Ubistezin: instructions, application, reviews. Local anesthesia in dentistry: reviews Indications and contraindications

In 1 ml of solution articaine hydrochloride - 40 mg, epinephrine hydrochloride - 0.006 mg, which corresponds to 0.005 mg . Water for injection, sodium chloride, sodium sulfite - as excipients.

Release form

Solution in carpules in a metal container.

pharmachologic effect

Local anesthetic.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Combined preparation intended for local anesthesia for minor surgical interventions, including dentistry . Its action is determined by its constituent components.

Pharmacokinetics

Articaine has a high penetrating power. 95% protein bound. It practically does not penetrate the placental barrier, and is not excreted with a woman's milk. The half-life is 22-25 minutes.

Indications for use

Anesthesia for minor dental interventions:

• uncomplicated tooth extraction;
• filling of carious teeth;
• preparation for prosthetics (grinding of teeth).

For (retrobulbar , intercostal , paravertebral ), blockades (trigeminal nerve, stellate ganglion, brachial plexus, vulva).

Contraindications

• hypersensitivity to components;
• paroxysmal tachycardia ;
• and hypersensitivity to sulfites;
• angle-closure glaucoma ;
• concomitant therapy with non-selective beta-blockers , tricyclic antidepressants;
• heavy liver failure ;
• cardiogenic shock ;

Exercise caution when the following diseases and states:

• chronic heart failure ;
• inflammation in the area of ​​anesthesia;
• weakened patients;
• elderly age.

Side effects

• headache, muscular, impaired breathing and consciousness (possible loss of it), muscle twitching, generalized convulsions are possible;
• nausea, vomiting;
• "clouding" in the eyes;
• drop in blood pressure, tachycardia , oppression of cardiovascular activity;
• redness of the skin, itching, swelling of the lips, glottis;
• swelling at the injection site;
• nerve damage.

Instructions for Ubistezin (Method and dosage)

It is used in practically healthy patients during dental interventions. On average, 1–1.5 cartridges are used at a time, which corresponds to 2–3 ml of solution. A maximum of 2 carpules are administered within 2 hours, a more accurate dose calculation is 7 mg / kg.

Uncomplicated tooth extraction- under the mucous membrane 1.7 ml per tooth. With a palatine incision, 0.1 ml. Anesthesia for tonsillectomy- 5-10 ml per tonsil, with suturing the perineum- 5-15 ml.

At conduction anesthesia(retrobulbar, intercostal, paravertebral, epidural, sacral), blockades (paracervical, trigeminal nerve, stellate ganglion, brachial plexus) from 1 to 30 ml of anesthetic is used, depending on the location and volume of anesthesia.

Instructions for Ubistezin forte

Ubistezin forte contains articaine 40 mg as well doseepinephrine 2 times more -10 mcg / ml. It is an anesthetic with an average content of vasoconstrictor, is the most effective of the painkillers. Ubistezin forte is used for long and complex extractions, with a large group of teeth. It is recommended to use practically healthy patients. You can use 1–2 cartridges once, which corresponds to 2–4 ml of solution. A maximum of 2.5–3 carpules can be injected within 2 hours.

Overdose

Overdose is manifested by symptoms: dizziness, tachycardia or bradycardia, impaired consciousness, anxiety, lowering blood pressure.

It is necessary to stop the manipulation, lay the patient down and restore adequate patency respiratory tract, monitor blood pressure and heart rate. Inhalation of oxygen and artificial ventilation of the lungs are shown. In the presence of convulsions administered intravenously barbiturates ; at shocked- infusion electrolytes , glucocorticosteroids ; at vascular collapse- intravenously 0.1 mg; at tachycardia- intravenously selective beta blockers ; at increase in pressure- peripheral vasodilators .

Interaction

The anesthetic effect of the drug is enhanced by vasoconstrictor drugs.

Do not use Ubistezin during therapy with non-selective beta-blockers, as there is a risk hypertensive crisis and bradycardia .

Hypertensive effect epinephrine intensifies tricyclic antidepressants .

Terms of sale

Released by prescription.

Storage conditions

At temperatures up to 250 C.

