameter and length
57. LOCAL COMPLICATION OF
LOCAL ANESTHESIA
1. Complications arising from drugs or
chemicals used for local anesthesia
2. Complications arising from injection
techniques
3. Complications arising from both
58. Complications arising from drugs or
chemicals used for local anesthesia
1. Soft tissue injury
2. Sloughing of tissues (Tissue
ischemia and necrosis)
59. SOFT TISSUE INJURY
■ Causes
1. It is seen in the form
of self-inflicted
trauma to lips,
tongue and cheek
2. It is common in
children and mentally
retarded adults
ikassem@dr.com
60. 2- Sloughing of Tissues
(Tissue Ischemia and Necrosis)
Causes
1. predisposition: Commonly
in hard palate, as in the
region of distribution of
nasopalatine and greater
palatine nerves, because
mucoperiosteum is firmly
attached to the bone.
2. Deposition of excessive
volume of local anesthetic
agent with high
concentration of
vasoconstrictors
3. Rapid deposition of the
local anesthetic solution
with undue pressure
4. Application of topical
local anesthetic agent for
prolonged period
(epithelial desquamation)
62. COMPLICATIONS ARISING FROM
INJECTION TECHNIQUES
1. Breakage of anesthetic cartridge
2. Breakage of needle
3. Needle-stick injuries
4. Hematoma
5. Failure to obtain local anesthesia
ikassem@dr.com
63. Breakage of Anesthetic Cartridge
■ Causes
It occurs when there is
resistance to flow of
local anesthetic solution
in to the tissues
It occurs due to
following reasons:
1. Blockage of the needle
2. Too rapid injection;
especially during
administration of
palatal injection.
64. Breakage of Needle
■ Its very rare since the
introduction of sterile,
stainless steel
disposable needles
■ Causes :
Primary cause: Sudden
unexpected
movements by the
patient
65.
66. Needle-stick Injuries
■ It’s an accidental injuries
occurring to dental staff caused by sharp
instruments such as needles, blades, scalpels,
explorers, root canal instruments, and wires, etc
■ These injuries are not usually serious, unless,
the instruments used were contaminated by
blood from patients with conditions such as
Hepatitis B virus HBV Infection, Hepatitis C virus
HCV Infection, A IDS
67. Failure to Obtain Local Anesthesia
■ Causes
1. OPERATOR-DEPENDENT
II. Selection of local anesthetic agent (type and dose;
too small a dose)
III. Use of a local anesthetic solution which has
crossed its date of expiry
IV. Improper injection technique:
a. Wrong technique: Inaccurate placement of
solution
b. Not waiting long enough for anesthesia to act;
before commencing the surgery
IV. Intravascular administration
V. Intramuscular administration
68. 2- PATIENT - DEPENDENT
I. Anatomical:
b. Barriers to diffusion
c. Anatomical aberrations
d. Additional innervations
II. Psychological:
Fear and apprehension : unco-operative
patient, inadequate opening of the
mouth, movement by the patient
70. PAIN ON INJECTION
■ This increases patient’s anxiety;
and may lead to a sudden unexpected
movement by the patient and increases
the risk of needle breakage.
■ Management
Not required. However, steps should be
taken to avoid pain associated with
injection of local anesthetic agent
71. PAIN ON INJECTION
■ Causes
1. Careless injection technique
2. Dull needles
3. Rapid deposition of local anesthetic solution
4. Needles with barbs: There is pain while
withdrawal of the needle from the tissues
5. Temperature: Extremes of temperature
such as warm or hot or very cold
(refrigerated) local anesthetic solution
72. TRISMUS
■ Trismus is the inability to normally open
the mouth
■ It is a fairly common complication of local
anesthesia, particularly while giving
pterygomandibular block
73. MUCOSAL BLANCHING
■ It is caused by the spasm of the artery
accompanying
the nerve at the point of injection
Causes
1. Use of excessive amount of vasoconstrictor
2. Deposition of excessive volume of local
anesthetic solution in firm or tight tissue
74. PERSISTENT ANESTHESIA OR
PARESTHESIA (NERVE INJURIES)
■ Persistent paresthesia can lead to self-inflicted
injury. Biting, or thermal or chemical insults can
occur without the patients awareness
■ The condition is more frequent as a result of
operative procedure than injection itself
■ The sensory nerves most frequently traumatized
are inferior alveolar nerve, lingual nerve, and
mental nerves in lower jaw; and infraorbital nerve
in upper jaw
75. POST-INJECTION HERPETIC LESIONS OR
POST-ANESTHETIC INTRAORAL LESIONS
■ Patients’ reporting of
development of ulcerations
around the site of injection a
few days after intraoral injection
of local anesthetic agent. Patient
complains of intense pain
■ Cause
❑ Recurrent Aphthus Stomatitis
(RAS): It is a frequent
manifestation, developing in
gingival tissues (movable part,
i.e. not attached to the bone)
76.
77. FACIAL NERVE PARALYSIS
■ Paralysis of some of the muscles
of facial expression which are
supplied by some of the terminal
branches of facial nerve, when the
solution is deposited in their
vicinity