20 Anesthesia and Sedation. 2 Anesthetics and Sedation Reduce pain Relieve anxiety Different levels...
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Transcript of 20 Anesthesia and Sedation. 2 Anesthetics and Sedation Reduce pain Relieve anxiety Different levels...
20
Anesthesia and Sedation
2
Anesthetics and Sedation
• Reduce pain
• Relieve anxiety
• Different levels of sedation can be achieved based upon procedural need and patient response
3
Conscious Sedation
• Causes an altered state of consciousness
• Patient can still communicate
• May experience headache, nausea, brief periods of amnesia
4
IV Sedation
• Administered directly into the bloodstream
• Patient may be conscious but in a deeply relaxed state
• Patient has no memory of events taking place while sedated
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Oral Sedation
• Prescription taken before appointment
• May make the patient calm and drowsy or calm and relaxed
6
Inhalation Sedation
• Odorless and colorless gases
• Inhaled through mask
• Patient doesn’t remember much of procedure
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Intramuscular Sedation
• Injection into muscle of upper arm or thigh
• Not commonly used
• Takes 20 to 30 minutes to take effect
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General Anesthesia
• Creates an unconscious state
• Must be carefully controlled
• Sensation and feeling is lost
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Topical Anesthesia
• Numbs a particular area
• Used prior to local anesthetic
• Desensitizes the oral mucosa
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Local Anesthesia
• Produces a deadened or pain free area
• Sensory impulses are temporarily blocked
• Affects the nerve fibers carrying messages to brain
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Topical Anesthetics
• Used for the following:– Subgingival scaling– Root planing– Seating crowns– Placing matrix bands– Periodontal probing– Preparation for local sedation – Repress gag reflex
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Placing Topical Anesthetic
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Local Anesthetics
• Used to manage pain
• Can be short, intermediate, or long in duration
• Vasoconstrictor
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Possible Complications of Local Anesthetics
• Toxic reactions– Patient becomes ill– Many factors
• Paresthesia– Numbness does not go away as expected
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Types of Injections
• Local infiltration– Injection near small terminal nerve
branches
• Field block– Injection near large terminal nerve
branches
• Nerve block– Injection near main trunk nerve
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Maxillary Arch Injection Sites
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Anesthetic Setup
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Aspirating Syringe
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Components of a Needle
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Needle Care and Handling
• Maximum of four penetrations• Stick protection• Caps and shields• Proper disposal• OSHA guidelines• Sharps container• Procedure if stick occurs• OSHA Bloodborne Pathogens protocol
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Anesthetic Cartridge Components
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Retracting Harpoon
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Loading Cartridge into Syringe
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Engaging Harpoon
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Placement of Needle into Syringe
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Passing the Syringe
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Disassembling the Syringe
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Intraosseous Anesthesia
• Cancellous bone injected directly• Special equipment required• Anesthetizes the following:
– Bone– Soft tissue– Root– Teeth– Single or multiple teeth
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Periodontal Ligament Injection
• Used for pulpal anesthesia of one or two teeth in a quadrant
• May be an adjunct to another injection where patient is partially anesthetized
• Aids in diagnosing abscessed teeth
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Periodontal Ligament Injection System
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Intrapulpal Injection• Delivered directly into nerve chamber
• Procedures– Root canal therapy – Severe abscess
32
Electronic Anesthesia
• Used with nitrous oxide provides a better effect
• Used in the following procedures:– Placing restorations– Muscle relaxation– Determination of centric occlusion
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Computer-Controlled Local Anesthesia Delivery System
• Pain-free injections
• Used for all traditional infiltration and block injections
34
Nitrous Oxide• Safe, stable, non-flammable gas
• Relaxes and comforts the patient
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Nitrous Oxide• Contradictions
– Blocked nasal passage– Emotional instability
• Drug users
– First trimester of pregnancy– Risk of bone marrow suppression– In-vitro fertilization procedures– Neurological complaints