Best before date

Analogues

Alfacain , Brilocaine-adrenaline , Brilocaine-adrenalineforte , Primakain , Ultracaine suprarenin , Cytopicture .

Ubistezin during pregnancy

During pregnancy, the use of this drug is possible. It does not pass through the placental barrier, so it is a safe anesthetic during this period. Does not have a negative effect on the fetus with any technique of use and dosage. Only possible bradycardia at the fetus. A nursing mother does not need to interrupt feeding, since the active substances are not excreted in milk in quantities significant for the child.

Many people are afraid of dental treatment. And absolutely in vain. Modern anesthetics make it possible to carry out all kinds of dental procedures completely painlessly. For example, quite often doctors use the drug "Ubistezin forte.This medicine providesnot tolAs effective anesthesia, but also rapid wound healing.

"Ubistezin forte": composition and form of release

This drug belongs to the group of local anesthetics. Active ingredients it includes two:

articaine hydrochloride(40 mg);

epinephrine hydrochloride(0.012).

Andjust such a four percent solution of the drugUbistezin forte (40 mg articaine hydrochloride)used by dentists for anesthesia most often.

Also the composition of the drug includes:

sodium chloride and sulfate;

water.

This medication is supplied to the market in cartridges of 50 pieces in metal cans. It is a colorless transparent liquid.

Indications for use

used"Ubistezin forte",descriptionwhich was given abovein dentistry for conduction and infiltration anesthesia. It can also be used in the treatment of patients with concomitant serious somatic diseases. Dentists use this medication mainly for:

uncomplicated extraction of one or more teeth;

filling with caries;

grinding teeth during preparation;

operations on the oral mucosa;

operations on the bones;

cystectomy;

percutaneous osteosynthesis;

Condwell-Luc operations.

This drug can be used as an anesthetic not only in dentistry. It is sometimes also used by traumatologists and gynecologists.

How does the drug work

The effect of anesthesia occurs in the patient within a couple of minutes after the injection of the drug "Ubistezin forte.The effect of the drug continues for 45 minutes. Good feedback doctors and their patients, this anesthetic deserved, among other things, because it has a minimal vasoconstrictor effect. It is thanks to this that wound healing after dental procedures with its use does not cause any complications.

There is very little epinephrine in this preparation. Therefore, the remedy does not have too strong a negative effect on the patient's heart. During the procedures and after them, patients do not experience jumps in blood pressure and changes in heart rate.

What are the contraindications

Of course,does not allow in all casesuse medication"Ubistezin forte"instructions for use. In dentistrythis medication is not used when the patient has:

tachycardia or tachyarrhythmia;

bronchial asthma;

angle-closure glaucoma;

severe degree of renal failure;

porphyria, some pathologies of the central nervous system, hyperthyroidism.

This medicine is not used for anesthesia and if the patient is intolerant of any of its components.

Side effects

In some cases, the medicinebandstezine forte "mcan have a negative impact on the patient's body. Side effects This tool has:

headache;

clouding of consciousness (sometimes loss);

respiratory failure (may be stopped);

convulsions;

muscle tremor.

Sometimes in patients using such a medicine, it may also darken in the eyes, develop nausea and vomiting. Occasionally, this remedy has on the body of patients and such a negative effect as tachycardia, arterial hypotension, bradycardia, apnea, dyspnea.

Overdose

Only a qualified doctor can decide on the use of this medication for local anesthesia. He also prescribes the dosage. Introduction to the patient too a large number medication "Ubandstezine forthose" can lead to such negative consequences as motor restlessness and clouding of consciousness.

In case of an overdose, the doctor should:

lay the patient on the couch;

in case of muscle twitches, give him some kind of babiturate;

in case of increasing bardycardia, use adrenaline or a glucocorticoid.

If necessary, the patient with an overdose is given oxygen and artificial respiration is done. Also, sometimes a procedure such as endotracheal intubation (with ventilation of the lungs) is performed. With increasing pressure, it is recommended to use peripheral vasodilators.

Interaction of the drug with other drugs

To enhance the hypertensive effect when using"Ubandstezine forte"it is recommended to use tricyclic antidepressants or MAO inhibitors. It is not allowed to conduct anesthesia with this medication in the treatment of non-selective beta-blockers. The combination of these drugs can lead to severe bradycardia in the patient and the development of a hypertensive crisis.

