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Local & Systemic Complications of Local Anesthesia
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- IB GLOBAL POLITICS - CASE STUDIES
Local & Systemic Complications of Local Anesthesia
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Local & Systemic Complications of LocalAnesthesia
Which technique of local anesthesia produced the greatest number of needle
breakage? - ANS-Inferior Alveolar Nerve Block
In what size needle does most breakage occur? - ANS-30-gauge short
What can be done to prevent needle breakage? - ANS--Use larger needles
-Don't bend the needle
-Talke to pt prior to and during injection
-Don't insert to the hub which is the weakest point
-Don't redirect the needle with it embedded in tissue - must remove until almost out of
tissue to redirect
How can pain/burning be prevented during the injection of local anesthetics? -
ANS--Slow injection - shouldn't exceed 1.8 (1 cartridge) of anesthesia per minute
-Dry storage at room temperature
Name some causes of pain/burning on injection. - ANS-- more acidic anesthetic solution
(esp. in those with vasoconstrictors)
-rapid deposition of anesthetic
-dull needle or barb on needle
-storing anesthetic solution in alcohol
What is the most likely site of nerve injury after administration of local anesthesia? -
ANS-Lingual nerve because of few fasciles
What are the main causes of nerve injury from the administration of local anesthesia? -
ANS--hyper responder
-chemicals (alcohol, disintectants, local anesthetics)
-trauma
-hemorrhage
If a patient complains of "numbness," what should be done? - ANS--be reassuring -
speak directly to patient
-explain that paresthesia is not uncommon after local anesthesia administration
-have the patient return for examination
, -record the incident in chart
What should be done at appointment to examine pt complaining of "numbness?" -
ANS--determine the degree and extent of paresthesia
-explain that paresthesia normally persists for at least 2 months before resolution
begins, and that it may last up to a year or longer
-offer to send to an OMFS (oral and maxillofacial surgeon)
-appointments weekly for first month
-document
A prolonged, tetanic spasm of the jaw muscles by which the normal opening of the
mouth is restricted. - ANS-Trismus
Causes of trismus from the injection of local anesthetics. - ANS--trauma to muscles or
blood vessels in the infratemporal fossa
-hemorrhage
-low grade infection
-multiple needle injections
-excessive volumes of local anesthetic area into a restricted area
-local anesthetics are slightly myotoxic to skeletal muscles
-muscle necrosis from injects of LA solution intramuscularly or supramuscularly
How should trismus be treated? - ANS--arrange appointment for examination
-Prescribe heat therapy (hot, moist towels should be applied to affected area for
approximately 20 minutes every hour)
-warm saline rinses (1 teaspoon of salt added to a 12-ounce glass of warm water) hold
water in the infected side, then spit out
-NSAIDS analgesic
-muscle relaxants
-physiotherapy of the jaw (sugarfree chewing gum, open/close mouth, move jaw
side-to-side
-antibiotics if pain is persistent after 2-3 days
Trismus is most common after which local anesthetic injection? - ANS-inferior alveolar
nerve block
What is the cause of a hematoma from the injection of a local anesthetic? -
ANS-puncture or partial laceration of an artery or vein
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