Local Complications in Anesthesia Administration

1. Local ComplicationsinAnesthesia Administration

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

3. Local Complications Trismus Hematoma Infection Edema Sloughing of tissues

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

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

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18mm Never insert to hub Redirect only when adequately withdrawn

7. 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

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

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

11. Burning on Injection Causes pH of solution Rapid injection Contamination Warmed solutions

12. Persistent Anesthesiaor Paresthesia Causes Trauma to nerve Neurolytic agents (alcohol, phenol) Intraneural injection Hematoma

13. Persistent Anesthesiaor Paresthesia Prevention Careful injection technique Unavoidable at times

14. Persistent Anesthesiaor Paresthesia Management Patient counseling and reassurance Documentation Follow-up Appropriate referral

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

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

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

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

19. Hematoma The effusion of blood into extravascular spaces

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

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

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

25. Infection Prevention Disposable needles Proper care of equipment Aseptic technique

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

27. Edema Causes Trauma during injection Infection Allergy Hemorrhage Irritating solutions

28. Edema Management Address cause Treat accordingly hemorrhage allergy infection

29. Sloughing of Tissue Causes Topical anesthetic Prolonged ischemia

30. Sloughing of Tissue Management Observation Documentation

31. Lip Chewing Management Analgesics Antibiotics Saline rinses Lip lubricants

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

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

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

35. Post Anesthetic Intraoral Lesions Recurrent apthous Herpes Simplex