"Ubistezin forte": instructions for use of the drug

The dosage of this medication depends on which procedure is being performed.doctor.

Injection into the area of ​​\u200b\u200binflammation when using the remedy "Ubandstezine forte" affairsit is prohibited.With uncomplicated tooth extraction, the medication is injected under the mucous membrane in the region of the transitional fold. In this case, 1.7 ml per tooth is used. Sometimes an additional 1-1.7 ml is used additionally. But to do so is allowed only in extreme cases.

PWhen turning teeth for crowns or when preparing a cavity, a vestibular injection is performed using 0.5-1.7 ml of the drug per tooth. The only exception in this case are molars. mandible. The maximum dose of the drug in this treatment is 7 ml.

special instructions

This is what the drug hasUbistezin forte "instruction pabout usage. When using this medication, doctors are also required to comply with such special recommendations:

Eating a patient who was treated with the use of "Ubistezine forte",allowed only after sensitivity is restored in the tissues. That is, not earlier than 1-1.5 hours after the injection.

During the procedures, the doctor should use only new, sterilized syringes and needles. Otherwise, the patient may become infected with any disease transmitted through the blood.

Already opened cartridges should not be used for new patients.

Do not use damaged cartridges.

On the label of refillable bottles, you need to make marks about the time of the first injection.

Opened reusable vials are allowed to be used for a maximum of 2 days. They must be stored according to the instructions.

Ubistezin
Instructions for medical use- RU No. P N016046/01

Last Modified Date: 11.09.2012

Dosage form

Solution for injection (with epinephrine)

Compound

Active substances:

Articaine hydrochloride 40 mg, epinephrine hydrochloride 0.006 mg (equivalent to 0.005 mg epinephrine);

Excipients:

Sodium sulfite 0.6 mg (equivalent to 0.31 mg SO 2), sodium chloride 1.125 mg, water for injection up to 1 ml.

Description of the dosage form

Clear, colorless liquid.

Pharmacological group

Local anesthetic + vasoconstrictor.

pharmachologic effect

Ubistezin - combination drug for local anesthesia in dentistry. Articaine, which is part of it, is a local anesthetic of the amide type of the thiafene group. The action of the drug begins quickly - after 1-3 minutes. The duration of anesthesia is at least 45 minutes. Wound healing proceeds without complications, due to good tissue tolerance and minimal vasoconstrictive effect.

Due to the low content of epinephrine in the preparation, its effect on the cardiovascular system is little pronounced: there is almost no increase in blood pressure and an increase in heart rate.

Pharmacokinetics

Articaine with submucosal administration in the oral cavity has a high diffuse ability. Communication with proteins is 95%. Active substances penetrate the placental barrier to a minimal extent, are practically not excreted in breast milk, the half-life is 25 minutes.

Indications

Infiltration and conduction anesthesia in dentistry (especially in patients with concomitant severe somatic diseases), including when carrying out the following manipulations:

• Uncomplicated extraction of one or more teeth;
• Filling of carious cavities, grinding of teeth before preparation.

Contraindications

• Hypersensitivity to articaine, epinephrine, sulfites, as well as to any of the auxiliary components of the drug;
• Known or congenital deficiency of cholinesterase activity;
• Patients with hemorrhagic diathesis;
• Severe liver failure, porphyria, hyperthyroidism;
• Angle-closure glaucoma;
• Cardiac disease (unstable angina, recent myocardial infarction, period after coronary artery bypass grafting, uncontrolled severe arterial hypertension, uncontrolled congestive heart failure), severe arterial hypotension, paroxysmal tachycardia and other tachyarrhythmias, severe or uncontrolled cardiac conduction disorders (including atrioventricular block II and III degree, bradycardia;
• Bronchial asthma with hypersensitivity to sulfites;
• Inflammation in the area of ​​​​the proposed anesthesia;
• Cardiogenic shock;
• Simultaneous use of non-selective beta-blockers, concomitant therapy with monoamine oxidase inhibitors or tricyclic antidepressants;
• Children's age up to 4 years (due to lack of relevant clinical data).

