Ubistezin: instructions, application, reviews. Ubistezin forte: instructions for use Septanest - instructions for use

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. The articaine it contains local anesthetic 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 expressed: there is almost no increase 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 with 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;
• Severe general condition, weakened 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 case of removal of premolars mandible 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 at 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 kidney failure

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 may develop: side effects:

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 side of the digestive system: 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 these phenomena can progress to the development of 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 caused by 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 patency respiratory tract, monitor 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; in severe circulatory disorders and shock - intravenous infusion of electrolyte solutions and plasma substitutes, glucocorticosteroids, albumin; with vascular collapse and increasing bradycardia - slowly intravenously 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 is enhanced and lengthened by vasoconstrictor drugs.

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 driving transport or working 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 place protected from light 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 package.

Terms of dispensing from pharmacies

On prescription.

Ubistezin - instructions for medical use - RU No.

Registration number:

Brand name of the drug: UBISTESIN

Dosage form:
Solution for injection (with epinephrine)

Compound
1 ml contains:
active substances: articaine hydrochloride 40 mg, epinephrine hydrochloride 0,006 mg (equivalent to 0.005 mg epinephrine)
Excipients: water for injection, sodium sulfite (equivalent to 0 31 mg SO2), sodium chloride.

Description
Clear, colorless liquid.

Pharmacotherapeutic group
Local anesthetic + vasoconstrictor

ATX code: N018858

pharmachologic effect
Ubistezin is a combined 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 expressed: 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 for use
Infiltration and conduction anesthesia in dentistry (especially in patients with concomitant severe somatic diseases), including during the following manipulations:

Ubistezin (Ubistesin) refers to drugs that have a local anesthetic effect. The drug is one of the most modern and effective representatives of the group of local anesthetics.

Ease of use, low amount of preservatives and adverse reactions allowed Ubistezin to become an option of choice in the presence of somatic pathologies in a patient. Dentists widely use anesthetic for and.

Anesthetic components and features of carpule

The preparation contains:

• articaine hydrochloride 40 mg;
• epinephrine hydrochloride or adrenaline;
• water for injections;
• sodium chloride;
• sodium sulfite.

The product is produced in 2 versions: Ubistezin 1/200000 and Forte version 1/100000. They differ in the amount of vasoconstrictor. In the first case, the amount of epinephrine will be 5 μg / ml, and in the second - 10 μg / ml.

The anesthetic itself is produced in the form of a 1.7 ml cartridge. They are packed in special cans with a soft surface on the inside.

Thanks to this, integrity is maintained during transportation, and further storage proceeds without any difficulties.

Moreover, each individual carpula has its own characteristics:

1. Coating of the inner surface with a special silicone layer. As a result, the injection becomes smooth and controlled, the piston moves more smoothly, and the amount of force applied is much less.
2. All the necessary information is printed on the carpool with a marking tape. which replaced printing on glass. Accordingly, the risk of damage by fragments in the event of its destruction has decreased. This point is very important when conducting, since the pressure exerted in this case is very high.

Pharmacological properties

All properties of the drug are achieved due to the main active ingredients: articaine and epinephrine.

Articaine is a local anesthetic of the amide type. Its effect occurs within 2-3 minutes after administration and lasts approximately 50-60 minutes. Compared to older substances, such as novocaine or lidocaine, the effect of articaine is 2 times stronger.

It is also more quickly excreted from the body, does not increase the time of wound healing and has less toxicity. Therefore, Ubistezin can be used by the elderly, pregnant women and children over 5 years of age.

Epinephrine is responsible for blood vessels. It has a vasoconstrictive effect, which significantly increases the time of the anesthetic effect.

Thanks to this component, the drug has a high penetrating ability and almost completely binds to blood plasma proteins. This ensures the safety of its use in the treatment of pregnant and lactating women. The drug does not pass into breast milk and does not cross the placenta.

