Anesthetics/Complications

Local complications of injection anesthesia

• Nerve injury - it is possible to injure: lingual nerve (paresthesia to anaesthesia), VII nerve - peripheral palsy, alveolar nerve inf. - long-term paresthesia in the area of ​​the lower lip. ! neurodystrophic ulcer − pac. with numbness (face area, lips), possible infection (rinse with antiseptics, possibly use ATB). It is treated by administering vitamin B (Thiamine and B₁₂);
• Facial nerve palsy - during mandibular anesthesia;
• Vessel injury - formation of hematoma and subsequent contracture (can also be myogenic in case of injury to the pterygoideus med. muscle), first aid: ice pack, compression, antibiotics are administered in case of inflammation;
• Anemic zones' - frequent, white spot at the injection site, mod. vasoconstrictors;
• Post-injection necrosis - caused by vasoconstriction, further toxic necrosis. In the area of ​​the palate = Williger's necrosis. Pac. performs mouth rinses with chamomile decoction, analgesics, anesthetic and granulation-supporting paste;
• Muscle injury - no. m. pterygoideus med., the formation of a hematoma between the muscle bundles, this leads to a loss of elasticity, the so-called "myogenic contracture", the situation is solved by rehabilitation + warming up;
• 'Infection;
• Swelling - a symptom based on a hematoma. It can also be caused by an allergic reaction (diffuse swelling). No. injury to the pterygoid plexus (great risk during anesthesia on the tuber maxillae);
• Visual disturbances - reflex spasm of the retinae centralis + irritated sympathetic nerve. !KI for application of anesthetic − glaucoma. Solution - mainly calm the patient (diazepam), give papaverine 2 ml s.c.;
• Needle kink - today it doesn't happen much anymore, before because of repeated sterilization. The bent needle must be removed either with pean forceps or surgically (if it does not protrude);

General complications after injection anesthesia

• Collapse - not directly related to the anesthetic, rather a stress reaction (a sudden event), syncope.
• Allergic reaction - antihistamines and corticoids are used for treatment. First aid: adrenaline − 2 ml + 8 ml of physical solution, i.v. application, I can repeat in short intervals, or epinephrine.;
• Anaphylactic reaction - treatment uses adrenaline 1 mg i.v., hydrocortisone 400–600 mg i.v., antihistamines i.v., [[noradrenaline] ]] 1–2 mg by infusion, the patient should be placed in the Trendelenburg position;
• Sudden collapses to death - the patient is placed in a horizontal position, we undress him, the next procedure is different;
• Toxic reaction - overdose of pac. pharmakem - absolute (extremely large amount at once) / relative (adequate amount, but incorrectly, e.g. intravasally), depends on the concentration, dose and technique of anesthetic administration! Evaluate: age, general health. condition (!!! he. liver and kidneys), weight. First aid − anxiolytic − 5−10 mg of diazepam i.v., i.m., Apaurin, Seduxen. Next, oxygen.Zdroj.
• Spasms;

Links

Related Articles

• Local and Seductive Anesthesia
• Anesthetics (Dentistry)

References

• MAZÁNEK, Jiří – URBAN, František. Stomatologické repetitorium. 1. edition. Grada Publishing a.s, 2003. 456 pp. ISBN 80-7169-824-5.

• PAZDERA, Jindřich – MAREK, Oldřich. Neodkladné situace ve stomatologii. 1. edition. 2005. 136 pp. ISBN 80-247-0622-9.

• HRUBÝ, Jan. Anestezie v orální chirurgii [lecture for subject Orální chirurgie 1, specialization Zubní lékařství, 1. LF UK]. Praha. 14.10.2014.