dr. maged omar local anesthesia complications 4thy lec1
TRANSCRIPT
Complications of Local Anesthesia
Dr. Maged A Omar
•Any deviation from normally expected pattern during or following the securing of regional anesthesia
Complications
• Mucosal irritation or tissue reactions due to the solution• Pain on injection• Burning on injection• Lip trauma• Prolonged impairment of sensations• Hematoma• Trismus• Facial paralysis• Visual disturbance• Broken needle• Gagging
Local Complications
• Mucosal irritation due to topical anesthesia
• Sloughing of palatal mucosa (delayed)
• Blanching of peripheral tissues supplied by artery
• Patient relaxation
Pain on Injection Lowered by :
• Topical anesthesia
• Stretching of mucosa
• Apprehensive patient position on the dental chair
Pain on Injection
• Slow injection
Pain on Injection Lowered by :
• Warmed solution
• Sharp needle
• Reasonable quantities
• Touching the nerve• Contaminated solution• Subperiosteal injection• Intramuscular injection• Injection against resistance• Too rapid injection• Cold solution
Pain on InjectionCauses:
• Touching the nerve
Pain on InjectionCauses:
• Contaminated solution
Pain on InjectionCauses:
•Subperiosteal injection
Pain on InjectionCauses:
• Intramuscular injection
Pain on InjectionCauses:
• Injection against resistance
Pain on InjectionCauses:
• Too rapid injection
Pain on InjectionCauses:
• Cold solution
Pain on InjectionCauses:
• Acidic preservative
• Immersion of sterilizing solution seeping into the cartridge
Burning on InjectionCauses:
Oral Surgery
• Lip chewing
Lip Trauma
• Prevented by cotton role in the labial vestibule
Lip Trauma
Prolonged impairment of sensations• Prolonged anesthesia• Paresthesia (tingling, burning)• Hyperesthesia ( sensitivity to stimuli)Causes• Hemorrhage within the nerve sheath• Impinging on the nerve trunk• Infection close to the nerve• Contaminated solution (e.g. alcohol)
Trismus
• Limited mouth opening (after 1-6 days)
Causes• Trauma to medial pterygoid muscle• Hemorrhage and hematoma
Treatment• Symptomatic• In severe cases; forcible opening exercises ,sometimes under GA
Trismus
Hematoma• Most commonly in posterior superior alveolar block
Facial paralysis
Facial paralysis
Facial paralysis
Visual Disturbance
Visual Disturbance
Broken needles• When using 27 gauge needle• Bending needle• Inserting needle to its hub• Major changes in position of the needle during administration• Unexpected movement of the patient
Broken needles
Broken needles
Broken needles
Broken needles
Gagging