Carefully apply in the following cases:

• Pheochromocytoma;
• Blood clotting disorders;
• Diabetes;
• Epilepsy;
• Arterial hypertension, angina pectoris, atherosclerosis, intraventricular and atrioventricular block I degree, chronic heart failure;
• Bronchial asthma;
• Liver failure;
• kidney failure;
• Simultaneous reception of phenothiazine, cardioselective beta-blockers, anticoagulants and antiplatelet agents;
• heavy general state, debilitated patients;
• Elderly age.

Use during pregnancy and lactation

There are not enough clinical observations on the use of the drug during pregnancy and lactation.

Currently, there is no information on the safety of the drug during pregnancy in relation to the impact on fetal development.

Therefore, the use of the drug during pregnancy is possible only if the expected benefit to the mother from its use outweighs the potential risk to the fetus.

It is not known whether articaine and epinephrine are excreted in breast milk. During the period of breastfeeding, they are used only if the intended benefit to the mother outweighs the potential risk to the child.

When maintaining breastfeeding after anesthesia with articaine, it is recommended to skip one breastfeed. (extract and do not use milk), replacing it with artificial.

Dosage and administration

adults

With uncomplicated extraction of the teeth of the upper jaw in the absence of inflammation, 1.7 ml of the drug is usually injected into the submucosa in the region of the transitional fold from the vestibular side (for each tooth).

In some cases, an additional injection of 1 to 1.7 ml of the drug may be required to achieve complete anesthesia. In most cases, it is not necessary to perform painful injections from the palatal side. For anesthesia with palatine incisions and suturing in order to create a palatine depot, about 0.1 ml of the drug is needed per injection. When removing several adjacent teeth, the number of injections can usually be limited. In the case of removal of mandibular premolars in the absence of inflammation, mandibular anesthesia can be dispensed with, because. infiltration anesthesia provided by an injection of 1.7 ml per tooth is usually sufficient. If this way it was not possible to achieve the desired effect, an additional injection of 1-1.7 ml of the drug into the submucosa in the region of the transitional fold of the lower jaw from the vestibular side should be performed. If, in this case, it was not possible to achieve complete anesthesia, it is necessary to block the mandibular nerve. To prepare the cavity of the tooth for filling or processing under the crown of any tooth, with the exception of the lower molars, the administration of the drug in a dose of 0.5 to 1.7 ml per each tooth is indicated according to the type of infiltration anesthesia from the vestibular side. The exact amount depends on the desired depth and duration of the procedure.

When performing one medical procedure adults can enter up to 7 mg of articaine per 1 kg of body weight.

The duration of intrapulpal anesthesia is at least 45 minutes, the duration of soft tissue anesthesia is from 120 to 240 minutes.

Elderly patients

An increase in the concentration of the drug in the blood plasma may be caused by a decrease in metabolic processes and a decrease in the volume of distribution. In particular, the risk of cumulation of the drug after repeated administration increases. Dose reduction is required for heart and liver disease.

Patients with liver failure

Articaine is metabolized by the liver. Dose reduction may be required to achieve sufficient depth of anesthesia and systemic accumulation.

Patients with renal insufficiency

Basically, articaine and its metabolites are excreted in the urine. Dose reduction may be required to achieve sufficient depth of anesthesia and systemic accumulation.

Dose reduction is required for angina pectoris, atherosclerosis and other diseases listed in the "With caution" section.

Children (from 4 years old to 18 years old)

Patients childhood(over 4 years) the dose of the drug is selected depending on the age and body weight of the child.

Do not exceed a dose equivalent to 7 mg articaine/kg body weight!

Because articaine diffuses rapidly into tissues and bone density is lower in children than in adults, infiltration anesthesia may be used in children instead of conduction anesthesia.

