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    Calculate The Max Doses of Local Anesthesia in Dentistry

    Uploaded by

    Yasser Magrami
    The document discusses calculating the maximum dose of local anesthetics (L.A.) in dentistry. It is important to know the maximum dose to avoid potential health problems from overdose. The maximum recommended doses are provided for commonly used L.A. drugs based on guidelines from organizations like the AAPD. Examples are provided on calculating the maximum number of cartridges that can be safely administered for different drugs and for patients of varying weights. Following the recommended dosages helps ensure safe use of L.A. in dental procedures.

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    Calculate The Max Doses of Local Anesthesia in Dentistry

    Uploaded by

    Yasser Magrami
    155 views13 pages
    The document discusses calculating the maximum dose of local anesthetics (L.A.) in dentistry. It is important to know the maximum dose to avoid potential health problems from overdose. The maximum recommended doses are provided for commonly used L.A. drugs based on guidelines from organizations like the AAPD. Examples are provided on calculating the maximum number of cartridges that can be safely administered for different drugs and for patients of varying weights. Following the recommended dosages helps ensure safe use of L.A. in dental procedures.

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    Calculate the Max Doses of Local Anesthesia in Dentistry

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    The document discusses calculating the maximum dose of local anesthetics (L.A.) in dentistry. It is important to know the maximum dose to avoid potential health problems from overdose. The maximum recommended doses are provided for commonly used L.A. drugs based on guidelines from organizations like the AAPD. Examples are provided on calculating the maximum number of cartridges that can be safely administered for different drugs and for patients of varying weights. Following the recommended dosages helps ensure safe use of L.A. in dental procedures.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    155 views13 pages

    Calculate The Max Doses of Local Anesthesia in Dentistry

    Uploaded by

    Yasser Magrami
    The document discusses calculating the maximum dose of local anesthetics (L.A.) in dentistry. It is important to know the maximum dose to avoid potential health problems from overdose. The maximum recommended doses are provided for commonly used L.A. drugs based on guidelines from organizations like the AAPD. Examples are provided on calculating the maximum number of cartridges that can be safely administered for different drugs and for patients of varying weights. Following the recommended dosages helps ensure safe use of L.A. in dental procedures.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 13

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    The max dose of L.A in dentistry


    ? How to calculate the max dose of L.A in dentistry
    Local Anesthetics

    Local anesthetics are the most commonly


    used drugs in dentistry. This article provides a
    brief update on the pharmacology, adverse
    effects and clinical applications of these drugs,
    . as well as the role of vasoconstrictors

    Local Anesthesia in adult Dentistry

    Local Anesthesia in Pediatric Dentistry

    / http://www.dentalcare.com Steven Schwartz, DDS C LINICAL P RACTICE Book An Update on Local Anesthetics in Dentistry • Daniel A. Haas, BSc, DDS, BScD, PhD, FRCD(C)
    Local anesthetics

    ?!!Why we have to know the max dose of L.A

    Because

    With overdose there may be health problems may occur to the patient
    Toxicity
    The toxicity of local anesthetics is a function of systemic absorption. High blood levels of the
    drug may be due to repeated injections or could result from a single inadvertant intravascular
    . administration
    Adverse reactions of commonly used local
    anesthetics
    Psychogenic
    Syncope (most common) Hyperventilation Nausea, vomiting Alterations in heart rate or blood pressure Mimicking
    of an allergic reaction

    Allergic (potential allergens)


    Esters (true amide allergy is very rare) Metabisulfite (present with epinephrine and with levonordefrin)
    Methylparaben (no longer added to dental cartridges)

    Toxic effects
    Primarily neurologic signs May initially manifest as sedation, lightheadedness, slurred speech, mood alteration,
    diplopia, sensory disturbances, disorientation, muscle twitching Higher blood levels may result in tremors,
    respiratory depression, tonic–clonic seizures If severe, may result
    in coma, respiratory arrest, cardiovascular collapse

    Methemoglobinemia
    Associated with prilocaine, articaine, benzocaine

    Paresthesia
    Apparently more common with articaine and prilocaine

    C LINICAL P RACTICE Book An Update on Local Anesthetics in Dentistry • Daniel A. Haas, BSc, DDS, BScD, PhD, FRCD(C)
    the max dose of L.A
    Recommended maximum doses of local
    anesthetics with vasoconstrictor

    No Maximum Maximum Drug


    of cartridges dose

    7 mg/kg (up to 500 mg) 7 Articaine


    mg/kg in children 5

    10 mg/kg (up to 200 mg) 2 Bupivacaine

    13 mg/kg (up to 500 mg) 7 Lidocaine

    11 mg/kg (up to 400 mg) 6.6 Mepivacaine


    ) or 7 if plaina (

    8 mg/kg (up to 500 mg) 8 Prilocaine

    a3% solution without vasoconstrictor C LINICAL P RACTICE Book An Update on Local Anesthetics in Dentistry • Daniel A. Haas, BSc, DDS, BScD, PhD, FRCD(C)
    Maximum Recommended Dosage of Local Anesthetic Agents (AAPD). 1
    the max dose of L.A American Academy of Pediatric Dentistry

