Anesthesia Techniques Flashcards

When administering a Gow-Gates mandibular block, the injection target is which anatomical landmark?

Answer: Neck of the mandibular condyle

The Gow-Gates technique targets the neck of the mandibular condyle, anesthetizing the entire mandibular nerve trunk at a higher level than the conventional inferior alveolar block.

A patient receiving IV sedation begins to show paradoxical excitement after midazolam administration. The most appropriate next step is to:

Answer: Add a small dose of opioid or consider alternative sedation agent

Paradoxical excitement with benzodiazepines is managed by adding an opioid analgesic or switching to an alternative agent, not by increasing the benzodiazepine dose.

Which monitoring parameter is MOST critical to assess ventilation adequacy during moderate sedation?

Answer: End-tidal CO2 (capnography)

Capnography provides real-time ventilation monitoring and detects apnea or airway obstruction before hypoxia appears on pulse oximetry.

The vasoconstrictor epinephrine is contraindicated at high concentrations in patients taking non-selective beta-blockers because it can cause:

Answer: Severe hypertension with reflex bradycardia

Epinephrine's unopposed alpha-adrenergic stimulation in beta-blocked patients causes severe hypertension with compensatory vagal bradycardia.

During nitrous oxide administration, a patient complains of nausea. The FIRST intervention should be:

Answer: Reduce nitrous oxide concentration by 5-10%

Reducing the nitrous oxide concentration is the first step; if nausea persists, nitrous is discontinued and 100% oxygen administered.

When using the 'pressure technique' for intraoral topical anesthetic application, the purpose of applying pressure after topical placement is to:

Answer: Enhance mucosal penetration of the topical agent

Applying pressure with a cotton-tipped applicator helps drive the topical anesthetic deeper into the mucosa, improving analgesia at the injection site.

Which of the following best describes the correct sequence for a Vazirani-Akinosi (closed-mouth) mandibular block injection?

Answer: Bevel toward ramus, needle parallel to mandibular occlusal plane, advance 25 mm

In the Vazirani-Akinosi technique, the bevel faces the ramus, the needle is directed parallel to the mandibular occlusal plane, and advanced approximately 25 mm to the pterygomandibular space.