Local Anesthesia (Part2)

Dr. Gao Yin, MDS

Oral and Maxillofacial Surgery Department
The Affiliated Stomotological Hospital
Wenzhou Medical University

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 Objectives

Basic Injection Complications of

Techniques Local Anesthesia

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 Basic Injection Techniques
Position of operator relative to the chair

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques
19 Steps for An Atraumatic Injection Technique
1. Use a sterilized sharp needle 13. Slowly advance the needle toward
2. Check the flow of local anesthetic sloution the target
3. Determine whether to warm the anesthetic
cartridge and/or syringe 14. Deposit several drops of local
4. Position the patient anesthetic before touching the
5. Dry the tissue periosteum
6. Apply topical antiseptic (optional) 15. Aspirate
7. Apply topical anesthetic; communicate with
the patient
16. Slowly deposit the local anesthetic
8. Establish a firm hand rest solution; communicate with the
9. Make the tissue taut patient
10. Keep the syringe out of the patients line of 17. Slowly withdraw the syringe. Cap
sight the needle and discard
11. Insert the needle into the mucosa; watch and
communicate with the patient 18. Observe the patient after the
12. Inject several drops of local anesthetic injection
(optional) 19. Record the injection on the
patients chart

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Techniques of
Mandibular Regional
Anesthesia

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Basic Injection Techniques

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 Complications of Local Anesthesia
Always make notes in the patients chart of all perioperative
complications

Maintain excellent fundamental knowledge on the following

areas relating to complications of local anethesia:
Causes
Specific Problems
Prevention
Management

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 Complications of Local Anesthesia
Infection
Local Complications Edema
Sloughing of tissues
Needle Breakage
Soft tissue injury
Pain on injection
Burning on injection Facial nerve paralysis
Persistent anesthesia or Postanesthetic intraoral
paresthesia lesions
Trismus
Hematoma

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 Complications of Local Anesthesia
Systemic Complications

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 Complications of Local Anesthesia
Systemic Complications

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 Complications of Local Anesthesia
Systemic Complications

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 Complications of Local Anesthesia
Systemic Complications

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 Complications of Local Anesthesia
Systemic Complications

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 Complications of Local Anesthesia
Systemic Complications

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 Complications of Local Anesthesia
Procedures Recommended for Minimizing the Occurrence of Systemic
Complications

Complete preliminary medical Topical anesthetic should be

evaluations prior to local applied before all injections
anesthetic administration for a minimum of 1 minute
Anxiety, fear, and The weakest effective
apprehension should be concentration of local
recognized and managed anesthetic solution should be
before administration of a injected in the minimum
local anesthetic volume compatible with
All dental injections should be successful anesthesia
administered with the patient
supine or semisupine. Patients
should not receive local
anesthetic injections in the
upright position unless special
conditions dictate (e.g., severe
cardiorespiratory disease)

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 Complications of Local Anesthesia
Procedures Recommended for Minimizing the Occurrence of Systemic
Complications

The anesthetic solution selected Aspirating syringes must always

should be appropriate for the
dental treatment contemplated
(duration of action)
Vasoconstrictors should be
included in all local anesthetics
unless specifically contraindicated
by the desired duration of effect
or the patients physical status
Needles should be disposable,
sharp, rigid, capable of reliable
aspiration and of adequate length
for the contemplated injection
techniques
be used for all injections
Aspiration should be carried out
in at least two planes prior to
injection
Injection should be made slowly,
a minimum of 60 seconds for
deposition of 1.8 ml of anesthetic
Observe the patient both during
and after the administration for
signs of undesirable reaction.
Never give the injection and leave
the patient alone while doing
other procedures

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