{"id":1342,"date":"2010-12-05T10:36:48","date_gmt":"2010-12-05T10:36:48","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/infiltration-anaesthesia\/"},"modified":"2023-11-15T16:43:22","modified_gmt":"2023-11-15T16:43:22","slug":"infiltration-anaesthesia","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/minor-surgery\/skills\/infiltration-anaesthesia\/","title":{"rendered":"Infiltration Anaesthesia"},"content":{"rendered":"<hr \/>\n<h3><span style=\"color: #003366;\"><strong>Introduction<\/strong><\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Ask the patient about any prior adverse reactions to local anaesthesia. <\/span><\/li>\n<li><span style=\"color: #003366;\">If the patient indicates that they cannot tolerate local anaesthesia, determine which type of anaesthesia is responsible for the allergy.<\/span><\/li>\n<li><span style=\"color: #003366;\">Do not give more than the maximum allowed dose of local anaesthetic.<\/span><\/li>\n<li><span style=\"color: #003366;\">Avoid <span style=\"color: #33cccc;\"><strong>intravasal<\/strong><\/span> injection.<\/span><\/li>\n<li><span style=\"color: #003366;\">Be prepared for allergic or toxic reactions.<\/span><\/li>\n<li><span style=\"color: #003366;\">Inject the fluid very slowly; this avoids unnecessary pain.<\/span><\/li>\n<li><span style=\"color: #003366;\">If more than one injection is needed, try to administer subsequent injections in the area that is already anaesthetised.<\/span><\/li>\n<\/ul>\n<hr \/>\n<h3><span style=\"color: #003366;\"><strong>Material<\/strong><\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">Syringes 2 ml and 5 ml (<em>the smaller the syringe, the greater the control when injecting liquid<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Aspiration needle (<em>low gauge needle<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Fine needle with a length sufficient to reach halfway to the area to be anaesthetised.<\/span><\/li>\n<li><span style=\"color: #003366;\">Local anaesthetic.<\/span><\/li>\n<li><span style=\"color: #003366;\">Disinfectants.<\/span><\/li>\n<li><span style=\"color: #003366;\">In medicine chest:<\/span>\n<ul>\n<li><span style=\"color: #003366;\">Tavegil\u00ae 2 mg = 2 ml i.v.<\/span><\/li>\n<li><span style=\"color: #003366;\">Dexamethasone 5 mg = 1 ml i.v.<\/span><\/li>\n<li><span style=\"color: #003366;\">Epinephrine 1 mg = 1 ml, 0.3 ml i.m.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124602775?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Tell the patient what you are about to do and ask if they are allergic to <span style=\"color: #33cccc;\"><strong>iodine<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Ask the patient to lie down.<\/span><\/li>\n<li><span style=\"color: #003366;\">Select your anaesthetic (<em>lidocaine 0.5-1%, with or without epinephrine<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Aspirate, depending on the size of the area to be anaesthetised and the amount of solution (<em>5-10 ml<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Mark the desired site of incision; some defects are no longer palpable after infiltration anaesthesia.<\/span><\/li>\n<li><span style=\"color: #003366;\">Disinfect the area to be injected.<\/span><\/li>\n<li><span style=\"color: #003366;\">Use the fine needle for <span style=\"color: #33cccc;\"><strong>infiltration<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Position the needle at the point of entry.<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong>For wounds:<\/strong> Beyond the edges of the wound and in line with its longitudinal axis <em><strong>[Figure 9]<\/strong><\/em>.<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong>For small tumours or skin lesions:<\/strong> On either side of the area to be removed, beyond the tumour<\/span><br \/>\n<span style=\"color: #003366;\"><em><strong>[Figure 10]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1341\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-9.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-9.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-9-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 9<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-796\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-10.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-10.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-10-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 10<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Confirm by aspiration that the needle has not been inserted intravasally.<\/span><\/li>\n<li><span style=\"color: #003366;\">Create a subcutaneous depot of local anaesthetic by injecting slowly (<em>this can be achieved by advancing and pulling back the needle<\/em>). <\/span><\/li>\n<li><span style=\"color: #003366;\">First inject <span style=\"color: #33cccc;\"><strong>superficial subcutaneous areas<\/strong><\/span> (<em>direction of the cutis<\/em>) and then inject somewhat deeper.<\/span><\/li>\n<li><span style=\"color: #003366;\">For excising or suturing wound margins, the subcutaneous depot should be created in the subcutis of the wound margins. <\/span><\/li>\n<li><span style=\"color: #003366;\">For excising a tumour, injections should occur in a diamond-shaped pattern around the area to be excised (<em>field block<\/em>)<em><strong> [Figure 10]<\/strong><\/em>. <\/span><\/li>\n<li><span style=\"color: #003366;\">A depot is also created under the tumour; this will raise the tumour and make it more <span style=\"color: #33cccc;\"><strong>palpable<\/strong><\/span> and <span style=\"color: #33cccc;\"><strong>visible<\/strong><\/span> <em><strong>[Figure 11]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-797\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-11.jpg\" alt=\"\" width=\"400\" height=\"267\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-11.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-11-300x200.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 11<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\">Observe the patient for allergic or toxic reactions during the administration of local anaesthesia.<\/span><\/li>\n<li><span style=\"color: #003366;\">Wait until pain stimuli are completely anaesthetised before beginning the surgery (<em>the time to effect for lidocaine is 5 minutes<\/em>).<\/span><\/li>\n<\/ul>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Introduction Ask the patient about any prior adverse reactions to local anaesthesia. If the patient indicates that they cannot tolerate local anaesthesia, determine which type of anaesthesia is responsible for the allergy. Do not give more than the maximum allowed dose of local anaesthetic. Avoid intravasal injection. Be prepared for allergic or toxic reactions. Inject [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[76],"tags":[146],"class_list":["post-1342","post","type-post","status-publish","format-standard","hentry","category-skills","tag-minor-surgery"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Infiltration Anaesthesia - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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