Scope of application and contraindications

The anesthetic is used for and during the following dental procedures:

Ubistezin, and even more so Ubistezin Forte, cannot be used for:

• individual intolerance to the components of the drug;
• paroxysmal ventricular tachycardia and ciliary tachyarrhythmias;
• hyperthyroidism;
• angle-closure glaucoma;
• the use of non-selective beta-blockers;
• severe forms of liver failure;
• bronchial asthma;
• treatment with tricyclic antidepressants and drugs containing monoamine oxidase;
• cardiogenic shock;
• methemoglobinemia;
• B12 deficiency anemia.

Conditions in which the use of the product should be carried out with caution:

• cholinesterase deficiency;
• failure of the kidneys;
• diabetes;
• hypertonic disease;
• children under 4 years old.

How is the drug administered and in what dosages?

The method of administration and dosage of the anesthetic depends on the goals of the dentist:

The maximum dosage is calculated from the ratio of 7 mg of articaine per 1 kg of body weight. One cartridge contains 40 mg of anesthetic.

Application in special cases

Due to the low content of the vasoconstrictor, the risk of side effects is quite low. Therefore, the use of the drug in the treatment of patients with diseases of the cardiovascular system is not excluded.

During pregnancy, Ubistezin can be used, it does not have a harmful effect on the fetus. Only in rare cases does bradycardia develop. The drug of choice in such situations is a drug at a dosage of 1/200,000.

special instructions

Intravenous administration is completely excluded. To prevent the occurrence of such situations, an aspiration test should be carried out.

The drug should not be used in the area of ​​pronounced inflammatory process. It is recommended to inject the drug near the inflamed area.

To prevent the development of infections, needles and syringes must be changed during each collection from a vial or ampoule. Open carpules are not reused. It also excludes the use of damaged cartridges.

Possible adverse reactions and cases of overdose

Ubistezin can have the following inhibitory effect on body systems:

1. Effect on the central nervous system. The patient may develop headache, loss of consciousness, respiratory failure, convulsions.
2. Influence on the gastrointestinal tract. In some cases, nausea, vomiting and diarrhea occur.
3. Changes in the functioning of the sense organs are rare. Sometimes, if the technique of anesthesia is violated, diplopia or a temporary impairment of visual acuity is possible.
4. Effect on the heart and blood vessels. There is a possibility of lowering the level of blood pressure, tachy- or bradycardia, arrhythmia.
5. allergic reactions. The skin may appear flushed and itchy. There is also a risk of developing allergic conjunctivitis and rhinitis. Of more serious complications produce angioedema and anaphylactic shock.
6. Local manifestations. Swelling or inflammation may occur at the injection site. If the anesthesia technique is violated, ischemia zones appear and the nerve trunk is damaged.

Symptoms of overdose of the drug are:

• dizziness;
• change of consciousness;
• lowering blood pressure;
• tachy or bradycardia.

What to do if unwanted reactions occur:

• immediate stop of drug administration;
• giving the patient a horizontal position;
• providing oxygen;
• monitoring of pulse and pressure;
• in case of respiratory failure, the introduction of air ducts and artificial ventilation of the lungs is recommended;
• if convulsions appear, then barbiturates are used;
• circulatory disorders are corrected with electrolyte solutions;
• bradycardia is treated with intravenous administration of 0.1 mg of adrenaline;
• with tachycardia, selective beta-blockers are used;
• pressure is reduced by peripheral vasodilators.

Cost and analogues

The price of the Ubistezin Forte solution is 1500-2000 rubles for 50 cartridges, the drug at a dosage of 1/200000 - 1800-2200 rubles per pack.

similar pharmacological properties have the following drugs:

INN: Articaine, Epinephrine

Manufacturer: 3M Deutschland GmbH

Anatomical-therapeutic-chemical classification: Articaine in combination with other drugs

Registration number in the Republic of Kazakhstan: No. RK-LS-5 No. 016460

Registration period: 14.10.2015 - 14.10.2020

Instruction

Tradename

UbistezinTM ()

International proprietary name

Dosage form

Solution for submucosal injections in dentistry 4% 1.7 ml

Compound

1 ml of solution contains

active substances: articaine hydrochloride 40 mg

epinephrine hydrochloride 0.006 mg,

Excipients: sodium sulfite (equivalent to 0.31 mg SO2), hydrochloric acid (hydrochloric) 14%, sodium hydroxide solution 9%, sodium chloride, water for injection.

