oral surgery

basic injection technique

General guide lines for safe injection

The general guide lines for safe and atraumatic injections include

basic injection procedures are

  1. Use a sterile، sharp needle .
  2. Use an appropriate gauge and length of needle for the injectionsite
  3. Check the flow of anesthetic solution by expelling a few drops of local anesthetic solution from the cartridge.
  4. Armamentarium and anesthetic cartridge should be kept at room temperature .
  5. The patient should be reclined comfortably , to reduce the incidence of fainting ( head parallel with the heart and feet raised slightly ) .
  6. Use gauze to dry the area of injection .
  7. Communicate with the patient at this time that you are taking steps to make sure the procedure will be as comfortable as possible .
  8. Apply a topical antiseptic with cotton tipped applicator to reduce the incidence of infection .
  9. Use Betadine or Merthiolate , not one containing alcohol because it can irritate the tissues .
  10. Apply topical anesthetic to the area of tissue penetration with cotton tipped applicator .
  11. Keep the applicator in place for two minutes to allow the topical anesthetic time to take effect .
  12. Explain to the patient at this time about the topical gel , how it anesthetizes the area and makes the procedure more comfortable .
  13. Use positive terms like anesthetic , comfortable , and procedure rather than Novocaine , pain, or shot .
  14. Try not to make promises that are unreasonable like ” You won’t feel anything ” or ” This will not hurt
  15. have the armamentarium behind the patient and passed out of the field of vision
  16.  Pull the tissue as taut as possible .
  17. Use a firm hand rest and move with purpose .
  18. Penetrate the tissue up to the end of the bevel . Watch the patient for signs of discomfort and slowly deposit a drop or two of anesthetic
  19. Advance the needle slowly to the target depth and deposit a few drops of anesthetic as you go.If you approach bone , make sure to deposit a few drops of anesthetic and wait a few seconds because this area is highly innervated .
  20. Aspirate : Draw the plunger ring back just a few millimeters to produce negative pressure withinthe cartridge.If blood is visible in the cartridge , withdraw the needle slightly and aspirate again .If there is no visible blood , deposit a few drops of anesthetic and aspirate again . If still negative , slowly deposit more anesthetic Slow depositing of the anesthetic keeps the tissues in the area from tearing and reduces postoperative discomfort .Deposit about 1/4 of the required dose , then aspirate again. Continue aspirating and depositing until the desired dose is administered
  21. Slowly withdraw the needle
  22. Be careful while recapping the needle and use a proper technique .
  23. Make sure that some one stays in the room with the patient to observe any adverse reaction to the anesthetic.
  24. Enter the type of anesthetic used , what concentration of vasoconstrictor , how much solution was administered , what gauge needle used , what type of injection method used and the patient’s reaction in the patient’s chart .

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