Side effects

The drug is usually well tolerated by patients, but the following side effects may develop:

From the side of the central nervous system(depending on the size of the applied dose): headache, impaired consciousness up to its loss, respiratory failure up to its stop, muscle tremor, involuntary muscle twitching, sometimes progressing up to generalized convulsions;

From the digestive organs: nausea, vomiting, diarrhea;

From the organ of vision : rarely - "clouding" in the eyes, transient blindness;

From the side of cardio-vascular system : moderate hemodynamic disturbances, manifested in a decrease in blood pressure, tachycardia or bradycardia, depression of cardiovascular activity, which in extreme manifestation can lead to collapse and cardiac arrest, which threatens the patient's life.

allergic reactions: swelling or inflammation at the injection site; in other areas - skin redness, itching, conjunctivitis, rhinitis, angioedema varying degrees severity (including swelling of the upper and/or lower lip and/or cheeks, glottis with difficulty swallowing, urticaria, difficulty breathing). All of these phenomena can progress to the development anaphylactic shock.

Local reactions : swelling or inflammation at the injection site; the appearance of ischemic zones at the injection site (up to the development of tissue necrosis - with accidental intravascular injection);

Other : headaches are often observed, probably associated with the presence of epinephrine in the preparation; other side effects due to the action of epinephrine (tachycardia, arrhythmia, increased blood pressure), are extremely rare; nerve damage (up to the development of paralysis) - occurs only if the injection technique is violated.

Overdose

Symptoms :

Dizziness, restlessness, impaired consciousness, lowering blood pressure, tachycardia, bradycardia.

Treatment : when the first signs of an overdose appear during the injection, it is necessary to stop the administration of the drug, give the patient a horizontal position, ensure free airway patency, control heart rate and blood pressure. In case of respiratory failure - oxygen, endotracheal intubation, artificial ventilation of the lungs (central analeptics are contraindicated); with convulsions - intravenously slowly short-acting barbiturates with simultaneous oxygen supply and hemodynamic control; at severe violations blood circulation and shock - intravenous infusion of electrolyte solutions and plasma substitutes, glucocorticosteroids, albumin; with vascular collapse and increasing bradycardia - intravenously slowly epinephrine 0.1 mg, then intravenously drip under the control of heart rate and blood pressure; with severe tachycardia and tachyarrhythmia - intravenous beta-blockers (selective); with an increase in blood pressure - peripheral vasodilators.

Oxygen therapy and monitoring of blood circulation parameters are necessary in all cases.

Interaction

The hypertensive effect of sympathomimetic amines such as epinephrine can be enhanced by tricyclic antidepressants and monoamine oxidase inhibitors. An interaction of this type has been described for epinephrine and norepinephrine when used as vasoconstrictors at concentrations of 1:25,000 and 1:80,000, respectively.

The drug should not be prescribed during treatment with non-selective beta-blockers, since in this case there is a high risk of developing a hypertensive crisis and severe bradycardia.

The local anesthetic effect of articaine enhances and lengthens the vasoconstrictor medicines.

special instructions

Ubistezin contains sulfites, which may increase the anaphylactic reaction. The drug should not be administered intravenously. Do not inject into the area of ​​inflammation. Eating is possible only after the restoration of sensitivity. To prevent infection (including hepatitis), it is necessary to always use new sterile syringes and needles every time a solution is taken from vials or ampoules.

Opened cartridges must not be used again for other patients (risk of hepatitis). Do not use a damaged cartridge.

Influence on the ability to drive vehicles and control mechanisms

In special tests, there was no clear effect of the drug on the concentration of attention and the speed of motor reactions. However, due to the fact that the patient's preoperative anxiety and stress caused by surgery can affect the effectiveness of the activity, the dentist must individually, in each case, decide on the admission of the patient to drive transport or work with mechanisms.

Release form

Solution for injection (with epinephrine) 40 mg + 5 mcg/ml.

1.7 ml in cartridges of colorless neutral glass, sealed at both ends with bromobutyl rubber stoppers. The cork that closes the neck of the cartridge is protected by an aluminum foil ring. 50 cartridges with instructions for use in a tin can, additionally corked with a translucent plastic lid.

Storage conditions

Store in a dark place at a temperature not exceeding 25°C.

Keep out of the reach of children.

Best before date

2 years. Do not use after the expiry date stated on the packaging.

Terms of dispensing from pharmacies

On prescription.

Ubistezin - instructions for medical use - RU No.

If long-term surgical intervention on the face is required, a sensitivity reaction is observed to many local anesthetics, with an unstable mentality of the patient, general anesthesia or sedation (drug sleep) is used.

