Complications of local

anaesthesia
Dr. Mumena C.H
General complications
Complications following anaethesia depends
how correctly it was given
After injection of local anaesthesia, patient
shouldnt be left alone
Prophylactic measures should be taken before
any complication
There 4 groups of general complications
General complications
4 groups of general complications are:
Psychogenic
Toxic
Allergic reactions
Drug interactions
General complications
Psychogenic complications:
Occur most often due to mental stress (Dental
treatment is threatening-Dental threatment
Common symptoms produced are:
Cold perspiration
Palpation
Anxiety
Restlessness
Excitation
Fainting
General complications
Psychogenic complications:
In most cases psychogenic reactions may be mixed
with toxic reactions
Examples of such complications are fainting which
is a psychogenic of vasomotor origin
Vasovagal syncope is a special form of fainting and
is a reflex to manipulate in the head and neck
region
General complications
Psychogenic complications:
Risks to fainting are:
Orthostatic patients
Pain anxiety combination
Patient with habit of holding breath under psychic
stress
Patients with defective cardiac nerve conduction

General complications
Psychogenic complications:
NB: telling patients to take long and deep breaths
during injection helps
Increase oxygen supply
Reduce anxiety
Fainting is due to a fall in BP
Conscious can be restored by having patient lying
down with head low while making sure that
airway is free
General complications
Toxic complication
This is due to overdose of local anaesthesia
In normal doses toxic syndrome is rare and occur in
people with lowered tolerance for local anesthesia
(Hyper-reaction)
Toxic reactions occur in
CVS-Lowered BP
Myocardium
CNS overstimulation of CNS-symptoms of excitation and
convulsions
RS
General complications
Toxic complication
The maximum dose to cause toxic complication
differs with use of vasoconstrictors or without
vasoconstrictors
Risks to toxic reaction
Hyper-reaction persons
Renal failure
Hepatic failure
Anemia

General complications
Allergic reactions:
It is now rare than it used to be
It is more associated with other substances but
not local anesthesia such as iodine, euginol,
acrylate monomers etc,
Allergy due to local anesthesia is not common
since introduction of alide type of anaesthesia
General complications
Drug interaction:
Examples of drugs such as
Tricyclic antidepressants-potentiate the effect of
catecholamines (adrenaline and nor adrenaline)
Symptoms are: flushing, palpitation, severe headache
that often originate from back of the head
Tricyclic antidepressant inhibit the re-uptake of
noradrenaline in the nerve endings, increasing
concentration
Felypressin is not affected by tricyclic antidepressant