Complications Of Local Anesthesia Research Articles

Comparative Analysis of Different Variables on Complications of Local Anesthesia in Dentistry

Background: With continuous progress in medicine and treatments, anesthetists will more often have to treat risk patients in dental surgeries. Therefore there is a need to compare the rate of incidence of complications with risk factors so we can minimize the drug-related complications in patients undergoing dental anesthesia. The study aimed was to evaluate the incidence rate of local anesthetic complications in dentistry and also to analyze the effect of different risk factors on the incidence of local anesthetic complications. Methods: It was an observational cross-sectional study conducted at the Maxillofacial Department in Sardar Begum Dental College and Hospital. Once the patient signed a consent form, Performa was used to collect patient data. The patients were given lidocaine 2% with 1:100,000 epinephrine by either infiltration or inferior alveolar nerve block (IANB) injection or by both techniques to induce anesthesia, then underwent different dental procedures. We focused on six complications and six different risk factors regarding the total population in our study Performa. Results: Our study included 207 dental patients in total, of which 45% were men and 55% were women. The overall complications observed during the study were 11.5% of patients receiving dental local anesthesia in which non-risk factor patients were 6.7% and risk factor patients were 4.8%. Conclusion: The current study reports a high incidence of dental local anesthetic complications, including bleeding, tachycardia, and salivation. In addition, this study also reports the high incidence of bleeding and tachycardia in diabetic and hypertensive patients. Hence study recommends that dentists should take medical history before each procedure to reduce risk of complications associated with dental anesthesia.

Superficial skin necrosis as a rare complication of inferior alveolar nerve block in Egyptian child: A case report

AbstractAimThe aim of the presented case report was to report a rare complication of Inferior Alveolar Nerve Block (IANB) in a 5‐year‐and‐4‐month‐old child and to discuss the possible complications.Materials and MethodsFive years and four months old Egyptian male child presented in paediatric dentistry practice complaining of pain in the lower right primary molars that kept him awake all night. Examination revealed decayed lower right primary first and second molars and the treatment plan was designed to include a pulpectomy procedure for tooth 85 and a pulpotomy procedure for tooth 84. Administration of 1 mL of arctician 4% with 1:100,000 epinephrine anaesthetic solution using the inferior alveolar nerve block technique was done uneventfully. Then, the dental procedure was done as usual. The next morning, the child presented to the dental practice with a non‐painful change in colour in the lower part of the child's right cheek, with small scanty blisters.ResultsThe possible causes of such a complication and the proper management are discussed in this article with a confirmation of the superficial skin necrosis as the most possible cause.ConclusionAlthough proper awareness of the anatomical structures of the orofacial region along with meticulous administration technique of local anaesthesia is mandatory for the everyday dental practice, the dentist may face possible, sometimes rare complications of local anaesthesia and he should be able to manage them probably.

Assessing knowledge of dental house officers regarding dosage calculation and complications of local anaesthesia, in three tertiary care dental hospitals of DUHS, Karachi.

To assess the knowledge and awareness of dental house officers regarding calculation of local anaesthesia dosage, and to evaluate differences in practices at various tertiary care facilities. The cross-sectional study was conducted at three dental hospitals affiliated with Dow University of Health Sciences, Karachi from July to December 2022, and comprised house officers of either gender currently enrolled at the participating centres. Data was collected using a self-administered questionnaire to assess knowledge and awareness of local anaesthesia dosage calculation, administration methods, and common complications. Data was analysed using SPSS 26. Of the 200 subjects approached, 136(68%) responded, and 89(65.4%) of them were females. Knowledge regarding the meaning of 2% lidocaine solution was low 45(33%), and 68(50%) subjects were knowledgeable about the maximum dosage of lidocaine with epinephrine. In terms of practice, lidocaine was the most commonly administered local anaesthetic 115(85%), followed by bupivacaine 15(11%). The majority of subjects administered local anaesthesia with vasoconstrictor 127(94%), but only 36(27%) performed aspiration during administration. Syncope 71(52%) was the most commonly reported complication, followed by lip/cheek/tongue biting by 35(26%). House officers' knowledge level of local anaesthesia administration indicated the need for adequate training.

Neurological Complications of Local Anesthesia in Dentistry: A Review.

Local anesthesia is a technique that temporarily desensitizes a specific body area, typically for a surgical procedure, dental work, or pain management. It is described as a sensation loss in a specific area of the body due to depression of excitation in the nerve endings or due to the inhibition of the conduction process within the peripheral nerves. It allows for safer and more comfortable medical procedures, reducing the need for general anesthesia and facilitating faster recovery. Local anesthesia is generally safe, but like any medical intervention, it carries potential risks and side effects. The complications related to local anesthetics can be assessed in terms of neurological, vascular, local, systemic, and neurological.In this review article, we discussed the neurological complications of local anesthesia related to the ophthalmic nerve, maxillary nerve, mandibular nerve, branches of the trigeminal nerve, and facial nerve. These include diplopia, ptosis, paralysis of the eye, blindness, paresthesia, trismus, soft tissue lesions, edema, hematoma, facial blanching, infection, allergy, overdose, neuralgia, facial palsy, etc.

Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: report 11, techniques and complications of local anesthesia for cataract surgery in the United Kingdom.

To describe variation in local anesthesia techniques and complications over a 10-year period for cataract surgery in the United Kingdom. Reporting centers to the Royal College of Ophthalmologists (RCOphth) National Ophthalmology Database (NOD). Retrospective cross-sectional register-based study. Data from the RCOphth NOD were used. Eligible for analysis were 1 195 882 cataract operations performed using local anesthesia between April 1, 2010, and March 31, 2020, in 80 centers. Overall, topical anesthesia alone was used in 152 321 operations (12.7%), combined topical and intracameral in 522 849 (43.7%), sub-Tenon in 461 175 (38.6%), and peribulbar/retrobulbar in 59 537 (5.0%). In National Health Service (NHS) institutions, 48.3% of operations were topical with/without intracameral vs 88.7% in independent sector treatment centers (ISTCs). 45.9% were sub-Tenon in NHS vs 9.6% in ISTCs. 5.8% were peribulbar/retrobulbar in NHS vs 1.7% in ISTCs. Anesthetic complication rates decreased from 2.7% in the 2010 NHS year to 1.5% in the 2019 NHS year (overall, 2.1% for NHS; 0.2% for ISTCs). Overall anesthetic complication rates were 0.3%, 0.3%, 3.5%, and 3.1% for topical alone, combined topical/intracameral, sub-Tenon, and peribulbar/retrobulbar, respectively. Complication rates were higher for sharp-needle anesthesia (peribulbar/retrobulbar) in patients taking warfarin rather than direct oral anticoagulants (4.8% vs 3.1%; P = .024). Considerable variation was observed between centers on anesthetic choices and anesthetic complication rates. Combined topical and intracameral is the most common choice of anesthesia for cataract surgery in the United Kingdom and is associated with lower anesthetic-related complication rates than sub-Tenon and peribulbar/retrobulbar anesthesia. Variation in the anesthetic choice exists between centers and between NHS and ISTC sectors.

Transient Facial Nerve Palsy as a Complication of Local Anesthesia After Tonsillectomy.

Chronic tonsillitis is a common otolaryngological disease worldwide. The treatment of choice is tonsillectomy, which is one of the most frequently performed procedures in Ear, Nose and Throat Departments. As with any surgical procedure, there are possible complications. Among them, rarely encountered and reported mainly in the pediatric population, is a short-term, transient facial nerve palsy resulting from local anesthetic administration. Here, we present a rare case of a 20-year-old woman with recurrent angina, who developed short-term, fully transient peripheral facial nerve palsy immediately after tonsillectomy under local anesthesia.

Agents, Techniques, and Complications of Local Anesthesia: Experience in a Tertiary Care Hospital

Introduction: Local anesthesia has opened a new door for surgeries recently as a replacement of general anesthesia. The complications of general anesthesia can be minimized using local anesthesia as a substitute. Aim of the Study: The aim of this study was to evaluate the agents, techniques, and complications of local anesthesia. Methods: This cross-sectional study was conducted in department of Anesthesiology and Gynaecology, Rangamati Medical College Hospital, Rangamati, Bangladesh, during the period from July 2020 to June 2022. Total 60 patients having different surgeries were included in this study. Lidocaine, Bupivacaine and Chloroprocaine were used for different surgical procedures. 2% lidocaine, 0.5% bupivacaine and 2% chloroprocaine were given along with adrenaline after dilution. After collection of data, statistical analysis was done using SPSS version 22. Numerical variables were expressed as mean and standard deviation, whereas categorical variables were count with percentage. Result: In this study, mean age was found 56.6 years (SD±4.50 years). Mean hospital stay was 2.2 days (SD±1.4 days). Mean blood loss was 86 mL (SD±26.4 mL). In anterior vaginal wall repair surgery, 5 (23.8%) patients had bleeding and 1 (4.8%) patient had urinary retention. In vaginal correction surgery, 2 (7.7%) patients had nausea, 1 (3.85%) patient had congestive heart failure and 1 (3.85%) patient had superficial thrombophlebitis. In Tension-Free Vaginal Tape surgery, 2 (15.4%) patients had myocardial infarction, 1 (7.7%) had bleeding and 1 (7.7%) had nausea. Conclusion: Local anesthesia has been successful for different surgical procedures. Though there were very few complications using local anesthesia for anterior vaginal wall repair, vaginal correction and Tension-Free Vaginal Tape surgery.

