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What is a common symptom reported by patients who experience paresthesia due to trauma to a nerve during injection?
What is a common symptom reported by patients who experience paresthesia due to trauma to a nerve during injection?
What is a potential cause of paresthesia due to contamination of a local anesthetic solution?
What is a potential cause of paresthesia due to contamination of a local anesthetic solution?
How long does most paresthesia resolve without treatment?
How long does most paresthesia resolve without treatment?
What is the primary cause of needle breakage?
What is the primary cause of needle breakage?
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What is a common point of needle fracture?
What is a common point of needle fracture?
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What is a consequence of severe damage to a nerve?
What is a consequence of severe damage to a nerve?
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What is a recommended prevention measure for needle breakage?
What is a recommended prevention measure for needle breakage?
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What is a consequence of re-using a needle?
What is a consequence of re-using a needle?
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What is the primary goal when a patient exhibits an allergic response to local anesthesia?
What is the primary goal when a patient exhibits an allergic response to local anesthesia?
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Which of the following is NOT a clinical manifestation of an allergic reaction?
Which of the following is NOT a clinical manifestation of an allergic reaction?
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What is the recommended dosage of epinephrine in the management of anaphylaxis?
What is the recommended dosage of epinephrine in the management of anaphylaxis?
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Which type of local anesthetic agent can be substituted for an ester-type agent in the event of an allergic reaction?
Which type of local anesthetic agent can be substituted for an ester-type agent in the event of an allergic reaction?
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What is the primary characteristic of anaphylactic shock?
What is the primary characteristic of anaphylactic shock?
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What is the recommended course of action after administering epinephrine for anaphylaxis?
What is the recommended course of action after administering epinephrine for anaphylaxis?
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What is the cardiovascular symptom associated with anaphylactic shock?
What is the cardiovascular symptom associated with anaphylactic shock?
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What is the purpose of administering oxygen in the management of anaphylaxis?
What is the purpose of administering oxygen in the management of anaphylaxis?
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What is the most common age group in which trauma occurs?
What is the most common age group in which trauma occurs?
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What is the primary reason for selecting a local anesthetic of appropriate duration?
What is the primary reason for selecting a local anesthetic of appropriate duration?
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What is the primary symptom of hematoma following injection?
What is the primary symptom of hematoma following injection?
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Which of the following blood vessels is most commonly associated with hematoma?
Which of the following blood vessels is most commonly associated with hematoma?
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What is the primary management strategy for hematoma that is visible immediately following injection?
What is the primary management strategy for hematoma that is visible immediately following injection?
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What is the primary reason why infection after local anesthesia has become rare?
What is the primary reason why infection after local anesthesia has become rare?
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What is the primary management strategy for trauma?
What is the primary management strategy for trauma?
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What is the primary reason for instructing the patient to avoid drinking hot fluids after local anesthesia?
What is the primary reason for instructing the patient to avoid drinking hot fluids after local anesthesia?
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What is the first step in the first aid treatment of a vasovagal attack?
What is the first step in the first aid treatment of a vasovagal attack?
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What is the recommended rate of chest compressions in CPR for adults?
What is the recommended rate of chest compressions in CPR for adults?
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What is the primary reason for loosening tight belts and collars in a patient with a vasovagal attack?
What is the primary reason for loosening tight belts and collars in a patient with a vasovagal attack?
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What is the universal compression to ventilation ratio recommended for adults in CPR?
What is the universal compression to ventilation ratio recommended for adults in CPR?
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What is the most common cause of hypersensitivity reactions to local anesthesia?
What is the most common cause of hypersensitivity reactions to local anesthesia?
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How common are hypersensitivity reactions to local anesthesia?
How common are hypersensitivity reactions to local anesthesia?
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What is the primary goal of CPR in a person who is in cardiac arrest?
What is the primary goal of CPR in a person who is in cardiac arrest?
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What is the recommended depth of chest compressions in CPR for adults?
What is the recommended depth of chest compressions in CPR for adults?
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What is the primary cause of infection spreading during local anesthesia administration?
What is the primary cause of infection spreading during local anesthesia administration?
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What is the primary reason for a patient experiencing pain and trismus after local anesthesia administration?
What is the primary reason for a patient experiencing pain and trismus after local anesthesia administration?
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What is the recommended treatment for a patient experiencing trismus after local anesthesia administration?
What is the recommended treatment for a patient experiencing trismus after local anesthesia administration?
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What is the primary element necessary for efficient local anesthesia administration?