    Maximum Dosage

    Maximum Total
    Anesthetic mg/1.7ml carpule
    Dosage

    mg/kg mg/lb

    Lidocaine 2% 1:000,000 epi 4.4 2.0 300mg 34mg

    Mepivacaine 3% plain 4.4 2.0 300mg 51mg

    Articaine 4% 1:100,000 epi 7.0 3.2 500mg 68mg

    Prilocaine 4% plain 8.0 3.6 600mg 68mg

    Bupivacaine 0.5% 1:200,000 epi 1.3 0.6 90mg 8.5mg

    / http://www.dentalcare.com Steven Schwartz, DDS


    the max dose of L.A Maximum Recommended Dosage of
    Local Anesthetic Agents (MRD). 3
    Membership in Restorative Dentistry
    (MRD)

    Maximum Dosage

    Maximum Total
    Anesthetic mg/1.7ml cartridge
    Dosage

    mg/kg mg/lb

    Lidocaine 2% 1:000,000 epi 7.0 3.2 500mg 34mg

    Mepivacaine 3% plain 6.6 3.0 400mg 51mg

    Articaine 4% 1:100,000 epi 7.0 3.2 None Listed 68mg

    Prilocaine 4% plain 6.0 2.7 400mg 68mg

    Bupivacaine 0.5% 1:200,000 epi 2.0 0.9 90mg 8.5mg

    / http://www.dentalcare.com Steven Schwartz, DDS


    calculate the max dose of L.A in dentistry
    calculate the max dose of L.A in dentistry
    To calculate the maximum amount of
    lidocaine 2% with 1:100,000 epinephrine and
    the number of cartridges that can be safely
    administered to a 30 pound patient, the
    clinician would perform the following
    . calculations

    Maximum Dosage (mg/lbs) X weight (lbs) = Maximum Total Dosage (mg)


    X 30 = 60 mgs 2.0

    Maximum Total Dosage (mg) ÷ mg/cartidge = Maximum # cartridges


    cartridges 1.67 = 36 ÷ 60

    Thus for a 30 pound child one can safely


    administer 1.67 cartridges of lidocaine 2%
    . with 1:100,000 epinephrine

    Note : maximum dosage (mg/lbs) = 2.0mg/lbs


    maximum dosage (mg/kg) = 4.4mg/kg Note : 1 carpule holds 1.8 ml of solution = 36mg
    1kg = 2.2 lbs
    / http://www.dentalcare.com Steven Schwartz, DDS
    calculate the max dose of L.A in dentistry
    To calculate the maximum amount of
    mepivacaine 3% plain and the number of
    cartridges that can be administered to a 30
    pound patient the clinician would perform the
    . following calculations

    Maximum Dosage (mg/lbs) X weight (lbs) = Maximum Total Dosage (mg)


    X 30 = 60 mgs 2.0

    Maximum Total Dosage (mg) ÷ mg/cartidge = Maximum # cartridges


    cartridge 1.1 = 54 ÷ 60

    Note the difference between the number of


    cartridges of lidocaine 2% and mepivacaine
    3% that can be administered to a 30 pound
    child is due to the difference in the number of
    mg of anesthetic solution in a 1.8cc cartridge
    of anesthesia; lidocaine contains 36 mg and
    . mepivacaine contains 54 mg
    Note : maximum dosage (mg/lbs) = 2.0mg/lbs
    maximum dosage (mg/kg) = 4.4mg/kg

    1kg = 2.2 lbs


    / http://www.dentalcare.com Steven Schwartz, DDS
    Quick Dosage Chart for AAPD Maximum
    Recommended Dosages

    Maximum Number of 1.8ml Cartridges


    Age Kg Lbs Lidocaine 2% Mepivicaine 3% Articaine 4%
    yrs + 1 7.5 16.5 0.9 0.6 0.7
    10.0 22.0 1.2 0.8 1.0
    yrs 2-3
    12.5 27.5 1.5 1.0 1.2
    15.0 33.0 1.8 1.2 1.5
    yrs 4-5
    17.5 38.5 2.1 1.4 1.7
    20.0 44.0 2.4 1.6 2.0
    yrs 6-8
    22.5 49.5 2.8 1.8 2.2
    25.0 55.0 3.1 2.0 2.4
    yrs 9-10
    30.0 66.0 3.7 2.4 2.9
    32.5 71.5 4.0 2.6 3.2
    35.0 77.0 4.3 2.9 3.4
    yrs + 11
    37.5 82.5 4.6 3.1 3.7
    40.0 88.0 4.9 3.3 3.9
    The maximum amount of local anesthetic agent needs to be reduced if the patient is receiving a supplementary dose of enteral or parenteral
    sedative agent for behavior management. The action of the sedative has an additive depressive effect on the central nervous and
    cardiovascular systems can initiate overdose consequences
    / http://www.dentalcare.com Steven Schwartz, DDS
    Thank you

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