05074 - Anaesthesia and Resuscitation

Learning outcomes

At the end of the course students should know the anatomical, physiological and pathophysiological bases of acute pain (especially trigeminal). Students should have knowledge of anatomy, physiology and pharmacology useful for understanding the action of local anesthetics and vasoconstrictor drugs associated with local anesthetics. They should also know the pathophysiological and clinical bases of acute clinical manifestations of complications related to loco-regional dental anesthesia and serious acute events occurring in patients undergoing stomatological treatment. In particular, students should be able to: • Know the anatomical pathways of pain and the physiological bases of functioning and pain control • Know the anatomical and functional bases of pain and inflammation receptors • Quantify the severity of pain with scales • Know the principles of the use of analgesic drugs and their classes • Know the main adverse effects of analgesic drugs • Know the basics of stomatological loco-regional anesthesia • Recognize allergic reactions from local anesthetic • Recognize the negative effects of overdose of local anesthetics and vasoconstrictors • Recognize acute cardio-vascular disorders (fainting, syncope) • Recognize acute disturbances of consciousness (coma) and signs of central nervous system irritation (epileptic seizures) • Establish the foundations of clinical and treatment monitoring collaborating with the dentist • Know how to conduct anamnestic questioning oriented at the main risk factors for complications related to stomatological anesthesia • Know the basic nursing techniques aimed at recognizing and treating the aforementioned clinical pictures.

Course contents

Physiology of neurotransmission: action potentials, saltatory conduction, sodium channels and their functioning.
Local anesthetics: pharmacodynamics, pharmacokinetics, relationship between structure and function, routes of administration. Main adverse effects of local anesthetics: allergic and non-allergic reactions.
Systemic toxicity from local anesthetics (LAST): epidemiology, pathophysiological mechanisms, clinical presentation, diagnosis and hints of therapy.
The fear / anxiety caused by dental treatment: etiology, epidemiology and diagnosis.
Anxiolysis, sedation and general anesthesia: definitions. Non-drug treatment of anxiety.
Benzodiazepines: pharmacodynamics, pharmacokinetics, routes of administration and main adverse effects.
Nitrous oxide: pharmacodynamics, pharmacokinetics, method of administration, adverse effects.
Principles of analgesia. Non-steroidal anti-inflammatory drugs: application in the dental field. Example of postoperative analgesia protocols in odontostomatology.
Antibiotic prophylaxis in dentistry. Outline of the pathophysiology and prevention of bacterial endocarditis.
Bronchial asthma: pathophysiology, signs and symptoms, initial treatment.
Anaphylactic shock: pathophysiology, signs and symptoms, initial treatment.

Readings/Bibliography

Learning material provided by the teacher.

Teaching methods

Lectures and seminars.

Assessment methods

Oral exam.

Teaching tools

Slides and videos.

Office hours

See the website of Tommaso Tonetti