The most common complications of local anesthesia in pregnant women in dental practice

The article presents the results of a sociological study to identify the variability and frequency of complications caused by the use of local anesthetic drugs in pregnant women at the stomatological appointment. The study was conducted using a Google Forms application based on dental education sites on social media. 155 dentists of various specialties took part in the survey. According to the data obtained, among the doctors participating in the study, 70.3% faced complications of local anesthesia in pregnant women. The most common complications are from the nervous (n=54) and cardiovascular (n=19) systems. Some of them can be attributed to the manifestations of the psychogenic reaction of patients to the introduction of local anesthetic drugs, and not to the immediate undesirable effects of anesthetics. Taking into account the results obtained and the data of literature sources, recommendations are given to prevent the development of complications in pregnant patients from the introduction of local anesthetics. Recommendations can be useful for dentists and dental students.

The circumcision blues: a case report with literature review

An 11-day-old Caucasian male developed acquired methemoglobinemia as a result of repeated exposure to topical lidocaine/prilocaine cream following a circumcision. Our patient responded well with treatment of a single dose of intravenous (IV) methylene blue. Methemoglobinemia is a rare but well-explained complication of local anesthetics. It is important for providers to prescribe local anesthetics safely to avoid serious complications, especially with neonates who are at higher risk of developing methemoglobinemia.

Knowledge and awareness of complication of local anesthesia among undergraduates- a survey

Knowledge and awareness of complication of local anesthesia among undergraduates- a survey

Complications of Local Anesthesia

This chapter is presenting the local and systemic complications associated with the local anesthetics usedin oral and maxillofacial surgery. The prevention of complications and management method are alsogiven importance. Dental procedures are frequently performed under local anesthesia; thus, drug-relatedcomplications often come across. It is mandatory to have a preoperative evaluation of the patient andchoosing the proper local anesthetic agents.

Self-induced soft-tissue injuries following dental anesthesia in children with and without intellectual disability. A prospective study.

Self-induced soft-tissue injuries (SSI) are reported as local anesthesia complications, particularly in children. The purpose of the study was to evaluate the frequency of SSI following dental anesthesia in children with and without intellectual disability. 241 children receiving dental treatments with local anesthesia were divided into 2 groups: A, children without intellectual disability (159 individuals, 299 injections); B, children with intellectual disability (82 individuals, 165 injections). Each group was divided into subgroups according to age, injection technique and dental treatment. Two days after the dental procedure, a phone survey was conducted to determine the presence of SSI. The frequency of SSI in group B was 19%, with no differences in relation to gender and age. In group A the frequency of SSI was significantly lower (9%; p = 0.002; Chi-square test); the children in the ≤ 6years-old subgroup experienced a higher frequency of SSI (p = 0.002). The lower arch was at major risk of SSI in both groups (p = 0.002). According to a multilevel approach group (p = 0.001) and injection technique (p = 0.0001) significantly influenced SSI; no influence of dental treatment is evidenced. SSI are common complications of local anesthesia in young children and individuals with intellectual disability.

Facial Blanching after Local Anesthesia Injection: Clinico-anatomical Correlation-Review of Literature.

Facial blanching as a complication of local anesthesia is reported in dentistry. Inadvertent arterial penetration and subsequent vasospasm has been accepted as the mechanism of this phenomenon. Most cases occur after inferior alveolar nerve block injection. In this article, five cases are reported after Gow-Gates injection, maxillary nerve block via greater palatine foramen, inferior alveolar nerve block, and maxillary buccal infiltration. It is the largest case series in this topic. Also, clinico-anatomical correlation between facial–mucosal blanching and the site of intra-arterial injection is explained. To the best of our knowledge, partial blanching of the face subsequent to buccal infiltration is reported for the first time in this article. Cutaneous surgeon should be aware of this complication and should not carry out unnecessary treatment.

Knowledge and Attitude Regarding Local Anesthesia among Dental Professionals and Awareness in General Population

