Evaluating complications of local anesthesia administration and reversal with phentolamine mesylate in a portable pediatric dental clinic

Self-Instruction Exercise No. 336
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Exercise No. 336
Subject Code: 132
Anesthesia and Pain Control

The 15 questions for this exercise are based on the article, “Evaluating complications of local anesthesia administration and reversal with phentolamine mesylate in a portable pediatric dental clinic”, on pages 70-76. This exercise was developed by Steven E. Holbrook, DMD, MAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing this exercise will enable you to:

  • identify the mechanism of action of phentolamine mesylate;
  • recognize that comprehensive care with local anesthesia delivered by a school-based portable dental clinic has a low risk of complications; and
  • understand that the use of phentolamine mesylate can improve safety outcomes.

Answers for this exercise must be received by July 31, 2014.
  1. Phentolamine mesylate is a/an __________ blocker.

    A. alpha adrenergic
    B. beta adrenergic
    C. cholinergic
    D. nootropic

  2. Phenotolamine mesylate decreases the duration of soft tissue anesthesia, after local anesthetic administration, by increasing

    A. the ion exchange phenomenon at the dendrite membrane.
    B. total peripheral resistance.
    C. the elimination of anesthetic.
    D. venous return to the heart.

  3. A complication that resolved in an immediate manner following provider intervention was classified as a __________ complication.

    A. mild
    B. moderate
    C. severe
    D. critical

  4. In this study, the percentage of complications from the administration of local anesthesia was __________.

    A. 2.7
    B. 5.3
    C. 8.6
    D. 12.2

  5. The area most often injured in self inflicted soft tissue trauma is the

    A. tongue.
    B. upper lip.
    C. lower lip.
    D. cheek.

  6. The most frequently reported complication of phentolamine mesylate in early clinical trials was

    A. increased heart rate.
    B. injection site pain.
    C. soft tissue trauma.
    D. decreased heart rate.

  7. Phentolamine mesylate was administered __________ % of the time in this study.

    A. 24.2
    B. 41.3
    C. 67.8
    D. 87.5

  8. Safe administration of dental care was achievable with or without phentolamine mesylate. The use of phentolamine mesylate did not improve safety outcomes.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  9. The anesthetic most often associated with complication reports was

    A. articane.
    B. mepivocaine.
    C. marcaine.
    D. lidocaine.

  10. Patients with __________ were more likely to have a complication.

    A. attention deficit hyperactivity disorder
    B. asthma
    C. intellectual and developmental disabilities
    D. an autism spectrum disorder

  11. Patents considered overweight or obese were associated with what percentage of reported complications?

    A. 11.9
    B. 23.9
    C. 46.9
    D. 72.9

  12. Children administered local anesthetics were not disruptive to class. Children administered local anesthetics were not distracted in their ability to reorient to work.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  13. What percentage of patients administered phentolamine mesylate reported complications?

    A. 2.6
    B. 5.8
    C. 11.3
    D. 21.4

  14. The most common cause of trismus, following the administration of an inferior alveolar nerve block, is damage to which of the following muscles?

    A. Masseter
    B. Lateral pterygoid
    C. Medial pterygoid
    D. Temporalis

  15. The second most common complication reported to occur as the result of local anesthetic administration was

    A. pain at the injection site.
    B. self-inflicted injury to the tongue.
    C. local anesthetic readministration.
    D. hematoma.

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
Did this exercise achieve its objectives? Yes No
Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins

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