Description

Colorless, transparent, non-opalescent solution.

Pharmacotherapeutic group

Anesthetics. Local anesthetics. Amides. Articaine in combination with other drugs.

ATX code N01BB58

Pharmacological properties

Pharmacokinetics

Ubistezin is absorbed quickly and almost completely.

The maximum plasma level of articaine after intraoral injection is reached after approximately 10-15 minutes. The volume of distribution is 1.67 l/kg, the half-life is approximately 20 minutes and Tmax is approximately 10-15 minutes.

Articaine binds up to 95% to plasma proteins.

Articaine is rapidly hydrolyzed by plasma cholinesterases to the primary metabolite, articaic acid, which is further metabolized to articaic acid glucuronide. Articaine and its metabolites are excreted in the urine.

Epinephrine is rapidly catabolized in the liver and other tissues. Metabolites are excreted through the kidneys.

Pharmacodynamics

Ubistezin is a combined drug for local anesthesia in dentistry. Contains articaine, which is an anesthetic local action amide type and epinephrine - an adrenergic agonist that increases the duration of action of local anesthetics. Articaine leads to a reversible inhibition of the sensitivity of autonomic, sensory and motor nerve fibers. The mechanism of action of articaine is to block voltage-gated sodium channels on the nerve fiber membrane. Epinephrine locally leads to vasoconstriction, resulting in a higher concentration of local anesthetic at the injection site for a long time, as well as a decrease in the likelihood of common unwanted side effects.

This drug is characterized low level toxicity.

The action of the drug begins quickly (in 1 - 3 minutes after the injection). The drug provides a reliable anesthetic effect, is well tolerated. The duration of action of Ubistezin during pulp anesthesia is at least 45 minutes, and during soft tissue anesthesia - 120-240 minutes.

This drug provides a reliable analgesic effect.

Wound healing occurs without any complications, due to good tissue tolerance and minimal vasoconstriction. Due to the low concentration of epinephrine in the preparation, its effect on the cardiovascular system is weakly expressed: there is no increase in blood pressure and an increase in heart rate.

Indications for use

Infiltration and conduction anesthesia in dentistry:

uncomplicated single and consecutive tooth extractions

preparation of carious cavities and preparation of the tooth stump before prosthetics

incisions and sutures in the palate

Dosage and administration

Whenever possible, the smallest volume of solution that promotes effective anesthesia should be used.

To extract upper teeth in most cases, infiltration anesthesia using 1.7 ml of Ubistezin per tooth is sufficient; in this way, painful palatal injections can be dispensed with. In the case of sequential removal of adjacent teeth, it is often possible to reduce injections.

For anesthesia for incisions or sutures in the palate shows about 0.1 ml of the drug per injection.

With a simple removal of premolars of the lower jaw , sufficient is infiltration anesthesia using 1.7 ml of Ubistezin per one tooth; in some cases, an additional injection into the submucosal region of the transitional fold may be required in an amount of 1 to 1.7 ml of the drug.

Mandibular anesthesia is indicated in rare cases. 1.7 ml of Ubistezin is sufficient.

When preparing a carious cavity and preparing a tooth stump for an artificial crown, injections from the vestibular side in the amount 0.5-1.7 ml Ubistezina for one tooth.

In the treatment of mandibular premolars conduction anesthesia should be used. 1.7 ml of Ubistezin is sufficient.

For children weighing 20-30 kg, a dose of 0.25-1 ml is sufficient; for children weighing 30 - 45 kg - doses of 0.5 - 2 ml.

Ubistezin should not be used in children under 4 years of age.

In elderly patients, due to reduced metabolic processes and a lower volume of distribution, there may be elevated levels Ubistesin in blood plasma.

The risk of accumulation of Ubistezin increases after repeated use (eg, repeated injection). A similar effect can be observed with worsening general condition the patient, as well as in severe violations of the liver and kidneys (see "Special Instructions"). Thus, in all such cases, a lower dose of the drug is recommended (the minimum amount for a sufficient depth of anesthesia).

