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Ch 37 Anesthesia
anesthesia and pain control
| Question | Answer |
|---|---|
| Analgesia | stage of anesthesia in which the patient is relaxed and conscious |
| Anesthesia | temporary loss of feeling or sensation |
| Anesthetic | medication that produces the temporary loss of feeling or sensation |
| Aspirate | to draw back or to draw with in |
| Diffuse | to spread from an area of high concentration to one of low concentration |
| Duration | time from induction to complete reversal of anesthesia |
| Guage | standard dimension or measurement of the thickness of an injection needle |
| Induction | time from injection to effective anesthesia |
| Innervation | supply or distribtion of nerves to a specific body part |
| Lumen | the hollow center of the injection needle |
| Oximetry | measurement of oxygen concentration in the blood |
| Permeate | to spread or flow throughout |
| Porous | an object with minute openings that allow the passage of gas or fluid. |
| Systemic toxicity | relating to a system, or typically the entire body |
| Tidal volume | amount of air inhaled and exhaled with each breath |
| Titrate | to determine the concentration of a substance |
| Titration | the process of determining the exact amount of a drug or substance that would be used to achieve a desired level of sedation. |
| Vasoconstrictor | type of drug that constricts ( narrows ) blood vessels;used to prolong anesthetic action. |
| What 5 methods of pain control are used in dentistry to alleviate or reduce anxiety and pain | topical anesthesia, local anesthesia, inhalation sedation, antianxiety agents, intravenous sedation, and general anesthesia |
| how long must topical anesthetic remain on the site of injection for optimum effectiveness | 3-5 minutes |
| the topical patch provides anesthesia with in ________ seconds | 10 |
| when was local anesthesia first discovered? | mid 1800's |
| which 2 chemical groups does local anesthetic come under | amides and ester type |
| which chemical type does topical anesthetic belong to | ester type |
| why is sodium chloride in anesthetic solution | it makes the solution isotonic with body tissues |
| why is distilled water in anesthetic solution | supplies an added volume of solution |
| what is the purpose of adding a vasoconstrictor to an anesthetic | to slow down the intake of an anesthtic agent and increase the duration of action |
| what are the 3 major vasoconstrictors used with local anesthetic agents | epinephrine, lefonordefrin, and neo-cobefrin |
| with vasoconstrictor levels the smaller the ratio..... | the higher the percentage of vasoconstrictor |
| what medical conditions would indicate using an anesthetic with out a vasoconstrictor | unstable angina, recent myocardial infarction, recent coronary artery bypas surgery, untreated or uncontrolled severe hypertension & untreated or uncontrolled congestive heart failure. |
| a short acting anesthetic will last | 60-180 minutes |
| a intermediate acting anesthetic will last | 120-240 minutes |
| a long acting local anesthetic will last | 240-540 minutes |
| to create anesthesia where does a local anesthetic need to be injected | near a nerve where treatment is to take place |
| what are the 3 major types of local anesthetic injections that are given in the maxillary arch | local infiltration, field block, and nerve block |
| what does local infiltration mean | is completed by injecting into a small isolated area |
| what does field block mean | refers to the injection of anesthetic near a larger terminal nerve branch |
| what does nerve block mean | occurs when local anesthetic is deposited close to a main nerve trunk, usually indicated for quadrant dentistry |
| types of nerve block injections | posterior superior alveolar, inferior alveolar and the nasopalatine |
| what are the commom palatal injections called | anterior ( or greater ) palatine nerve block and the nasopalatine nerve block |
| the anterior palantine nerve block provides anesthesia | in the posterior portion of the hard palate |
| the nasopalatine nerve block provides anesthesia | in the anterior portion of the hard palate |
| what block is often referred to as a mandibular nerve block | inferior alveolar nerve block |
| when given a inferior alveolar nerve block, where will the patient experience numbness | over half of the lower jaw including the teeth ,tongue,and lip. |
| what nerve block provides anesthesia to the buccal soft tissues closest to the mandibular molars | Buccal nerve block |
| what block is given only when the mandibular anterior teeth or premolars require anesthesia | incisive nerve block |
| where is the incisive block injection given | at the site of the mental foramen, the branch of nerve continues with inthe mandibular canal to the apices of the anterior teeth |
| what injection is generally an addition to conventional techniques that may be completed with the use of a conventional syringe or a special syringe | Periodontal ligament injection |
| what are the parts of the anesthetic syringe | thumb ring, finger grip, harpoon, piston rod, barrel of the syringe,threaded tip |
| what are the parts of the anesthetic cartridge | glass carpule, rubber or silicone stopper at one end and an aluminum cap with a rubber diaphragm at the other end |
| why do we color code anesthetic carpules | so the dental practitioner could easily recognize different brands of anesthetic, the band of color is placed 3 mm from the stopper end |
| what is the color band color on the lidocaine 2 % 1:100,000 carpule | red |
| what is the color band color on the Mepivacaine HCI 3% | tan |
| what is the color band color on the prilocaine HCI 4% 1:200,000 | yellow |
| what are the 3 most common needle guage sizes | 25, 27 and 30 |
| what color is the 30 guage needle | blue |
| what color is the 27 guage needle | yellow |
| what color is the 25 guage needle | red |
| what are the 2 common lengths of anesthetic needles | 1 inch or 1 5/8 inch |
| the larger the guage number of the needle | the thinner the needle |
| the smaller the guage number of the needle | the thicker the needle |
| how would you know that the needle has entered the blood vessel | a thin line of red blood cells will be drawn into the anesthetic cartridge when aspirating |
| when are local anesthetic agents not effective | where a tooth or soft tissue is infected |
| which end of the anesthetic carpule goes in first toward the thumb ring | stopper end |
| what is paresthesia | is a condition in which numbness lasts after the effects of local anesthetic solutions should have worn off |
| how long does most paresthesia last | 8 weeks without treatment, it is permanent only if damage to the nerve is severe |
| who replaced the needle in to the guard after injection | Dentist |
| what is to be considered the safest type of sedation method used in dentistry | inhalation sedation w/ N2O/O2 |
| what happens in the beginning and the end of the administration of N2O/O2 | 100% oxygen given |
| why would you not use N2O/O2 | pregnant pt ( unless ob dr says its ok ) nasal obstruction, emphysema and multiple sclerosis or emotional instability |
| what is color of the cylindar that N2O is in | Blue |
| why is a scavenger system used | to protect you and other dental personnel from the occupational risks of N2O,to reduce the N2O released into the treatment room |
| who was the first dentist to use N2O on his patients | in 1844 Horace Wells |
| why are sedatives or antianxiety agents used in dentistry | nervous patients, long or difficult procedure,mentally challenged patient, very young children who are undergoing extensive treatment |
| which 2 specialists who most often used Iv sedation | oral and maxillofacial surgeon and the periodontist |
| is the patient conscious during Iv Sedation | yes,they maintain the ability to keep an open airway and can respond appropriately to physical or verbal stimulation |
| what is the controlled state of unconsciousness characterized by loss of protective reflexes, including the ability to maintain an airway or the ability to respond | general anesthesia |
| what are the 4 stages of anesthesia | analgesia, excitement, general anesthesia and respiratory failure |
| when doing a surgical procedure with gengeral anesthesia what do you give patients as far as before instructions go | do not eat 8-12 hours prior to procedure |
| when using nitrous ( inhalation sedation ) what is the higest ratio of nitrous to oxygen that can be used | 70/20 , 70 % nitrous and 20 % oxygen |
Created by:
cynthia.fryer