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Local Anesthesia Manual Local Anesthesia Loma Linda University School of Dentistry 2011/2012 Barry Krall DDS 1 Local Anesthesia Manual Local AnesthesiaTable of Contents 4 Course Objectives 5 History of Anesthesia and Sedation 6 Armamentarium 9 Fundamentals of injection technique 12 Pharmacology of local anesthetics 22 Pharmacology of vasoconstrictors 25 Patient evaluation 32 Dosages 36 Complications of local anesthetic injections 42 Supraperiosteal injection 44 IA, lingual and buccal nerve blocks 51 Infratemporal fossa 53 Posterior superior alveolar nerve block 57 Pterygopalatine fossa 58 Greater palatine and nasopalatine nerve blocks 61 Mental/Incisive nerve blocks 64 ASA “field block” injection 66 Supplemental injections 68 Miscellaneous injections 77 Bacterial endocarditis prophylaxis regimen 78 Table of blocks 79 Dosage guidelines 81 References 3 LOCAL ANESTHESIA MANUAL COURSE OBJECTIVES To learn how to administer local anesthetics effectively, safely and painlessly. To do this you need to know how and be able to do 5 things: 1. What you’re giving? Therefore we will discuss the pharmacology of local anesthetics. 2. Who you’re giving it to? We will discuss how to evaluate patients physically and emotionally. This will involve some physiology. Emergency prevention is emphasized. 3. Where to place it? The anatomy of respective nerves and adjacent structures must be learned. 4. How to place it there? Painlessly, in the right amount at the proper rate (slowly). The technique is both an art and a science. 5. How to handle emergencies? Some may occur in your office or elsewhere. As health professionals we should know what to do, especially if we precipitated the event! 4
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