The dose of Ubistezin should be reduced in patients suffering from angina pectoris and atherosclerosis.

adults

For adults, the maximum dose is 500 mg of articaine (7 mg / kg of body weight), which is equivalent to 12.5 ml of Ubistezin, respectively - 7 cartridges.

Children

The amount of the drug to be administered should be determined by the age and body weight of the child, as well as the extent of the operation. Do not exceed the equivalent of 7 mg articaine/kg (0.175 ml Ubistezin/kg) body weight.

The drug is intended for injection as a local anesthetic for dental purposes.

In order to exclude the possibility of intravascular injection, it is always necessary to use aspiration control in two projections (with a rotation of the needle by 180 °), although its negative result does not always rule out unintentional or unnoticed intravascular injection.

The injection rate should not exceed 0.5 ml in 15 seconds, i.e. 1 cartridge per minute.

Major systemic reactions resulting from accidental intravascular injection can in most cases be avoided by using the following administration technique - after aspiration control, slowly inject 0.1-0.2 ml and not earlier than 20-30 seconds later, slowly inject the rest of the solution.

Opened cartridges should not be used on other patients.

The rest must be liquidated.

Side effects

Side effects may occur as a result of overdose, being caused by accidental intravascular administration or pathological absorption, for example, in inflamed or vascularized tissues, and manifest themselves as symptoms of disorders of the central nervous system and / or cardiovascular system.

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

Bradycardia, heart failure

Arterial hypotension

Asystole, cardiac arrest

Metallic taste in the mouth

Noise in ears

Dizziness, headache

Nausea, vomiting

Restlessness, irritability, hyperventilation

Drowsiness, tremor, nystagmus, logorrhea (verbal excitement), muscle tremor and tonic-clonic seizures

Paresthesia of lips and/or tongue

Tachypnea

Bradypnea, which can lead to sleep apnea

Respiratory paralysis

Very rarely (< 0,01 %)

- allergic reactions

Possible manifestation of hypersensitivity to articaine in the form of rashes, swelling, itching, redness of the skin, urticaria, angioedema, conjunctivitis, rhinitis, bronchospasm or anaphylactic shock. In patients with bronchial asthma possible manifestations in the form of nausea, diarrhea. Cross-sensitivity to articaine has been reported in patients with a delayed allergic reaction to prilocaine.

For patients with severe hypersensitivity to articaine or other amides, the use of local anesthetics of ester groups is recommended for subsequent procedures.

In patients with asymptomatic methemoglobinemia, the administration of large doses of articaine may cause clinical manifestations.

Rarely (> 0,01 %)

feeling hot

sweating

migraine-like headache

Increase in blood pressure

Pain behind the sternum

Tachycardia

Tachyarrhythmia, cardiovascular failure

Heart failure

Acute edema thyroid gland

Very rarely (< 0,01 %)

- allergic reactions

Allergic reactions or hypersensitivity in patients with bronchial asthma manifest as bronchospasm, acute asthma attack, loss of consciousness or shock, vomiting, diarrhea.

Possibility of delayed development of paralysis cannot be ruled out facial nerve within 2 weeks from the date of administration of the drug. There is evidence that this phenomenon may occur after 6 months.

Local reactions: swelling and inflammation at the injection site.

Contraindications

Hypersensitivity to any of the active and auxiliary components of the drug

Due to the presence of articaine, Ubistezin is not approved for use in the following cases

hypersensitivity to local anesthetics of the amide type

severe violations transmission of nerve impulses and conduction of the heart (for example: AV block II and III degree, severe bradycardia)

acute heart failure in the stage of decompensation

severe arterial hypotension

in patients with cholinesterase deficiency

hemorrhagic diathesis(especially during conduction anesthesia)

injections into the inflamed area

Due to the presence of epinephrine as a vasoconstrictor component, Ubistezin is not allowed for use in the following cases

Unstable angina

Recent myocardial infarction

Recent coronary artery bypass surgery

Refractory arrhythmia

Paroxysmal tachycardia or persistent arrhythmia with a high heart rate

Untreated or uncontrolled severe hypertension

Untreated or uncontrolled congestive heart failure

Concomitant therapy with monoamine oxidase (MAO) inhibitors or tricyclic antidepressants

Due to the presence of sulfite in the composition of sodium as an auxiliary substance, Ubistezin is not allowed for use in the following cases

Hypersensitivity to sodium sulfite

Severe form of bronchial asthma

Drug Interactions

The sympathomimic effect of epinephrine may be enhanced while taking monoamine oxidase inhibitors or tricyclic antidepressants.

