Podcast
Questions and Answers
What characterizes a severe complication of local anaesthesia?
What characterizes a severe complication of local anaesthesia?
Which category of complications is attributed to the solution used in local anaesthesia?
Which category of complications is attributed to the solution used in local anaesthesia?
What type of complication leaves a residual effect after administration of local anaesthesia?
What type of complication leaves a residual effect after administration of local anaesthesia?
Which of the following should be avoided to minimize complications during local anaesthesia procedures?
Which of the following should be avoided to minimize complications during local anaesthesia procedures?
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What type of local complication could manifest as tenderness in the jaw after a procedure?
What type of local complication could manifest as tenderness in the jaw after a procedure?
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Which of the following practices is important in managing the risks associated with local anaesthesia?
Which of the following practices is important in managing the risks associated with local anaesthesia?
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Which of the following is NOT a classification of local anaesthesia complications?
Which of the following is NOT a classification of local anaesthesia complications?
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What is a common first-line treatment for trismus caused by local anaesthesia?
What is a common first-line treatment for trismus caused by local anaesthesia?
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What should be done if there is no improvement within 7 days in the pterygoid muscle region?
What should be done if there is no improvement within 7 days in the pterygoid muscle region?
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What is a common local complication associated with local anaesthesia?
What is a common local complication associated with local anaesthesia?
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What might prolonged anaesthesia or paresthesia result in?
What might prolonged anaesthesia or paresthesia result in?
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Which condition is characterized by difficulty in opening the mouth due to muscle spasm?
Which condition is characterized by difficulty in opening the mouth due to muscle spasm?
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What should NOT be done at the site of nerve trauma?
What should NOT be done at the site of nerve trauma?
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What commonly follows a parenteral infection during anaesthetic procedures?
What commonly follows a parenteral infection during anaesthetic procedures?
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What should be prescribed if an infection leads to an abscess?
What should be prescribed if an infection leads to an abscess?
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What is a potential long-term effect of chronic trismus?
What is a potential long-term effect of chronic trismus?
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Study Notes
Needle Insertion Issues
- If a needle is not fully embedded, retrieve it with a hemostat.
- If not, refer the patient to an oral and maxillofacial surgeon for imaging and removal.
- Avoid inserting the needle fully until the hub is embedded.
- Use a suitable gauge needle.
- Be aware of patient movements, especially those who are pediatric or uncooperative.
Intra-vascular Injection
- Take notes from lectures and practical sessions on intravascular injections.
Jet Injector Complications
- Take notes from lectures and practical sessions on jet injector complications.
Neurotrophic Ulcers
- These ulcers form on the lip's mucous membrane after mandibular injections.
- Prolonged ischemia (reduced blood supply) resulting from high concentration vasoconstrictors (like epinephrine 1:50,000 or higher) or using norepinephrine can cause this.
- A sterile abscess on the palate is common due to ischemia.
Desquamated Ulcers
- Desquamated ulcers occur due to superficial injection lacerating the mucous membrane's superficial layer.
- They are common in areas with thin mucoperiosteum, like the lingual mandible area or anterior palate.
Traumatic Ulcers
- These ulcers result from lip biting, typically seen in children, the mentally handicapped, or patients with mental illness.
Palatal Tissue Sloughing
- Self-inflicted injuries to the lower lip or tongue need documented notes from lectures and practicals.
Self-Injuring of Lip/Tongue
- Notes from lectures and practicals document self-injurious behaviors of lip and tongue.
Self-Inflicted Lip Injuries
- A cotton is often placed on the lip to protect it.
Needle Breakage
- Though rare, broken needles can cause tissue damage or migration.
- Bent or old needles are a common cause.
Visual Disturbances (Facial Nerve Paralysis)
- This manifests as an inability to close the ipsilateral eye and a drooping ipsilateral upper lip when smiling or blowing the cheeks.
- The patient may deviate towards the unaffected side.
- Removing contact lenses and advising the patient to close their eye periodically are recommended.
- Paralysis can be partial or complete (all branches).
Nausea and Vomiting
- Nausea and vomiting can occur from lesser palatine nerve anesthesia (affecting the soft palate and tonsils).
- Limiting greater palatine nerve blocks to anterior to the foramen may prevent these issues.
Ischemia (Bleaching) at Injection Site
- Take notes from lectures and practical sessions about the bleaching of tissues at or distal to an injection site.
Sloughing of Tissues and Ulcers
- Epithelial desquamation can result from cotton swabs or excessive cleaning before injections.
- Inappropriate use of iodine or irritating disinfectants before injection can also cause this issue.
Failure to Obtain Anesthesia
- Inappropriate needle placement, such as being too far from the bone, is a common cause.
- An insufficient understanding of the anatomy of the injection site can be a factor.
- Infiltration issues are more likely due to incorrect site, depth, and technique.
- Block anesthesia involves similar potential issues.
Prolonged Anesthesia or Paresthesia
- Notes from lectures and practicals are essential to document prolonged or abnormal sensations.
Hematoma
- Notes from lectures and practicals document the occurrence of hematomas.
Infection
- Infection can be caused by contaminated needles or injecting into already infected tissue.
- Consider the risk of trismus, requiring incision and drainage if needed. Antibiotic treatment is crucial.
Post-Anesthetic Lesions
- Document recurrent aphthous ulcers from lectures and practicals.
Trismus and Muscle Spasm
- Trismus is difficulty opening the mouth due to muscle spasms.
- Infections, trauma, or chemicals can trigger it.
- Scarring from hematomas is also a possibility.
Local Complications and Their Causes
- Complications may arise from solution toxicity, allergies, tissue damage, improper needle insertion, edema, hematomas, and tissue infections.
Pain and Burning Following Injection
- Document how pain or burning sensations can result directly from injection procedures from lectures and practicals.
Edema
- Take notes from lectures and practicals about the development of edema post-injection.
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Description
This quiz covers essential knowledge on complications related to needle insertion, intravascular injections, jet injector issues, and types of ulcers. Gain insights into retrieval techniques, surgical referrals, and patient management during procedures. Ideal for medical students and practitioners involved in clinical practice.
