Anesthesia

• What is the minimum suggested volume of anaesthetic for IDB?

  1.5 ml
• Why is patient anatomy important for IDB injections?

  If not administered correctly, anaesthesia fails
• What should be done before administering an IDB injection?

  Locate the correct landmarks
• What could happen if the cartridge used for IDB is out of date?

  It may lead to ineffective anaesthesia
• What does lack of aspiration during IDB administration indicate?

  LA may enter a blood vessel
• What could occur if the needle does not hit bone during IDB administration?

  It may lead to injection in the parotid gland
• What could cause a needle to be blocked or faulty?

  Improper maintenance or damage
• Why might some patients require a higher dosage of anaesthesia?

  They have a higher resistance to anaesthesia
• What could affect the effectiveness of anaesthesia in the target area?

  Presence of infection
• What is a consequence of using citanest without vasoconstriction?

  Anaesthetic may not stay localized
• What are the possible reasons for the failure of an IDB injection?

  • Insufficient anaesthetic volume (minimum 1.5 ml)
  • Incorrect anatomical placement
  • Failure to locate landmarks
  • Outdated cartridge
  • Lack of aspiration during injection
  • Needle not hitting bone (risk of parotid gland injection)
  • Blocked or faulty needle
  • Higher patient resistance to anaesthesia
  • Infection in target area
  • Citanest used without vasoconstriction
• What should you check in a patient's medical history before administering lidocaine?

  Ensure lidocaine is not contraindicated
• What must be verified regarding the prescription before delivering an IDB?

  Check for a valid prescription
• Why is it important to check the cartridge before use?

  To ensure concentration, batch number, and expiry
• What gauge and length of needle should be selected for the procedure?

  27 gauge, 35mm needle
• What personal protective equipment (PPE) should be worn during the procedure?

  Gloves, apron, visor/goggles
• What should be ensured for the patient regarding PPE?

  Patient should have goggles and apron
• What is the purpose of completing an extra and intraoral exam?

  To ensure there are no signs of infection
• Where should the area for IDB be identified?

  Between coronoid notch, body of mandible, and raphe
• How should the patient be positioned during the procedure?

  Keep patient sat up in chair
• How long should xylonor topical gel be left to take effect?

  Leave for 3/4 minutes
• What should be done with soft tissues during the injection?

  Retract soft tissues with non-dominant hand
• Where should the needle be injected for IDB?

  2/3rds between coronoid notch and raphe
• What is the correct angle for the needle during injection?

  Angle across the pre-molars on opposite side
• How far should the needle be inserted before retracting?

  Insert 3/4 of the way until hitting bone
• What should be done after hitting bone during injection?

  Retract 1mm and aspirate
• How should the anesthetic be deposited?

  Deposit 1/2 a cartridge at a slow pace
• What should be done to reassure the patient during the procedure?

  Keep them calm and reassure them
• What should be done after depositing the anesthetic?

  Retract needle halfway, aspirate, deposit
• What should be done with the needle after use?

  Single click the safety cap
• What should be done after the IDB is administered?

  Reassure patient and allow time to set in
• What sensation indicates the IDB is effective?

  Tingling of lip/tongue
• Where can a long buccal injection be administered?

  In mucobuccal fold at last molar
• How much solution should be deposited for the long buccal injection?

  Deposit 0.5ml solution
• What should be done if more local anesthetic is required?

  Single click needle cap
• What post-operative instructions should be given to the patient?

  Avoid hot/cold drinks and cheek biting
• What should be done after the procedure regarding documentation?

  Make note of everything in notes