It is also possible to lubricate tissues with an anesthetic. This method is well suited for the treatment of small patients or when removing dental deposits. The drug is applied with a cotton swab. Very rarely, anesthesia is used by electrophoresis or inkjet method, using an injector, an electromagnet and a laser, freezing.

Local complications of local anesthesia in dentistry are short-lived. So, when using disposable needles, they are very rare, but they can break. To prevent this from happening, the needle is not inserted to its full length.

To ensure that the patient does not feel pain during the injection, the anesthetic is injected very slowly. There are also nerve injuries that slightly reduce sensitivity for a month. The frequency of this complication is about 20%. Sometimes a spasm of the chewing muscles can occur. It is associated with needle injury to blood vessels. Tissue necrosis may also develop.

The advantages of local anesthesia in dentistry over anesthesia are obvious: in most cases, local anesthesia is easily tolerated, and the toxicity of local anesthetics is minimal.

However, there are times when general anesthesia is justified. It can be mask anesthesia, endotracheal or intravenous. For general anesthesia, the dental clinic must have a special permit. Most often, general anesthesia is used for dental implants. Before general anesthesia, the patient undergoes an examination, as before an operation, doctors study his anamnesis in detail. Under general anesthesia, you can treat many diseased teeth at once and save time. General anesthesia contraindicated in heart disease, stroke, asthma, diabetes, diseases of the liver and kidneys with a significant decrease in their function, pregnancy.

Care should be taken with anesthesia in patients with diabetes mellitus and a recent myocardial infarction.

Pain relief reinforces the normal response to dental treatment. Dentistry and pain today - incompatible concepts. That's why everything less people are afraid of dental treatment. You can always choose an anesthetic that is right for you. No longer uses toxic novocaine. The patient does not experience stress and negative emotions when visiting the dentist, and the doctor calmly performs all the manipulations. The success of treatment is determined not only by the extent to which new tools and technologies are used, not only by the skills of the doctor, but also by the psychological mood of the patient. And it cannot be positive if the patient is afraid. This factor is especially important in dental surgical interventions, since a person who is even a little sensitive to pain and calmly tolerates dental treatment without anesthesia will not want to remove teeth without anesthesia. Especially when it is necessary to install implants by implanting them into the bone. Most clinics use high-quality and safe imported drugs for pain relief. They can be used by pregnant women, they do not contain adrenaline. Sedatives may also be used to calm the mind. This is called premedication.

From this article you will learn:

• anesthesia in dentistry - drugs,
• types of anesthesia in dental treatment,
• pain relief during pregnancy and breastfeeding.

The article was written by a dental surgeon with more than 19 years of experience.

Local anesthesia- This is a type of anesthesia, the meaning of which is to block the transmission of pain impulses from the area where the intervention is performed. Options for local anesthesia in dentistry include infiltration, conduction or application anesthesia. They allow you to anesthetize only the area where the intervention is planned (this can be a group of teeth or a fragment of the jaw), while the patient is conscious.

For local anesthesia in dentistry, medicines are used, which are called the term " local anesthetics". But in some cases, for example, with major surgical interventions or panic fear a person before treatment or extraction of teeth - can also be used, in which, along with pain sensitivity, the patient's consciousness is temporarily turned off. General anesthesia is performed with narcotic analgesics administered intravenously or by inhalation (Fig. 3).

Local and general anesthesia in dentistry -

The very first local anesthetic in dentistry is, which, however, did not allow to achieve pronounced anesthesia, and practically did not anesthetize the inflamed tissues. Later, it appeared, which in terms of effectiveness was already about 2-2.5 times stronger, but like novocaine, it did not allow achieving great depth and duration of anesthesia. The real revolution occurred with the advent of anesthetics of the articaine series (based on articaine hydrochloride), which additionally contained vasoconstrictors.

The most popular local anesthetics in dentistry based on articaine are Ultracaine, Ubistezin, Alfacaine, Septanest and others. To further increase the depth and duration of anesthesia, vasoconstrictors began to be added to these drugs. The latter constrict blood vessels at the injection site of the anesthetic, thereby reducing the rate of its leaching from the tissues. The most commonly used vasoconstrictor is epinephrine at a concentration of 1:100,000 and 1:200,000.

