part2.anesthesia
DESCRIPTION
oral medicineTRANSCRIPT
![Page 1: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/1.jpg)
Local Anesthesia in Dentistry
Wang Yin Stomatology Department , General Hospital affiliated to Tianjin Medical U
niversity
![Page 2: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/2.jpg)
2
Local Anesthesia
• Local anesthesia is a local state of insensibility to pain produced by hypodermic injection, local application, or the instillation of an appropriate chemical compound.
![Page 3: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/3.jpg)
3
Local Anesthesia Agent Procaine Lidocaine Dicaine• Remain time 45-60 m 90-120 m 120-150m• Infiltration + +• Concentration topical ____ 2-4% 2% infiltration 0.5-1% 0.25-0.5% 0.1% block 2% 1-2% 0.1-0.2%• Toxicity + ++• Allergic response +
• Maximal 800- 300- 60-
dosage 1000 mg 400 mg 100 mg
![Page 4: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/4.jpg)
4
Using of Adrenalin Chloride
With the procaine or lidocaine is combined adrenalin chloride in the proportion of one part in about ten thousand can
Enhances and prolongs the anesthetic effectConstricts the blood vessels of the part, less
ening hemorrhageRetards absorption of the anesthetic
![Page 5: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/5.jpg)
5
Kinds of Local Anesthesia
• Refrigeration anesthesia
• Topical anesthesia• Local anesthesia by injection
• infiltration
• soft tissue infiltration
• bony tissue infiltration
• conduction (block)
![Page 6: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/6.jpg)
6
Refrigeration Anesthesia• Superficial and transie
nt local anesthesia• Ethyl Chloride• Opening superficial ab
scesses• Extraction of loose tee
th
![Page 7: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/7.jpg)
7
Topical Anesthesia
• Solutions applied to the mucosa or skin
• Produce insensibility of terminal nerve endings
• Painless insertion of sharp needles
• Opening superficial abscesses
• Extraction of loose teeth• Anodynes for alveolalgia,
ulcer,wound• Dicaine or Cocaine
![Page 8: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/8.jpg)
8
Infiltration Anesthesia (terminal, peripheral anesthsia
)
• The anesthesia solution is injected into the mucous membrane or beneath the skin to paralyze sensory nerve endings.
![Page 9: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/9.jpg)
9
Infiltration Anesthesia (terminal, peripheral anesthsia
) • Limit to a small area• Soft tissue• Bony tissue• Occur in 5-10 minutes• Remain for 0.5 hour• Extraction of individual teeth (except lower molor
s)• Minor operations
![Page 10: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/10.jpg)
10
Infiltration Anesthesia (submucous anesthsia )
![Page 11: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/11.jpg)
11
Infiltration Anesthesia (peridontal membrane anesthsia )
![Page 12: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/12.jpg)
12
Infiltration Anesthesia (subperiosteal anesthsia )
![Page 13: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/13.jpg)
13
Conduction Anesthesia• When injected in the vicinity
of a nerve trunk, an anesthetic solution penetrates by way of the perineurium into the central nerve substance, inhibiting its conducting function, and thus anesthetizing the entire peripheral areas supplied by the nerve. It is therefore anesthesia produced by elimination of the conductivity of the nerve trunk.
![Page 14: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/14.jpg)
14
Conduction Anesthesia
• Bone operations
• Extraction of teeth
• Extensive soft tissue procedures of face
![Page 15: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/15.jpg)
15
• Outer nerve loop infraorbital N. superior alveolar N.• Supply
bone and teeth of the upper jaw on one side
mucous membrane of mixillary sinus
buccal periosteum and gum tissue
Conduction Anesthesia in Maxilla
![Page 16: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/16.jpg)
16
Conduction Anesthesia in Maxilla
• Inner nerve loop anterior palatine N. nasopalatine N.• Supply
hard palate on one side
soft tissue covering it
![Page 17: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/17.jpg)
17
Conduction Anesthesia in Maxilla
• Maxillary tuberosity
• Posterior palatine foramen
• Infraorbital foramen
• Incisive fossa
![Page 18: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/18.jpg)
18
Maxillary Tuberosity• Injection here will block the posterior superior
alveolar nerve, which supplies the upper molar and sometimes the premolar teeth.
![Page 19: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/19.jpg)
19
Maxillary Tuberosity
![Page 20: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/20.jpg)
20
Infraorbital Foramen• Injection at the infraobital foramen blocks the peri
pheral distribution of the infraorbital nerve and the anterior superior dental nerve, producing anesthesia of the teeth, the buccal mucous membrane , and the bone, from the canine to the central incisor.
![Page 21: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/21.jpg)
21
Incisive Fossa
• Injection at this point blocks the naso-palatine nerve, and gives anesthesia of the anterior portion of the palate, immediately behind the incisor teeth.
![Page 22: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/22.jpg)
22
Posterior Palatine Foramen
• An injection at this point blocks the anterior palatine nerve and produces anesthesia of the hard palate as far forward as the canine tooth.
![Page 23: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/23.jpg)
23
Conduction Anesthesia in Mandible
![Page 24: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/24.jpg)
24
Conduction Anesthesia in Mandible
![Page 25: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/25.jpg)
25
Conduction Anesthesia in Mandible
![Page 26: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/26.jpg)
26
• Blocking the inferior alveolar nerve at the mandibular foramen produces anesthesia of the teeth, alveolar process and gum tissue of one-half of the lower jaw, with the exception of an area of gum tissue on the buccal side of the molar teeth,which is partly supplied by the long-buccal nerve, the mucous membrane on the lingual side of the teeth, partly supplied by the lingual nerve, and the anterior portion of the mandible, including the incisor teeth, which is supplied in part by overlapping fibers of the nerve from the opposite side.
Conduction Anesthesia in Mandible
![Page 27: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/27.jpg)
27
Conduction Anesthesia in Mandible
![Page 28: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/28.jpg)
28
Conduction Anesthesia of Lingual Nerve
![Page 29: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/29.jpg)
29
Conduction Anesthesia of Buccal Nerve
![Page 30: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/30.jpg)
30
Contraindication of Local Anesthesia
• acute suppurative infections• peridental membrane involvements• young children• neurasthenic, apprehensive ,uncooperative patients• patient’s jaw cannot be opened• hyperthyroidism• idiosyncrasy for procaine• hepatitis• cardiovascular disease
![Page 31: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/31.jpg)
31
Complications
• Idiosyncrasy
• Shock and collapse
• Breaking the needle
• Postoperative pain
• Hematoma
• Ecchymosis
• Trismus
• Infections
• Prolonged anesthesia
• Facial paralysis
• Procaine dermatitis
• ......
![Page 32: Part2.Anesthesia](https://reader035.vdocuments.us/reader035/viewer/2022070317/556b0320d8b42a2a4f8b51ac/html5/thumbnails/32.jpg)
32
CLASS OVER