local anesthestic

7/28/2019 Local Anesthestic

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LOCAL ANESTHESTIC

Definition & Indication

Definition

Produce loss of sensation to pain in a specific area of the body without the loss of

consciousness

Indication

Any surgical pressure that can be anticipated to be painful for the patient requires

local anesthesia.

Following are few indications:

1) Extraction of teeth

2) Apicetomy

3) Gingivectomy

4) Periodontal surgery

5) Pulpectomy,Pulpotomy

6) Alveloplasty

7) Bone grafting

8) Implants

9) Gingivoplasty

10) Treatment of jaw fracture (reduction and wiring)

11) Replacement of avulsed tooth

12) Dental cyst

13) Removal of tumors

14) Pericoronitis

15) Removal of odontomes

16) Stitching and muco-periosteal flapping.



Contraindication

Severe degree of S.A, A.V. block

Severe hypertension

Spinal deformities and neurological disorders

Liver diseases.

Special precaution in elderly with liver and renal disorders.

Pre-anesthetic Examination & patient Management

1. Pre-anaesthetic examination

2. Premedication - if indicated.

3. Proper injection procedure .

4. Prevention of complications & dealing with them when they occur.

Purpose & Goal of pre-anesthetic examination(PAS)

The purpose and overall goal of Pre-Anesthesia Screening (PAS) is to gather theclinical information necessary for the safe and effective administration of anesthesia

through a process that is convenient for patients and physicians and results in efficient

surgical throughput.

Functions of the PAS Process

1) Assess patients' medical status as soon as they are scheduled for surgery

2) If needed, obtain diagnostic tests to medically screen patients

3) Identify potential patients at risk 4) Increase patient confidence in how to prepare, what to expect and what they

will physically encounter during their surgical stay and how that may affect

their care after surgery

5) Inform patients about the risks and benefits of different types of anesthesia

- Provide patient-specific instructions (meds, diet) for the day of surgery

- Initiate post-op care expectations for patients and their families



Steps to Establish a PAS Process

1) Form a multidisciplinary committee (anesthesiologists, PAS nurse, pathologist,

radiologist, cardiologist)

2) Identify patient health conditions indicating:3) Identify surgical procedures creating risks independent of patients' underlying

health status

a. Need for additional diagnostics (x-ray, labs, ECG)

b. Need for specialist consultation (cardiology)

c. Need for anesthesiologist interview

REFERENCE:

1. http://www.surgerymanagement.com/presentations/pre-anesthesia-

screening.php#pashow

local anesthestic

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