Q1. Define nerve block.
Ans. It is a procedure in which the local anesthetic is deposited (injected) close to a nerve trunk. It blocks sensation from the region which receives the peripheral distribution of the nerve.
Q2. Define intra osseous injection.
Ans. Intra osseous injections are one which are used to obtain local anesthesia when conventional technique is failed, it consist of gaining access into the cancellous bone of the alveolus with a high speed engine using small round bur. A short 25 gauge needle is used to deposit the solution directly in the cancellous bone (some time interseptal bone is penetrated in children) about 0.5 ml of plain solution is injected.
Q3. Define jet injection.
Ans. It is a technique where in the solution is fixed into the soft tissues under hydrostatic pressure this is useful in painful injection like nasopalatine block and anterior palatine block.
Q4. Define periodontal ligament injection. (intra ligamentary injection).
Ans. It is a process of injecting local anesthetic solution directly into the area adjacent to tooth to be anesthetized. It can be a substitute for a nerve block.
Q5. Define intra pulpal infiltration.
Ans. It is a technique of anesthetizing the pulp canals after the pulp chamber is opened. It is a supplement to the blocks or infiltrations with a bent needle the needle tip is inserted as deeply into the canal as possible and the anesthetic fixed under pressure into the pulp tissue. The anesthesia is more due to the pressure rather than the drug.
Q6. Define Intra papillary infiltration.
Ans. It is basically a sub mucosal paraperiosteal infiltration. The needle is inserted approximately 1mm into the desired papillae and about 0.2 ml of the anesthetic solution deposited.
Q7. Classify different types of maxillary nerve block.
Ans.
- Posterior superior alveolar nerve block.
- Middle superior alveolar nerve block.
- Anterior superior alveolar nerve block.
- Greater palatine nerve blocks.
- Infra orbital nerve block.
- Naso palatine nerve block.
Q8. Define intra septal injection.
Ans. The intra septal injection is similar to periodontal injection it is useful for providing osseous and soft tissue anesthesia and hemostasis for periodontal curettage of surgical flap procedures.
Q9. Enumerate different types of (mandibular) anesthesia.
Ans.
Intra oral:
- Incisive nerve block.
- Mental nerve block.
- Inferior alveolar nerve block – (Direct technique, Indirect technique)
- Vazirani akinosi closed mouth technique.
Extra oral:
- Gow gates nerve block.
- Foramen rotundum nerve block.
Q10. What are the local complications of LA ?
Ans.
- Needle breakage.
- Persistent paresthesia.
- Facial nerve paralysis.
- Trismus
- Soft tissue injury.
- Haematoma.
- Burning on injection
- Infection
- Oedema
- Sloughing of tissues.
Q11. Define paresthesia.
Ans. Paresthesia is defined as persistent anesthesia or altered sensation well beyond the expected duration of anesthesia. It also includes, hyperesthesia and dysesthesia in which the patient experience both pain and numbness.
Q12. Define Trismus.
Ans. It is defined as a prolonged tetanic spasm of the few muscles by which the normal opening of the mouth is restricted (locked jaw).
Q13. Define hematoma.
Ans. The effusion of blood into extra vascular spaces can result from in advertently nicking a blood vessel (artery or vein) during the injection of a local anesthetic.
Q14. Mention a few systemic complications of LA.
Ans.
- Allergy.
- Anaphylaxis.
- Idiosyncrasy.
- Overdose.
Q15. Define Allergy.
Ans. It is defined as hypersensitive state required through exposure to a particular antigen (a substance capable of inducing altered bodily reactivity). Re-exposure to which brings about altered capacity to react.
Q16. Define Idiosyncrasy.
Ans. It is the term used to describe a qualitatively abnormal unexpected response to a drug differing form its pharmacological actions and thus resembling hypersensitivity.
Q17. Define drug over dose.
Ans. A drug over dose reaction has been defined as those whose clinical signs and symptoms that result from an overly high blood level of a drug in various target organs and tissues.
Q18. What is ABCD ?
Ans.
A – Airway.
B – Breathing
C – Circulation
D – Definitive care.
Q19. Define intra oral challenge test.
Ans. About 0.9 ml of LA injected via supra periosteal infiltration atraumatically above maxillary right or left premolar or anterior tooth, this term is provoked as intra oral challenge test.
Q20. Mention a few drugs in the recent advances in local anesthesia.
Ans.
- Centbucridine.
- Ropivacaine.
- EMLA.
- Hyaluronidase