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DCA Review_ Local Anesthesia.
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DCA Review_ Local Anesthesia.
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CDCA Review: Local AnesthesiaWhat local anesthetic is metabolized by pseudocholinesterase? - ANS-Esters
Where are ester local anesthetics hydrolyzed? - ANS-In the blood plasma by the
enzyme pseudocholinesterase
Which antiseptic should not be used? - ANS-Liquid Alcohol
Before using a cartridge you should:
1) wipe it with disinfectant
2) soak it in alcohol
3) autoclave it and or sterilize it? - ANS-None of the above
What part of the syringe indicates that it is an aspirating syringe? - ANS-Harpoon
What is a possible cause of pain on removal of the needle? - ANS-Needle barb from
impaling bone
If there is no organic basis for pain - ANS-Psychogenic pain
How does a self aspirating syringe work - ANS-When you let off pressure from injecting
it self-aspirates (negative pressure built into the syringe)
When do you aspirate? - ANS-Immediately before you inject local anesthetic
What is the action of vasodepressors in local anesthetic? - ANS-increases depth and
duration of anesthetic, decreases absorption of local anesthetic and vasopressor
Maximum Doses of Epinephrine - ANS-Normal healthy patient - .2 mg
Cardiac patient - .04 mg
How much epinephrine is in a cartridge of 1:50,000 epinephrine? - ANS-.036 mg
How much epinephrine is in a cartridge of 1:100,000 epinephrine? - ANS-.018 mg
, How much epinephrine is in a cartridge of 1:200,000 epinephrine? - ANS-.009 mg
What causes a hematoma? - ANS-Effusion of blood into extravascular spaces and can
result from nicking a blood vessel, artery or vein. Common in pterygoid plexus of veins
with a PSA injection.
Treatment of Hematoma - ANS-Apply pressure for at least 2 minutes, Ice the area
immediately, and then use warm moist towels 4-6 hours after to area, rinse with salt
water
In which injection is a hematoma most likely to occur? - ANS-PSA
What is the volume of local anesthetic in a cartridge? - ANS-1.8 mL or 1.7 mL
How do you determine gauge and lumen size of a needle? - ANS-Smaller the number,
larger the lumen
30 = small
27 = intermediate
25 = large
Which needle gauge has the smallest lumen? - ANS-30 gauge
What sensation is lost first? - ANS-Pain
What function does sodium chloride provide in local anesthetic solution? - ANS-Makes
the solution isotonic with tissue
What antioxidant prevents biodegradation of vasoconstrictors? - ANS-Sodium (Meta)
Bisulfite
What is the role of sodium bisulfite in local anesthetic? - ANS-Antioxidant prevents
oxidation of the vasopressor by oxygen which might be trapped in the cartridge by the
manufacturer or diffuse through the cartridge's latex diaphragm
Primary cause of needle separation (breakage)? - ANS-Weakening of the dental needle
by bending it before insertion into the patient's mouth
2nd most common reason is patient movement during injection
When does a patient receive an electrical shock sensation during and injection? -
ANS-When needle contacts the nerve sheath
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