What is the primary element necessary for efficient local anesthesia administration?
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What is the most common systemic complication of local anesthesia in the dental office?
What is the most common systemic complication of local anesthesia in the dental office?
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What is the primary cause of cerebral ischemia during a vasovagal attack?
What is the primary cause of cerebral ischemia during a vasovagal attack?
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What is the typical outcome of a vasovagal attack in the dental office?
What is the typical outcome of a vasovagal attack in the dental office?
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What is a common symptom experienced by patients during a vasovagal attack?
What is a common symptom experienced by patients during a vasovagal attack?
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Study Notes
Complications of Local Anesthesia
- Paresthesia is a transient or permanent condition caused by trauma to a nerve during injection, characterized by a sensation of an electric shock throughout the distribution of the involved nerve.
Causes of Paresthesia
- Trauma to any nerve during injection
- Injection of local anesthetic solution contaminated by a neurotoxic substance
- Hemorrhage and infection in close proximity to a nerve
Prevention of Paresthesia
- Strict adherence to injection protocol
- Proper care and handling of dental cartridges
Management of Paresthesia
- Most cases resolve within 8 weeks without treatment
- Reassure the patient that the condition is transient with strict follow-up
- If the damage to the nerve is severe, the paresthesia will be permanent
Needle Breakage
- Causes:
- Weakening of the dental needle by bending it before insertion
- Sudden unexpected movement of the patient
- Smaller needles (e.g., gauge 30) are more likely to break than larger needles (e.g., gauge 25)
- Re-use of the needle
- Incorrect use of the needle (e.g., aggressive insertion, sudden change in direction, too deep penetration)
- Defective needles in manufacture
Prevention of Needle Breakage
- Check the needles before using them
- Use appropriate needle size and type
- Handle needles carefully to avoid bending or damaging
Hematoma
- A localized mass of extravasated blood that may become clinically noticeable following injection
- Causes:
- Penetration of the blood vessel with the needle during injection
- Prevention:
- Learn anatomical landmarks and injection technique
- Avoid relocating the needle to different sites inside the tissue
- Management:
- Apply direct pressure if possible
- Inform the patient and reevaluate the possibilities of continuing the treatment
- Instruct the patient to avoid application of heat over the area
- Prescribe analgesic and antibiotic if necessary
Infection
- Causes:
- Contamination of the needle by touching the mucous membrane
- Improper technique in handling the local anesthetic equipment
- Injecting the solution into an area of infection
- Prevention:
- Use sterile disposable needles
- Proper handling of the needle to avoid its contact with non-sterile surfaces
- Use cartridge only once and store it in its original container, covered at all times
- Management:
- If an infection occurs, the patient will complain of pain and trismus
- Immediate treatment consists of procedures used to manage trismus
- Prescribe a course of antibiotic for 7 days
Systemic Complications of Local Anesthesia
Fainting (Vasovagal Attack)
- The most common systemic complication that occurs with local anesthesia
- Refers to a sudden transient loss of consciousness usually secondary to cerebral ischemia
- Causes:
- Vasodilatation or an increase in peripheral vascular bed
- Corresponding drop in blood pressure
- Management:
- The first aid treatment should be started at once
- Lower the head of the patient, elevate the legs, loosen tight belt and collar, and stimulate respiration
- Spontaneous recovery is usual and it is often possible to complete the treatment at the same visit
Hypersensitivity or Allergy to Local Anesthesia
- More commonly seen with ester type agents than amide type
- Causes:
- Local anesthetic agent
- Vasoconstrictor
- Additives like bisulfite used as a preservative
- Prevention:
- Proper pre-anesthetic evaluation, which includes a proper personal history and past dental history
- Management:
- Antihistamine injection
- Epinephrine 0.5 ml of 1:1000 IM
- Administer O2 if necessary
- Substitution of the local anesthetic agent
Anaphylactic Shock
- A rare, life-threatening hypersensitivity reaction to an antigen
- Develops fast, causing death within a few minutes
- Characterized by:
- Profound fall in the blood pressure
- Dyspnea and respiratory embarrassment
- Facial and laryngeal edema
- Loss of consciousness
- Management:
- If you suspect an anaphylactic reaction, immediately seek medical help
- Epinephrine is the most important medication, given as intramuscular injection
- Even if the patient responds to the epinephrine, it is vitally important to go to an emergency room immediately
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Description
Learn about the causes and prevention of paresthesia, a condition caused by nerve trauma during local anesthesia injections. Understand the risks and how to avoid them.
