EQUIPMENT AND TECHNIQUE FOR LOCAL ANAESTHESIA

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EQUIPMENT AND TECHNIQUE FOR LOCAL ANAESTHESIA

EQUIPMENTS

infiltration & regional anesthesia

Basic requirements

syringe

cartridge

needle

LA solutions used for injection

citanest

3% prilocaine

xylocaine 2%

salt solution

fungicide

preservative

reducing agent

vasoconstricter

LA agent

topical/surface anesthesia

ethyl chloride spray

lignocaine spray

flavoured xylocaine gel

xylocaine ointment

TECHNIQUE

Positioning

Lower jaw injection The operator should stand in front of the patient The patient should be sitting upright in the chair OR Patient titled back and the operator stands behind the patient

Upper jaw injection The chair should be positioned so that the operator will not have to bend too much forward and downwards. The patient should be slightly tilted back in the chair.

Needle after use

Needle guards

Needle pliers

Recap with scoop technique

Nerve block

Inferior dental nerve block

Insert the needle just superior and posterior to the lingual

Area anaesthetized: mandibular teeth to midline, body of mandible, buccal mucosa anterior to mental foramen, anterior 2/3 tongue and floor of mouth (lingual nerve) lingual soft tissues and periosteum (lingual nerve)

Mental nerve block

Inject at the junction of mandibular 1st and 2nd premolars and down 1 cm inferior to the marginal gingiva

Areas Anesthetized: Buccal mucous membranes anterior to the mental foramen (around the second premolar) to the midline and skin of the lower lip and chin

Lingual nerve block

Inject on the lingual side of the second mandibular molar

Area anaesthetized: The lingual nerve block anesthetizes the anterior two thirds of tongue

Buccal nerve block

Inject 1mm lateral to 3rd mandibular molar at the anterior border of the ramus

Area anaesthetized: The mucous membrane of the cheek, vestibule and sometimes a small patch of skin on the face.

Steps for injection

Inject solution slowly

Aspirate (must be negative to proceed)

Retract slightly

Insert needle until bone is contacted

Position needle at targeted area

Apply topical anaesthesia

Retract cheek, lips, tongue depending on area

Infiltration anaesthesia

Palatal

Point of needle insertion:                                            Midway imaginary line between gingival margin of the tooth and the median palatine raphe, along the long axis of the tooth at 90 degree to the palatine bone

Lingual

The point of needle intersection of 2 imaginary lines:

2nd line is a horizontal line above the floor of the mouth

1st line is a vertical line parallel to the long axis of the tooth

Buccal

The point of needle intersection of 2 imaginary lines at 45 degree

2nd line is the imaginary horizontal line along the mucobuccal fold

1st line is the imaginary vertical line of long axis of the tooth

Proper ways to inject

Ensure that the aspiration is negative

Bevel the needle towards the bone

Do not inject patient with heart problems more than twice

Do not inject on swollen area

Topical anaesthesia

Ointment

Adhesive patch

Spray

Gel