(2) Local anesthetics are undoubtedly the most frequently used drugs
employed in the practice of dentistry. The local anesthetic most commonly used in the
Army is Xylocaine, also called lidocaine hydrochloride (two per cent concentration with
epinephrine 1:50,000 or 1:100,000). Packaging these anesthetics in disposable
cartridges makes their use in the dental syringe quick and simple. Anesthetic needles
come in different gauges and lengths. The long needle is used primarily for "block" type
injections and the short needle for infiltration type injections; however, the long needle
may be used for both types. The 25-gauge, long needle is the one provided in the dental
field kit.
c. Possible After Effects. Although the techniques are followed, drugs are used
which have a very high margin of safety, and equipment is used which is efficient and
easily sterilized, complications do occur. The most common is syncope (fainting) caused
by cerebral anemia (which is usually psychogenic in nature), normally lasting from 30
seconds to 2 minutes. If the patient does not injure himself (that is, by falling or by
aspirating a foreign body and obstructing his airway), no problem of any consequence will
arise. Syncope is treated by placing the unconscious patient in the shock position, using
a cold, damp towel on his forehead, and/or allowing him to inhale the irritating fumes from
an ammonia ampoule. Occasionally, allergic reactions to the drugs used may arise, but
these are extremely rare.
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