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Local Anesthesia — Techniques & Agents

Oral & Maxillofacial Surgery • NEET MDS Study Guide • AI-Generated Notes

⭐ High-Yield Facts for Exam

  • Lidocaine = most used amide LA.
  • Lidocaine max ≈ 4.4 mg/kg (more with epi).
  • Articaine = amide + ester linkage.
  • IANB = common mandibular block.
  • Epinephrine caution: uncontrolled HTN, hyperthyroidism.

Local Anesthesia

Agents

  • Lidocaine — the most commonly used amide LA; max dose ≈ 4.4 mg/kg (up to ~7 mg/kg with epinephrine, absolute max ~500 mg with vasoconstrictor).
  • Articaine — amide with an additional ester linkage (metabolised partly by plasma esterases).
  • Bupivacaine — long duration; Mepivacaine — useful without vasoconstrictor.

Techniques

The inferior alveolar nerve block (IANB) is the most common mandibular block. Infiltration suffices for most maxillary teeth.

Vasoconstrictors

Epinephrine prolongs action and reduces bleeding; caution/contraindication in uncontrolled hypertension, hyperthyroidism, and with certain drug interactions (e.g., TCAs, non-selective beta-blockers).

Exam Tips ⭐

Lidocaine = most used; IANB = common mandibular block; epinephrine caution in uncontrolled HTN/hyperthyroidism.

📝 Practice MCQs — Local Anesthesia — Techniques & Agents

Q1. The most commonly used local anesthetic in dentistry is:
A. Procaine
B. Lidocaine
C. Bupivacaine
D. Cocaine
Show Answer
✅ Answer: B
Lidocaine is the standard amide LA.
Q2. Which LA has both amide and ester characteristics?
A. Lidocaine
B. Articaine
C. Mepivacaine
D. Prilocaine
Show Answer
✅ Answer: B
Articaine is an amide with an additional ester linkage.
Q3. Epinephrine in LA should be used cautiously in:
A. Controlled diabetes
B. Uncontrolled hypertension/hyperthyroidism
C. Mild asthma
D. Healthy adults
Show Answer
✅ Answer: B
Vasoconstrictors are risky in uncontrolled HTN and hyperthyroidism.
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