Epinephrine may delay the release of insulin from the pancreas and thus reduce the effect of oral antidiabetic agents.

Concomitant use of non-cardioselective beta-blockers may lead to an increase in blood pressure due to the epinephrine content of Ubistezin.

Some inhaled drugs, such as halothane, can increase the sensitivity of the myocardium to catecholamines, leading to arrhythmias during the use of Ubistezin.

special instructions

Do not use intravenously! To avoid intravascular injection, an aspiration test should be performed by monitoring tissue resistance to the injected solution. Injection pressure should match the density of the tissue.

Do not inject into the inflamed area.

Eating is possible only after the restoration of sensitivity.

Do not use opened cartridges for other patients

Do not use damaged cartridges.

Ubistezin should be used with extreme caution in cases of

angina pectoris

atherosclerosis

a significant deterioration in blood coagulation

thyrotoxicosis

narrow angle glaucoma

diabetes

lung diseases - especially bronchial asthma

pheochromocytoma

epilepsy

arterial hypertension

intraventricular and artioventricular block I degree, chronic heart failure

liver failure

kidney failure

concomitant use of phenothiazine, cardioselective beta-blockers, anticoagulants and antiplatelet agents

severe general condition, debilitated patients

old age.

It is not recommended to use Ubistezin during the treatment of patients with allergic reactions to sulfites, as well as during the treatment of patients suffering from severe bronchial asthma. The use of Ubistezin can lead to allergic reactions with anaphylactic symptoms(for example: bronchospasm).

Accidental intravascular administration of the drug may be accompanied by convulsions, followed by inhibition of the activity of the central nervous system or cardiac arrest. If these symptoms occur, immediate resuscitation is necessary with the use of resuscitation equipment, oxygen and other resuscitative medicines.

Since local anesthetics of the amide type are also metabolized by the liver, Ubistezin should be used with caution in patients with liver disease, as the risk of developing toxic plasma concentrations of the drug is increased.

Ubistezin should be used with caution in the treatment of patients with impaired cardiovascular activity, since such patients may experience a decrease in the ability to compensate for functional changes associated with a slowdown in atrioventricular conduction caused by the drug.

The drug should be used with caution in the treatment of patients with a history of epilepsy.

There is a possibility positive results when conducting doping tests on athletes.

It must be taken into account that during treatment with inhibitors of blood coagulation and aggregation, accidental intravascular administration of a local anesthetic can lead to serious bleeding.

Accidental intravascular injections should be avoided (see Section "Method of administration and dosage")

When preparing a carious cavity for a crown, epinephrine leads to a decrease in blood flow in the pulp tissue, which leads to an increased risk of opening the tooth pulp.

When using a local anesthetic, the following medicines / therapeutic measures should be available to the doctor:

Anticonvulsants (eg, benzodiazepines or barbiturates), muscle relaxants, atropine and vasopressors, or epinephrine for severe allergic and anaphylactic reactions.

Resuscitation equipment (especially an oxygen source) that provides the possibility of artificial ventilation of the lungs if necessary.

Careful and constant monitoring of the main indicators of the state of the central nervous system, cardiovascular and respiratory systems of the patient after each injection of local anesthetic. Agitation, restlessness, tinnitus, dizziness, blackouts, tremors, depression, or drowsiness may be early warning signs of CNS toxicity (see Overdose section).

Phenothiazines may reduce the pressor effect of epinephrine. The simultaneous use of such drugs should be avoided. In cases where concomitant therapy is necessary, ensure close monitoring of the patient.

The concomitant use of non-cardioselective beta-blockers may lead to an increase in blood pressure due to the content of epinephrine. (see section "Drug Interactions").

