Complications of Local Anesthesia
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Questions and Answers

What is the primary cause of paresthesia during an injection?

  • Trauma to any nerve during injection (correct)
  • Injection of local anesthetic solution contaminated by a neurotoxic substance
  • Hemorrhage and infection in close proximity to a nerve
  • Needle breakage within the tissue

    • What is the common point of needle fracture?

  • The shaft of the needle
  • The middle of the needle
  • The tip of the needle
  • The hub of the needle (correct)

    • What is the recommended approach for managing paresthesia?

  • Reassuring the patient that the condition is transient with strict follow up (correct)
  • Performing surgery to repair the damaged nerve
  • Treating the patient with medication to alleviate the symptoms
  • Immediately removing the needle and injecting a new dose of local anesthetic

    • What is the reason for the rarity of needle breakage in modern dentistry?

    <p>The introduction of disposable needles</p> Signup and view all the answers

    What is the consequence of severe nerve damage due to paresthesia?

    <p>The paresthesia will be permanent</p> Signup and view all the answers

    What is a common factor that contributes to the risk of needle breakage?

    <p>The bending of the needle before insertion</p> Signup and view all the answers

    What is a recommended practice to prevent needle breakage?

    <p>Checking the needles before using them</p> Signup and view all the answers

    What is the consequence of reuse of needles?

    <p>Fatigue of the needle structure and increased risk of needle breakage</p> Signup and view all the answers

    What is the most common age group to experience trauma during local anesthesia?

    <p>Younger children</p> Signup and view all the answers

    What is the primary purpose of using a cotton roll during local anesthesia?

    <p>To prevent biting of the lips or tongue</p> Signup and view all the answers

    What is the recommended treatment for a patient who experiences hematoma after local anesthesia?

    <p>Apply direct pressure to the area</p> Signup and view all the answers

    What is the most common cause of hematoma after local anesthesia?

    <p>Penetration of the blood vessel with the needle</p> Signup and view all the answers

    What is the primary method of preventing hematoma after local anesthesia?

    <p>Learning anatomical landmarks and injection technique</p> Signup and view all the answers

    What is the recommended treatment for a patient who experiences trismus after local anesthesia?

    <p>Treat as a case of hematoma</p> Signup and view all the answers

    What is the primary reason for the reduction in infection rates after local anesthesia?

    <p>Introduction of sterile disposable needles</p> Signup and view all the answers

    What is the recommended treatment for a patient who experiences pain after local anesthesia?

    <p>Prescribe analgesics</p> Signup and view all the answers

    What is the recommended gauge of needle for an inferior alveolar nerve block?

    <p>Gauge 25</p> Signup and view all the answers

    What should be done if a portion of the broken needle is visible in the tissue?

    <p>Grasp it firmly with a hemostat and remove it</p> Signup and view all the answers

    What is the cause of facial nerve paralysis in relation to inferior alveolar nerve block?

    <p>Insertion of the needle too far back and behind the ascending ramus</p> Signup and view all the answers

    What is the result of solution deposition in the substance of the parotid gland?

    <p>Failure in anesthesia of the inferior alveolar nerve and paralysis of the facial nerve</p> Signup and view all the answers

    What should be done to comfort the patient who has experienced facial nerve paralysis?

    <p>Advise the patient to use an eye patch until the motor function returns, and reassure the patient of the transient nature of the event</p> Signup and view all the answers

    What is the consequence of not removing the broken needle from the tissue?

    <p>The patient will experience further complications and tissue damage</p> Signup and view all the answers

    Why is it important to stabilize the patient's jaws if a needle breaks during an inferior alveolar nerve block?

    <p>To prevent the patient from moving the jaw and dislodging the needle</p> Signup and view all the answers

    What is the recommended action if the practitioner is unable to remove the broken needle from the tissue?

    <p>Refer the patient to an oral and maxillofacial surgeon</p> Signup and view all the answers

    What is the first step in the first aid treatment for a vasovagal attack?

    <p>Lower the head of the patient and elevate the legs</p> Signup and view all the answers

    What is the purpose of Cardiopulmonary Resuscitation (CPR)?

    <p>To restore spontaneous blood circulation and breathing</p> Signup and view all the answers

    What is the recommended depth of chest compressions for adults in CPR?

    <p>About 5 cm deep</p> Signup and view all the answers

    What is the recommended rate of chest compressions for adults in CPR?

    <p>At least 100 per minute</p> Signup and view all the answers

    What is the most common cause of hypersensitivity reactions to local anesthesia?

    <p>All of the above</p> Signup and view all the answers

    What type of local anesthetic agent is more commonly associated with hypersensitivity reactions?

