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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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Depolarizing Blockers: Pharmocokinetics

Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary Resuscitation II: ACLS Airway Management

Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions01:27

Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions

Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
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Depolarizing Blockers: Mechanism of Action01:28

Depolarizing Blockers: Mechanism of Action

Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
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Ethanol-Induced Cervical Sympathetic Ganglion Block Applications for Promoting Canine Inferior Alveolar Nerve Regeneration Using an Artificial Nerve
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PSA block for maxillary molar's anesthesia - an obsolete technique?

Mukul Padhye1, Savina Gupta, Girish Chandiramani

  • 1Department of Oral and Maxillofacial Surgery, Padmashree Dr. D Y Patil Dental College and Hospital, Navi Mumbai, India.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
|September 20, 2011
PubMed
Summary

Maxillary infiltration anesthesia is as effective as the posterior superior alveolar (PSA) nerve block for maxillary molar extractions. The PSA block may not be necessary due to technique difficulty and potential complications.

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Area of Science:

  • Dentistry
  • Oral Surgery
  • Anesthesiology

Background:

  • Posterior superior alveolar (PSA) nerve block and maxillary infiltration are established anesthesia techniques for maxillary molar removal.
  • The relative efficacy of these methods requires further comparative analysis.

Purpose of the Study:

  • To compare the effectiveness of posterior superior alveolar (PSA) nerve block versus maxillary infiltration for anesthesia during maxillary molar extractions.
  • To evaluate pain, need for repeat injections, efficacy in infection, and analgesic requirements.

Main Methods:

  • A study involving 100 patients undergoing maxillary second and third molar removal.
  • Patients were randomized to receive either infiltration or PSA nerve block anesthesia using lignocaine with a vasoconstrictor.
  • Data collected included pain scores (VAS, verbal), repeat injection needs, efficacy in infection, and rescue analgesic use.

Main Results:

  • Statistical analysis demonstrated clinical equivalence between the infiltration technique and the PSA nerve block.
  • No significant differences were found in pain, need for additional anesthesia, or post-operative analgesic requirements.

Conclusions:

  • Given the comparable efficacy and the technical challenges and potential complications associated with the PSA nerve block, it may not be essential for maxillary molar anesthesia.
  • Maxillary infiltration offers a viable and potentially simpler alternative for achieving adequate anesthesia in these procedures.