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Topical Anesthetics

Topical Anesthetics. Topical Anesthetic Application. Topical anesthetic is applied to the mucous membrane to anesthetize terminal nerve endings ( 2-3 mm) thus increasing patient comfort during needle penetration. Concentration of Topical Anesthetic.

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Topical Anesthetics

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  1. TopicalAnesthetics

  2. TopicalAnestheticApplication • Topical anesthetic is applied to the mucous membrane to anesthetize terminal nerve endings (2-3mm) thus increasing patient comfort during needle penetration.

  3. Concentration of Topical Anesthetic • Concentration of topical anesthetic is higher than the same agent that will be injected • Higher concentration facilitates diffusion of the drug through the mucous membrane or abraded skin

  4. Vascular Absorption • Topical anesthetics do not contain vasoconstrictors and anesthetics (injectable) are vasodilators, so absorption is rapid • Levels of topical anesthetic may reach similar levels of the injectable anesthesia

  5. Benzocaine • Ester (plasma) • Availability (Cetacaine, Hurricaine) • Not suitable for injection • Available as a liquid, gel, ointment, and spray • Onset is approximately 30 seconds after application, recommend applying for 1-2 minutes • Duration of 5-15 minutes

  6. Topical Anesthetics Oral gels: • Topicale • Anbesol • Baby Orabase • Topex • Orajel • Etc. Is Benzocaine an ester or amide?

  7. Dyclonine HydrochlorideDyclone • Ketone • .5% solution, 200 mg • Used as a rinse, or applied with a cotton tip applicator • Onset is up to 10 minutes • Duration-may be up to one hour • Systemic toxicity–rare

  8. Dyclonine Hydrochloride

  9. Cetacaine • Benzocaine • Ester • Liquid • Rapid anesthesia- within 30 seconds • Duration is 30-60 minutes

  10. Lidocaine • Topical or water soluble preparation • Amide • Lidocaine ointment, 200 mg dose • Exceptionally low incidence of allergic reactions • Xylocaine, Octocaine

  11. EMLA (Eutectic Mixture of Local Anesthetics) 2.5% Lidocaine 2.5% Prilocaine

  12. AllergicResponsetoTopicalAnesthesia • Esters (benzocaine and tetracaine) • Allergic response is usually local

  13. Topical Anesthesia Quiz

  14. 1. Your patient has atypical pseudo-cholinesterase and your giving an injection. What topical anesthetic should you use on this patient? a. Cetacaine b. Dyclone c. Lidocaine d. Benzocaine e. b or c

  15. 2. Benzocaine is an: a. Ester b. Amide

  16. 3. Topical anesthetics contain vasoconstrictors. a. True b. False

  17. 4. Which topical anesthetic has a low incidence of patient allergic reactions? a. Benzocaine b. Lidocaine c. Cetacaine

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