Pain Management in Children including LA - 2.5

Pain Management in Children

• Spectrum of Patient Management: Includes behaviour management (non-pharmacological), local anaesthesia, sedation, and general anaesthesia, progressing from least to most invasive.

• Behaviour Management: Techniques include preparatory information, verbal communication (voice control, "tell-show-do"), distraction, behaviour shaping, positive reinforcement, and modelling/systematic desensitisation.

• Local Anaesthesia (LA): Lidocaine 2% with 1:80,000 adrenaline is a common choice. Key dosage information includes:

  • 20 mg/mL
  • 36 mg/1.8 mL cartridge
  • 44 mg/1.8 mL cartridge
  • Maximum dose is 4.4 mg/kg (toxic dose)
  • Safe dose is 0.1 (1/10) mg/kg (proportion of 2.2 mL cartridge)
  • Max dose of 2.2 mL cartridges is 20 for a 20 kg child (5 years old).

• Restorations and Extractions in Primary Teeth: LA techniques include buccal/labial infiltrations, buccal + palatal/labial infiltrations (for extractions)

• Additional LA Procedures: Intra-papillary infiltrations for specific procedures (restorations/extractions of lower permanent molars); infiltrations of ID regions (Injected blocks).

• Sedation: Verbal contact is maintained during the procedure (not fully unconscious).

  • Modes of Delivery: Intravenous, Oral, Inhalation (nitrous oxide/oxygen).

• Intravenous: Deep sedation, expensive, requires specialized training.

• Oral: Simple sedation, minimal compliance.

• Inhalation: Relatively simple, effective, safe (relatively safe), requires compliance.

• Contraindications for Sedation and General Anaesthesia Certain conditions may prevent procedures. - Mouth breathers - Upper respiratory tract infections - Patients with carious asymptomatic teeth and orthodontic extractions (certain types of dental problems/treatments)

This quiz covers essential techniques in pain management for pediatric patients, including behavior management and types of anesthesia. It explores both non-pharmacological strategies and pharmacological interventions such as local anesthesia for dental procedures. Understand the key concepts and dosing guidelines for safeguarding children's health during treatments.