Purpose of App Review
- To review the applicability of the Local Anesthesia app for guiding safe maximum dosing of local anesthetic
- To assess whether the features of the app warrant spending nearly $10 for it
Pain control, especially during a procedure, is a key tenet of medicine.
Sometimes to cure, we have to do procedures that require causing pain; fortunately, there are medicines for that.
Too much of a drug or multiple drugs can be a bad thing, though. The Local Anesthesia app seeks to guide providers, particularly dentists, with patient-specific guidelines for dosing one or multiple local anesthetics.
After the usual disclaimer, the app brings you to the homepage. From there, you can access all the app’s features. The question mark icon in the top corner provides a 15-page illustrated guide to the app. This is a good place to start if the you are not sure how to use the app. This guide also shows you the formulas for the calculations used in the app.
Before looking up doses, you should put in your patient’s information by selecting the icon in the top left corner (age, weight).
Once patient-specific data is entered, you can proceed to any of the three main sections. In the Dose Calculator section, you select an agent in the scroll box at the bottom. After you have selected the agent (also, if applicable, the cartridge you are using), the top half of the app lists several pieces of information as a result. The information includes: the agent name, maximum dose in milligrams, milligrams/kilogram of patient weight, maximum number of cartridges, and milligrams/cartridge.
The Overdose Index section was the most helpful section for me. In this portion, you can add multiple drugs for the calculator to calculate if the anesthetic, or combination of anesthetics, the patient has received is at a toxic level. If you do not use cartridges, you will need to make some of your own calculations to decide the number of carpules you have given the patient.
After you have entered in each agent, the app calculates a graph of toxicity. The graph’s presentation tells you how close you are to the toxic or max doses for the all agents included, as well as for the most toxic drug.
The Agents List section lists the default agents provided by the app (2% lidocaine, Mepivacaine, prilicaine, bupivacaine, etidocaine, and articaine). By selecting an agent, you can edit the agent, adding your own notes. If your agent of interest (or the percent of interest) is not listed, you can add an agent by selecting the plus sign icon in the top left. You will then need to put in the percent, the agent name, the max dose in mg/kg, and the maximum absolute dose in mg.
The final section allows you to share the app, provide feedback, access the help guide, and read the app disclaimer.
- Description of formulas used
- Ability to add commonly used agents
- Toxicity calculator based on all agents used
- Ability to add notes to each agent
- Cannot copy an agent and then modify to make it another
- Specialty-specific (dentistry-focused)
- Does not back calculate how much more you could give of a particular agent
- No links/suggestions for how to deal with toxicity
- Lacks search function for dose information for agents that have been added by the user
- Inability to simply add in milliliters of agent used (must put in as cartridges used)
Healthcare providers that would benefit from the app
- Health-care providers who use or teach about using local anesthetic
The Local Anesthesia app provides helpful dose and toxicity calculations for local anesthetics if you use multiple agents and you use carpulse or cartridges. The app is more specific to dentistry and is most useful for that field. User editing abilities extends the usability of this app to more general use in medicine. Available for the iPhone and iPad. It is not available for Android.
1. User Interface – 3. Cartridges are pretty specialty-specific, so needing to calculate cartridges from volume is troublesome. Easy to move between various sections.
2. Multimedia usage – 4. App utilizes rolling windows, PDF compatibility.
3. Price – 2. $9.99. Somewhat steep price for a less universally-designed app where user may need to add agents themselves
4. Real world applicability – 2. This will be specialty specific and more applicable to the field of dentistry than the field of medicine
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your healthcare provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or healthcare provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your healthcare provider.