Local anesthesia in the treatment and extraction of teeth -

If earlier novocaine and lidocaine were produced in the form of vials or ampoules, and injections with these drugs were performed using ordinary 5.0 ml disposable syringes, now all modern anesthetics are produced in the form of disposable carpool(cartridges). Each cartridge usually contains 1.7 ml of anesthetic, and before anesthesia it is inserted into a special cartridge syringe. Next, a very thin needle is screwed on (many times thinner than conventional needles for disposable syringes), after which the syringe is ready for use.

What does a carpool syringe look like?

The cost of anesthetics and anesthesia –
the cost of one anesthetic cartridge at the end of 2020 (be it ultracaine, ubistezin, septanest or others) will be approximately 40-50 rubles. It is at this price that dental clinics buy anesthetics. But the full cost of anesthesia for dental treatment in dental clinic will be about 400-500 rubles for 1 cartridge of anesthetic.

It is also worth noting that anesthesia in the treatment and extraction of teeth in dentistry is included in the guarantee program of the health insurance fund. Therefore, anesthesia in state dental clinics should be carried out free of charge, but only when using Lidocaine or Novocaine (imported anesthetic will be paid). Next, we will talk about the types of anesthesia in dentistry.

Types of anesthesia in dentistry - infiltration, conduction, application

As we said above, local anesthesia can be applied, infiltration or conduction. Application anesthesia in dentistry is used to anesthetize the oral mucosa by applying 10% lidocaine in the form of a gel or spray. Especially often this type of anesthesia is used in children to preliminarily anesthetize the injection site of the needle. Lidocaine spray is often sprayed on the root of the tongue in patients with an increased gag reflex.

Infiltration anesthesia in dentistry is most often performed during the treatment and removal of any teeth of the upper jaw, as well as in the area of ​​the anterior teeth of the lower jaw. In this case, the injection is carried out in the area transitional fold in the projection of the root of the tooth, which we will remove or treat (the transitional fold is the zone of transition of the tightly attached mucous membrane to the mobile mucous membrane of the cheek or lip). After the introduction of an anesthetic into the tissues, an infiltrate is formed in them, from which the anesthetic quickly penetrates into the jaw bone tissue.

Conduction anesthesia - in dentistry it is most often used to anesthetize 6-7-8 lower teeth (less often than other teeth). This is due to the fact that the bone tissue of the lower jaw is denser and thicker - especially in the last teeth. And therefore, if we do infiltration anesthesia in the lower molars, then the anesthetic simply will not penetrate into the bone and, accordingly, the patient will experience pain. And in this case, conduction anesthesia (mandibular or torusal) will help us - the injection is made into the nerve trunk, passing approximately in the middle of the inner surface of the lower jaw branch.

Infiltration and conduction anesthesia (video 1-2) -

How long does dental anesthesia take?
the effect of infiltration anesthesia on the upper jaw occurs within a few minutes, and lasts from 15 to 45 minutes (this depends on the type of anesthetic and the concentration of the vasoconstrictor in it). The onset of anesthesia is signaled to us by the appearance of numbness in the cheek area or upper lip. The effect of conduction anesthesia on the lower jaw occurs in 5-10 minutes, but it can last from 1 hour to several hours. The following symptoms will tell us about the onset of anesthesia - there must be a pronounced numbness of half of the lower lip, as well as the tip of the tongue.

Important : if, after conduction anesthesia in the lower jaw, the numbness of half of the lip is weak or completely absent, then the doctor missed and could not remove the anesthetic near the lower lunar nerve (it is this nerve that passes on the inner surface of the lower jaw branch, providing pain sensitivity of the teeth on this side). And in this case, you should either ask the doctor to repeat the anesthesia, otherwise the treatment will be painful.

Yes, and I would like to note that in most cases, poor anesthesia is associated only with the doctor's mistakes, i.e. with violation of the technique of conduction anesthesia. This type of anesthesia is the most difficult in general. dental appointment, and not all doctors confidently perform conduction anesthesia. Nevertheless, there are a number of patients in whom it is impossible to achieve good anesthesia in principle. These include patients who abuse analgesics, as well as alcohol and drugs.

