Local Complications in Anesthesia Administration Local Complications Needle

Local Complications in Anesthesia Administration

Local Complications Needle breakage Pain on injection Burning on injection Persistent anesthesia or paresthesia Lip chewing

Local Complications Trismus Hematoma Infection Edema Sloughing of tissues

Local Complications Facial nerve paralysis Post-anesthetic intraoral lesions Local Complications Written documentation is mandatory Follow-up care should be arranged

Needle Breakage Causes Unexpected movement Small needle size Bent needles Defective needles

Needle Breakage Prevention Use large needles Use long needles for deep injection, >18 mm Never insert to hub Redirect only when adequately withdrawn

Needle Breakage Management Remain calm Don't explore Have the patient keep opening wide If the needle is out remove it Refer to an Oral Surgeon

Pain on Injection Causes Careless technique Dull needles Rapid deposit of solution Needles with barbs

Pain on Injection Prevention Careful technique Sharp needles Topical anesthetic Slow injections Room temperature solutions

Burning on Injection Causes p. H of solution Rapid injection Contamination Warmed solutions

Persistent Anesthesia or Paresthesia Causes Trauma to nerve Neurolytic agents (alcohol, phenol) Intraneural injection Hematoma

Persistent Anesthesia or Paresthesia Prevention Careful injection technique Unavoidable at times

Persistent Anesthesia or Paresthesia Management Patient counseling and reassurance Documentation Follow-up Appropriate referral

Trismus A motor disturbance of the trigeminal nerve precipitating or resulting in spasm of the muscles of mastication

Trismus Causes Trauma to muscles or blood vessels Contaminated anesthetic solutions Hemorrhage Infection Excessive anesthetic volume

Trismus Prevention Sharp needles Proper care and handling of cartridges Aseptic technique and clean injection site Atraumatic insertion Minimal injections and volume

Trismus Management Examination Conservative therapy passive ROM therapy analgesics heat muscle relaxants

Hematoma The effusion of blood into extravascular spaces

Hematoma Prevention Care with needle placement Minimize injections Don't probe with needle Modify technique short needles penetration depth

Hematoma Management with IAN block Infraorbital block Mental Nerve block Buccal block PSA block

Infection Causes Needle contamination Improper handling of armamentarium Infection at injection site Improper handling of tissue

Infection Prevention Disposable needles Proper care of equipment Aseptic technique

Infection Management Usual sign is trismus Trismus persists (1 -3 day resolution ) Antibiotics, if suspicious

Edema Causes Trauma during injection Infection Allergy Hemorrhage Irritating solutions

Edema Management Address cause Treat accordingly hemorrhage allergy infection

Sloughing of Tissue Causes Topical anesthetic Prolonged ischemia

Sloughing of Tissue Management Observation Documentation

Lip Chewing Management Analgesics Antibiotics Saline rinses Lip lubricants

Facial Nerve Paralysis Cause Anesthesia of peripheral Facial nerve branches Temporal Zygomatic Buccal Mandibular Cervical

Facial Nerve Paralysis Prevention Bone contact when injecting Avoid over penetration Avoid arbitrary injection

Facial Nerve Paralysis Management Reassure patient Cornea care Documentation Consider deferring dental care

Post Anesthetic Intraoral Lesions Recurrent apthous Herpes Simplex