Pregnancy and lactation

Pregnancy

There are no sufficient clinical data on the use of the drug by women during pregnancy and lactation. When using articaine during pregnancy, no adverse effects on fetal development have been established. This medicinal product should be used during pregnancy only if absolutely necessary, when the expected benefit to the mother outweighs the potential risk to the fetus.

lactation period

There are insufficient data on the excretion of articaine and its metabolites into breast milk. However, preclinical data indicate that the concentration of articaine in breast milk does not reach a clinically significant value. In this regard, after anesthesia with the use of Ubistezin, it is necessary to express the first portion of breast milk, do not use expressed milk for feeding.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous 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 the stress caused by surgery can affect the efficiency of activity, the question of the patient's admission to driving vehicle or to work with potentially dangerous mechanisms is decided by the doctor individually in each case.

Overdose

Symptoms: may occur immediately upon accidental intravascular injection or under abnormal absorption conditions (eg, inflamed or vascularized tissue) and later, and manifest as central nervous system and/or vascular symptoms.

Symptoms caused by the action of articaine: manifest as symptoms of dysfunction of the central nervous system ( metallic taste mouth, tinnitus, dizziness, nausea, vomiting, agitation, restlessness, increased respiratory rate, drowsiness, confusion, tremor, muscle twitching, tonic-clonic convulsions, coma and respiratory paralysis) and / or vascular symptoms (drop in blood pressure, violations of the conduction of cardiac impulses, bradycardia, cardiac arrest.

Symptoms caused by the action of epinephrine: manifest as symptoms of dysfunction of the cardiovascular system (feeling hot, sweating, migraine headache, increased blood pressure, chest pain, tachycardia, tachyarrhythmia and cardiac arrest).

The simultaneous occurrence of various complications and side effects may be the result of the mutual influence of the components of the drug on the clinical picture.

Treatment: in case of side effects, immediately stop the introduction of local anesthetic.

Basic general measures

Diagnostics (breathing, blood circulation, consciousness), maintenance/restoration of vital functions of respiration and blood circulation, oxygen administration, intravenous access.

Special Measures

hypertension : elevate the upper body of the patient, if necessary, give nifedipine sublingually.

Convulsions: protect the patient from concomitant bruising, if necessary, diazepam IV.

Hypotension: horizontal position of the patient's body, if necessary, intravascular infusion of electrolyte solutions, vasopressors (for example, epinephrine IV).

Bradycardia : atropine i.v.

Anaphylactic shock: contact your doctor emergency assistance. In the meantime, put the patient in a horizontal position, raise the lower body, intensive infusion of electrolyte solutions, if necessary, IV epinephrine, IV glucocorticoid.

In 1 ml of solution articaine hydrochloride- 40 mg, epinephrine hydrochloride - 0.006 mg, which corresponds to 0.005 mg epinephrine. 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.

Artikain- local anesthetic thiafene group. It is characterized by fast action, since the action occurs in 0.5-3 minutes (compared to novocaine- after 5–10 minutes, s lidocaine- after 4-5 minutes). The duration of anesthesia is 45 minutes. It is 2 times stronger than lidocaine, is quickly excreted from the body and is less toxic. Does not slow down wound healing. Indicated for use in the elderly, as well as in children from 5 years of age.
epinephrine- a vasoconstrictor, which causes vasoconstriction, prolongs and enhances the effect of the anesthetic, since vasoconstriction makes it difficult to absorb. In addition, vasospasm leads to tissue hypoxia and suppresses the excitability of nerve endings, therefore, pain sensitivity is significantly reduced. Ubistezin refers to anesthetics with a low content of vasoconstrictor. Low levels of epinephrine do not have a pronounced effect on the cardiovascular system, there is no increase in blood pressure and tachycardia.

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 anesthesia(retrobulbar, intercostal, paravertebral), blockades(trigeminal nerve, stellate ganglion, brachial plexus, external genitalia).

Contraindications

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

Be careful with the following diseases and conditions:

• chronic heart failure;
• atrioventricular block;
• diabetes;
• inflammation in the area of ​​anesthesia;
• kidney failure;
• arterial hypertension;
• weakened patients;
• elderly age.