What to do if you are afraid of anesthesia -

Indeed, an anesthetic injection can be painful. Soreness will depend both on the threshold pain sensitivity the patient himself, and on the technique of anesthesia by the doctor. According to the rules, a solution of one anesthetic cartridge (1.7 ml) is excreted into the tissues within 40-45 seconds. If the doctor saves time, then it is logical that the rapid introduction of the solution will cause pain.

2) Ubistezin - instructions for use

3) Septanest: instructions for use

4) Scandonest: instructions for use

Which anesthetic is right for you - summary

• At bronchial asthma or high allergies –
  here you need an anesthetic without preservatives (usually sodium disulfite is used in anesthetics, which is needed to stabilize epinephrine or adrenaline). Therefore, the anesthetic "Ultracain D", which does not contain preservatives at all, is best for such patients.

• For diseases thyroid gland, diabetes mellitus –
  in this case, you also do not want to use anesthetics containing vasoconstrictor components - adrenaline, epinephrine. The drug of choice, for example, "Ultracain D", "Scandonest" or "Mepivastezin". But, choosing between these three anesthetics, I would prefer the first.

• If you have high blood pressure and heart disease –
  with moderate hypertension and compensated heart diseases, the optimal choice is anesthetics containing a concentration of epinephrine (adrenaline) - 1: 200,000. It can be anesthetics "Ultracain DS" or "Ubistezin 1: 200000".

  In severe hypertension, decompensated heart disease, it is necessary to use anesthetics that do not completely contain adrenaline and epinephrine. Suitable then, for example, "Ultracain D".

• If you healthy man –
  if you do not have the above diseases, then you can safely put anesthetics containing epinephrine / adrenaline at a concentration of 1: 100,000. Moreover, a person weighing about 70 kg can be given up to 7 cartridges of anesthetic, inclusive. An example of such anesthetics is "Ultracain DS forte", "Ubistezin forte" and analogues.

Anesthesia in dentistry during pregnancy and breastfeeding -

One of the most common questions is whether it is possible to treat pregnant women's teeth with anesthesia. Anesthesia in dentistry during pregnancy and breastfeeding really has its own characteristics. The safest anesthetic here is Lidocaine (safety category "B"), and it is desirable to use it with a small concentration of a vasoconstrictor 1: 200,000.

The presence of the latter not only makes it possible to enhance anesthesia, but also to reduce the peak concentration of the anesthetic in the blood, which will further reduce the effect of the anesthetic on the fetus, as well as reduce its entry into breast milk. Drugs with vasoconstrictors are contraindicated in pregnant women only in the presence of high blood pressure and at chronic hypoxia fetus. Therefore, the most optimal anesthetic would be Xylonor(preparation of 2% lidocaine in carpules, with an epinephrine content of 1:200,000), or any similar anesthetics based on lidocaine.

As for drugs based on articaine, they will already belong to the “C” safety category, which, in principle, is also considered to be sufficiently safe, but a little less. Of the anesthetics during pregnancy based on articaine, it is better to choose Ultracaine DS (with an epinephrine content of 1: 200,000). And only if the pregnant woman has high blood pressure or fetal hypoxia, we choose an anesthetic without a vasoconstrictor, for example, Ultracaine D.

Some doctors use anesthetics Scandonest or Mepivastezin for pain relief in pregnant women (they do not contain either adrenaline or epinephrine). But it is undesirable to use such anesthetics in pregnant and lactating women, because. due to the lack of a vasoconstrictor component, they are quickly absorbed into the blood. This results in a high concentration of the anesthetic in the blood, allowing it to cross the placenta more easily. In addition, both Scandonest and Mepivastezin are 2 times more toxic than novocaine. We hope that our article on the topic: Local anesthesia in dental treatment turned out to be useful to you!

Sources:

1. Higher prof. the author's education in surgical dentistry,
2. Based on personal experience work as a dental surgeon,
3. National Library of Medicine (USA),
4. "Local anesthesia in dentistry" (Baart J.),
5. "Propaedeutics of surgical dentistry" (Soloviev M.).