One of several complications that may occur when giving a local anesthetic in the dental office is paresthesia. Paresthesia happens when there is a lingering sensation of tingling or feeling of numbness around the injection site after local anesthetic has been administered, metabolized, and should have worn off. It is caused by trauma to the nerve from the needle or the solution that is used. Most cases of paresthesia end within eight weeks but some can be permanent depending on the nerve damage (Malamed, 2004, pg.289). The purpose of this paper is to determine which anesthetic is safer to use in regards to causing mandibular paresthesia. Our PICO question is, in a patient receiving a mandibular block, will administering the local anesthetic septocaine compared to lidocaine increase the incidence of paresthesia?
Septocaine, also called articaine, is a fairly new local anesthetic in the dental field. It is a four percent solution that contains epinephrine to help with the longevity of the anesthetic in the patient’s body. It was first used in dentistry in 1976 in Germany; it started becoming more popular around the world and in 2000 was approved by the Food and Drug Administration for use in the United States (Yapp, Hopcraft, & Parashos, 2010).
This local anesthetic has a thiophene ring that allows septocaine to enter neurons when given in greater doses. The thiophene ring also gives it better lipid solubility compared to other anesthetics (Yapp, Hopcraft, & Parashos, 2010). Lipid solubility is important because it allows the anesthetic to diffuse better through the injection site allowing for profound anesthesia. The half-life of this drug is twenty to thirty minutes compared to a ninety minute half-life of a regula...
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... M. (n.d.). Articaine: Efficacy and Paresthesia in Dental Local Anesthesia. Retrieved from ineedce: http://www.ineedce.com/coursereview.aspx?url=2071%2fPDF%2f1103cei_articaine_web.pdf&scid=14524
John Nusstein, J. B. (2004). Comparison of Injection Pain of Articaine and Lidocaine in a Primary Intraligamentary Injection Administered With a Computer-Controlled Local Anesthetic Delivery System. Anesth Prog 51 , 126-133.
K.E. Yapp, M. H. (2011). Articaine: a review of the literature. British Dental Journal , 210: 323-329.
Malamed, S. F. (2004). Handbook of Local Anesthesia. St. Louis: Elsevier Mosby.
Weaver, J. M. (1999). ARTICAINE, A NEW LOCAL ANESTHETIC FOR AMERICAN DENTISTS: WILL IT SUPERCEDE LIDOCAINE? Anesth Prog 46 , 111-112.
Webster's Online Dictionary. (n.d.). Retrieved from Definition: lidocaine: http://www.websters-online-dictionary.org/definitions/lidocaine
Prior to intubation for a surgical procedure, the anesthesiologist administered a single dose of the neuromuscular blocking agent, succinylcholine, to a 23-year-old female to provide muscular relaxation during surgery and to facilitate the insertion of the endotracheal tube. Following this, the inhalation anesthetic was administered and the surgical procedure completed.
Are you worried about feeling pain during a procedure? Are you scared of visiting the dentist and want to know how we can help? Our office offers three levels of dental sedation in order to help make your visit to Northwest Dental Healthcare as pleasant as possible. Learn more about our dental sedation options below.
This type of sedation should be used for patients who are fearful or very anxious about a procedure. It can also be used during longer or more complicated procedures in order to help the patient feel at ease. Oral sedation is administered via a pill or tablet and creates a sort of grogginess. You will need to have a friend or family member drive you to and from our office if you elect to use oral sedation. You will be conscious throughout the procedure, though you will feel very relaxed. If you are undergoing a complicated procedure or are afraid of the dentist, this type of sedation may be for
Individuals in this situation often benefit from sedation dentistry. With several forms available, a dentist and patient can together determine which option is most appropriate for a person's anxiety level.
Discuss the possible drug and excipient-related constrains of the formulation (no identity of the drug was given to you at this
Volles, D. F. (2011, April 11). University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures. Retrieved May 12, 2011, from University of Virgina Health System: University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures
Bowers, L., Allan, T., Simpson, A., Nijman, H., & Warren, J. (2007). Adverse Incidents, Patient
Sedation dentistry involves the use of medications to allow a patient to relax when they
Dentist believe the use of epinephrine is contraindicated in cardiovascular patients because it raises the blood pressure and heart rate. Studies show that the amount of epinephrine in dental cartridges is relatively low, therefore the use of one to three cartridges of lidocaine and epinephrine is safe, though it slightly raises blood pressure and heart rate. The slight rise in heart rate and blood pressure is not clinically or medically important. The wrong volume or concentration of anesthetic solution may produce systemic complications. A study given at Khorasgen Dental School determined that injection of lidocaine without epinephrine caused a reduction of blood pressure and heart rate due to the vasodilative effect of lidocaine. An increase in blood pressure and heart rate after injection of lidocaine with epinephrine was a result as well. Researchers have proved that an increase in cardiovascular parameters after injection of local anesthetics can be due to epinephrine
American Association of Nurse Anesthetists. Professional Aspects of Nurse Anesthesia Practice. Philadelphia: F. A. Davis Company, 1994. Print.
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety issues surrounding PCA use include infusion pump programing errors, basal infusion dosing, and proxy errors when using PCA by proxy (Ladak, Chan, Easty, & Chagpar, 2007). Therefore, the purpose of this report is to examine the benefits and risks of patient-controlled analgesia and how it relates to nursing practice.
Anesthesia is used in almost every single surgery. It is a numbing medicine that numbs the nerves and makes the body go unconscious. You can’t feel anything or move while under the sedative and are often delusional after being taken off of the anesthetic. Believe it or not, about roughly two hundred years ago doctors didn’t use anesthesia during surgery. It was rarely ever practiced. Patients could feel everything and were physically held down while being operated on. 2It wasn’t until 1846 that a dentist first used an anesthetic on a patient going into surgery and the practice spread and became popular (Anesthesia). To this day, advancements are still being made in anesthesiology. 7The more scientists learn about molecules and anesthetic side effects, the better ability to design agents that are more targeted, more effective and safer, with fewer side effects for the patients (Anesthesia). Technological advancements will make it easier to read vital life signs in a person and help better decide the specific dosages a person needs.
Patients feel fear not so much from the actual pain but from the lack of control that they feel lying in a dental chair. That creates a lot of anxiousness in some patients, as they don’t feel helpless. Most dentists continue treating all patients in a similarly assuming that they all have similar pain level and will handle the procedure in the same way. Dentists should be mindful of their patient’s level of tolerance and make them aware of the entire procedure ahead of time so that they are able to handle the unexpected situations. They should take time to ensure that the patient feels comfortable at every step. Use of medications and wide array of techniques can help patients eliminate pain and anxiety and making dental visits a pleasant experi...
Webster CS, Merry AF, Larsson L, McGrath KA, Weller J. The frequency and nature of drug administration error during anaesthesia. Anaesth Intensive Care 2001; 29: 494-500.
Parasomnia refers to a wide variety of disruptive, sleep-related events or, "disorders of arousal." These behaviors and experiences occur usually while sleeping, and most are often infrequent and mild. They may however happen often enough to become so bothersome that medical attention should be sought out. "Parasomnias are disorders characterized by abnormal behavior or physiological events occurring in association with sleep stages, or sleep-wake transitions."(DSM pg. 435)