    <p>Ester type</p> Signup and view all the answers

    What is the approximate percentage of complications of local anesthesia due to hypersensitivity reactions?

    <p>Less than 1%</p> Signup and view all the answers

    What is the recommended universal compression to ventilation ratio in CPR for adults?

    <p>30:2</p> Signup and view all the answers

    What is a common psychogenic factor that may trigger vasovagal syncope?

    <p>Pain of a sudden and unexpected nature</p> Signup and view all the answers

    What is the effect of the withdrawal of sympathetic nervous system tone on blood vessels?

    <p>Dilation of blood vessels</p> Signup and view all the answers

    What is the primary mechanism of vasovagal syncope, regardless of the trigger?

    <p>Enhancement of parasympathetic nervous system tone</p> Signup and view all the answers

    What is the result of the cardioinhibitory response in vasovagal syncope?

    <p>Decrease in heart rate and contractility</p> Signup and view all the answers

    What is a non-psychogenic factor that may predispose to vasovagal syncope?

    <p>Hunger or starvation</p> Signup and view all the answers

    What is the primary goal of prevention in vasovagal syncope?

    <p>Eliminating the cause</p> Signup and view all the answers

    What is the result of the vasodepressor response in vasovagal syncope?

    <p>Decreased blood flow to the brain</p> Signup and view all the answers

    Why is it recommended to take a light meal prior to a dental appointment to prevent vasovagal syncope?

    <p>To maintain cerebral blood glucose levels</p> Signup and view all the answers

    Study Notes

    Complications of Local Anesthesia

    • Paresthesia: Caused by trauma to a nerve during injection, leading to a sensation of an electric shock throughout the affected nerve distribution.
    • Paresthesia Causes: Injection of contaminated local anesthetic solution, hemorrhage, and infection near a nerve.
    • Paresthesia Prevention: Strict adherence to injection protocol and proper care of dental cartridges.
    • Paresthesia Management: Most cases resolve within 8 weeks without treatment; reassure the patient and provide strict follow-up.

    Needle Breakage

    • Causes: Weakening of the dental needle by bending, sudden patient movement, using smaller needles, reusing needles, incorrect use, and defective manufacturing.
    • Prevention: Check needles before use, use larger gauge needles, and avoid redirecting inserted needles.
    • Management: Stay calm, localize the broken part, and remove the visible portion with a hemostat; refer to an oral and maxillofacial surgeon if necessary.

    Facial Nerve Paralysis

    • Causes: Inserting the needle too far back and behind the ascending ramus, anesthetizing the facial nerve branches.
    • Management: Reassure the patient of transient nature, advise using an eye patch, and provide symptomatic treatment.
    • Prevention: Select appropriate local anesthetic duration and warn the patient against drinking hot fluids and biting lips or tongue.

    Hematoma

    • Causes: Penetration of blood vessels with the needle during injection.
    • Prevention: Learn anatomical landmarks and injection technique, and avoid relocating the needle.
    • Management: Apply direct pressure, inform the patient, and reevaluate treatment continuation; prescribe analgesics and antibiotics if necessary.

    Infection

    • Predisposing Factors: Psychogenic factors (anxiety, emotional stress, pain, and sight of blood), and non-psychogenic factors (prolonged standing, hunger, poor physical condition, and hot environment).

    Vasovagal Syncope

    • Mechanism: Brainstem activation by triggering stimulus, leading to simultaneous enhancement of parasympathetic and withdrawal of sympathetic nervous system tone.
    • Prevention: Good preoperative assessment, light meal before appointment, proper injection technique, sedation for anxiety relief, and elimination of causes.
    • Management: Lower the head, elevate the legs, loosen tight clothing, stimulate respiration, and provide spontaneous recovery.

    Cardiopulmonary Resuscitation (CPR)

    • Procedure: Combines chest compressions with artificial ventilation to preserve brain function until further measures restore spontaneous blood circulation and breathing in cardiac arrest patients.
    • CPR Techniques: Chest compressions (5 cm deep, 100 per minute, 30:2 compression-to-ventilation ratio), and artificial ventilation through mouth-to-mouth resuscitation or mechanical ventilation.

    Hypersensitivity or Allergy to Local Anesthesia

    • Causes: Reaction to local anesthetic agent, vasoconstrictor, or additives like bisulfite.
    • Incidence: Less than 1% of all complications of local anesthesia.

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    Related Documents

    Oral Surgery Lecture 7: Complications of Local Anesthesia PDF

    Description

    Learn about the causes, prevention, and management of paresthesia, a common complication of local anesthesia, including trauma to nerves and infection.

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