Background: Local anesthetics (LA) are stereotype drugs in dentistry. Though these drugs are used routinely, most of the dentists are unaware of the dose calculations, effective dose or complications and another vital knowledge about the drug. The objective of the survey was to evaluate the knowledge, attitude of dental professionals regarding local anesthesia and its implementation in their daily practice. Awareness of local anesthesia among general population and their expectations from the clinicians was also evaluated. Method: A survey was conducted on 1080 patients and 540 dental professionals of Odisha through google form survey and hand forms. Questionnaire were made in English and Odia language. Data were analyzed using SPSS statistics 24.0. Result: Out of 504 dental professional 31% were general dentist, 32.5% were specialist and 36.5 % were undergoing post graduate training. 73.3% of the clinicians didn’t knew the equivalent weight of adrenalin in 2% local anesthesia with 1:200000 concentration. 76.2% were wrong regarding dosage of lignocaine. 84% of the clinicians lacked in knowledge about LA allergy testing and 91.8% were unaware about Articaine. MDS especially more than 15 years of experience (100%) were found to be more knowledgeous and have a positive attitude towards local anesthesia when compared with PGs and BDS but when it comes to practice MDS (51.1%) with <5years (40.4%) experience implement better. Out of 1080 general population, 50% have fear for injections. 75.6% are unaware about the different complications of local anesthesia. 83% are unaware about different techniques of nerve block. 84.1% of the patients expect their clinicians to explain the techniques to them. Conclusion: Desired level of knowledge regarding local anesthesia is lacking among dental professionals, and a deliberate effort must be made to improve it. Lack of awareness of local anesthesia was found among general population.

Are drug-related dental management cautions in Lexicomp Online for Dentistry evidence-based? A systematic review of the literature.

Drug reference databases provide information on potential drug-related medical complications in a dental patient. It is important that database entries and recommendations are supported by evidence-based original studies focused on drug-related dental management complications. The aim of this study was to review and identify database drug categories associated with evidence-based drug-related medical complications during dental treatment. Relevant publications on adverse drug reactions and dental management complications were thoroughly reviewed from the literature published between July 1975 and July 2019. The drug reference database "Lexicomp Online for Dentistry" was reviewed to identify medications associated with the highest propensity to trigger drug-related dental management complications, and these were correlated with published original studies in PubMed, Embase, and Scopus databases that associated drug actions with dental treatment complications. Fifty-four publications (1.2% of all full-text articles) reported original studies that directly tested drug associations with dental management complications. The cautions in the drug reference database on drug-related dental treatment mainly focused on local anesthetic precaution (P < .001), xerostomia (P < .001), bleeding (P < .001), and a combination of xerostomia and bleeding (P < .001). Antipsychotics/antidepressants were mostly associated with local anesthetic complications (80.95%), xerostomia (81.93%), and a combination of xerostomia and bleeding (22.89%). Bleeding complication was associated with anticoagulants (80.00%) and cancer chemotherapeutic agents (59.21%). Similarities exist within and across different drug categories in the database entries on drug-related medical complications in a dental patient. There were a relatively limited number of publications that directly tested the association between drug-related medical complications and dental therapies. The most common drug cautions during dental treatment reported in Lexicomp Online for Dentistry were limited to drug-drug interactions with local anesthetic actions, excessive bleeding, xerostomia, or a combination of any of these. These recommendations were supported by limited evidence-based studies.

The risk that many do not recognize: Complications of local anesthesia

The risk that many do not recognize: Complications of local anesthesia

Awareness of dosage and complications of local anaesthesia among dental practitioners- a survey

Awareness of dosage and complications of local anaesthesia among dental practitioners- a survey

Palatal ulceration: A local anesthetic complication

The hard palate is one of the common sites of local complications following administration of local anesthetics. The hard, unyielding palatal tissues coupled with either forceful or excessive administration of solution, induction of trauma, use of contaminated solutions, or reactivation of latent viruses may present or aggravate local complications in the palatal area. Ulceration and necrosis is unusual and a rare complication of local anesthesia. Presented is such an uncommon case in a 16-year-old girl.

Systemic toxicity of local anesthetics

The paper presents characteristics of local anesthetics used in dentistry and maxillofacial surgery taking into account their effectiveness and toxicity. We described the main clinical symptoms of manifestation of systemic toxicity and measures for prevention of local anesthesia complications, as well as the detailed protocol of 'lipid rescue' and resuscitation at manifestation of systemic toxic reaction of local anesthetics with the mechanism of the fatty emulsion action.

Employment of lipid emulsion in the resuscitation for local anesthetics toxicity of central nervous system

Local anesthetic systemic toxicity(LAST) is a serious complication of local anesthesia. Comprehensive measurement to prevent LAST is very critical. Treatment of LAST exactly and timely is very important which can reduce the harm to patients. Now we reported a case of male patient with ASA Ⅰ who accepted continuous epidural anesthesia and appeared LAST with symptoms of central nervous system. With sedative-hypnotic drug the patient acted not so ideal. Then 100 ml of 20% medium-long chain triglycerides lipid emulsion(MLE) was injected. After that, this patient recovered well. The American society of regional anesthesia guidelines recommended that LE should be used as soon as possible when the LAST happened to avoid the development of the LAST. Key words: Medium chain triglycerides/long chain triglycerides fat emulsion; Ropivacaine; Toxic response; Central nervous system