Techniques for Local Anesthesia for the head and neck

Techniques for the Local Anesthesia

 for the head & neck

Mohmaim Local Anesthesia  << reference book

Local Anesthesia:  case of insensibility of a region

·         if we had pained tooth:  cortex à pain perception

Blocking the Pathway of impulses:

·         Decortication ( desensiting of the pain to cortex)

·         Patient is generally anesthetized

·         Stimulus à impulse (stop) X brain X

Topical Anesthesia:

     Penetrate till it reaches nerve filaments.

     Uses: 

·         I&D (incision & draining)

·         Taking impression for gagging patients

Choice of L.A. (Factors Influencing Selection):  << ESSAY

Management of Patient Receiving L.A.

·        Don't operate on strange patients…

Painless needle injection:  factors or precautions:  << ESSAY

·         Pressure on the site of injection (in palate) << not mentioned in the ppt

v  Use sharp bevel, sterile (or disposable –better- ) …[antiseptic àirritant to tissues è ننتبه لو معقمين الابر]

Paraperiosteal infiltration A.:

Method:

Max. - Buccal side\

     Retraction of lip & cheek till it makes right angle with alveolar mucosa.  Bevel the needle 45 degree to the floor & insert it while holding as –pin grasp –in the intersection of the mucobuccal fold (vesibulo-sulcus)and the dissecting line of the tooth which will be the level of the apices of the upper teeth. Insert the needle about 2mm till it touches the bone.

     This will Anesthetizes the pulp, periodontal ligament, buccal and palatal cortical bone, and buccal mucoperiostium

1.6 of the carpule

Tooth	Labial innervation	Palatal innervation
CentralsàCanine	Ant. Sup. Alveolar n.	Nasopalatine
Premolar	Middle Sup. Alveolar n.	Greater palatine or ant. palatine
Molars	Post. Sup. Alveolar n.	Greater palatine or ant. palatine

Max, - palatal side\

     Mid way between the med line of the palate and scalloping gingival is the line of intersection with the dissecting line of the tooth -45 degree (=perpendicular to the volt of palate)

Insert the needle 1.5mm labially & 0.3 palatally till it touched the bone (no more to avoid sloughing, necrosis & pain)

Block greater palatine nerve from ptrygopalatine ganglion it gave the palate 0.2 of the carpule

The infraorbital Injection:

     Ant. & middle superior alveolar N.B. << infraorbital foramina

Method:

·         Localization of the infraorbital notch

·         Put your thumb on the notch below the orbit in the line between middle & mesial thirds of the orbit

N.B.\

·        general anesthesia work on the cortex of brain

·        local anesthesia work in the pain pathway (block the way of impulse)