Side effects

• headache, muscle tremor, 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;
• skin redness, conjunctivitis, rhinitis, 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 extraction of teeth - under the mucous membrane of 1.7 ml per tooth. With a palatine incision, 0.1 ml. Anesthesia for tonsillectomy - 5-10 ml per tonsil, for suturing the perineum - 5-15 ml.

With 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 removals, with depulping 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 airway patency, 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; in shock - infusion electrolytes, glucocorticosteroids; with vascular collapse - intravenously Adrenalin 0.1 mg; with tachycardia - intravenously selective beta blockers; with increasing 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 Coincidence in the ATX code of the 4th level:

Alfacain, Brilocaine-adrenaline, Ultracain D-S, Ultracain D-S forte , Brilocaine-adrenaline forte, 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.

Reviews about Ubistezin in dentistry are mostly positive. The effectiveness of this drug is due to many points.

First of all, a high percentage of binding articaine with proteins indicates that 95% of the drug is in the blood in the form of an inactive substance. This means he has a low systemic toxicity with high anesthesia efficiency. Second, it is rapidly eliminated (half-life 22 minutes) 4 to 5 times faster than lidocaine and mepivacaine. Even if after 22 minutes it becomes necessary to re-inject, the toxic effect will be much less than that of other anesthetics, since half of the drug has already been excreted from the body at that time. Lastly, articaine has a very high separation and permeability through membranes and tissues, thus providing a large area of ​​anesthesia.

Ubistezin price, where to buy

You can buy in Moscow at any pharmacy. The price of Ubistezin in carpules No. 50 is 2098 rubles.

• Internet pharmacies in RussiaRussia

ZdravZone

Ubistezin forte solution for injections 40mg+10mcg/ml 1.7ml №50 3M Espe cartridges

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NOTE! Information about medicines on the site is a general reference, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medicines in the course of treatment. Before use medicinal product Ubistezin be sure to consult with your doctor.

• nerve removal;
• pulpitis;
• deep caries;
• removal of a tooth;
• periodontitis;
• preparation for prosthetics.

• lidocaine
• novocaine

For expectant mothers, anesthetics have been developed with a minimum dosage of adrenaline, which is not recommended during pregnancy. These are fifth generation drugs that are used in dentistry along with proven adrenaline form anesthetics.

During pregnancy for treatment can be used

1. Ultracaine
2. Ubistezin
3. Primakain
4. Septanest
5. Mepivastezin (Scandonest)

It is worth noting that the use of completely non-adrenaline drugs is not recommended. This component regulates the absorption of the anesthetic into the blood. In the absence of adrenaline, the anesthetic substance enters the woman's body in a short time and in significant concentration, which increases the risk of its penetration into the placenta.

From this article you will learn:

• anesthesia in dentistry - drugs,
• the best anesthesia for dental treatment,
• dental anesthesia during pregnancy breastfeeding.

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

Anesthesia in dentistry can be local or general. Local anesthesia is when only the area where the intervention is planned is anesthetized, while the patient is conscious (Fig. 1-2). But general anesthesia in dentistry, or in other words general anesthesia, is carried out with the help of narcotic analgesics injected into the patient's body by inhalation (Fig. 3) or intravenously. At general anesthesia the patient is unconscious.

Local anesthesia during tooth extraction, dental treatment -

For local anesthesia, carpool syringes and carpules are now used, in which the anesthetic solution is enclosed (Fig. 4-5). The quality of anesthesia with such a syringe is much higher than with a conventional disposable syringe. In addition, needles for carpool anesthesia are many times thinner than conventional disposable syringes (Fig. 6), which means that the injection will not be as painful.

The cost of anesthetics and anesthesia -
the cost of one cartridge of anesthetic (whether it be ultracaine, ubistezin, septanest or others) is about 30 rubles. The cost of one anesthesia in a dental clinic will average 250 rubles.

What to do if you are afraid of anesthesia -

Indeed, an anesthetic injection can be painful. Soreness will depend both on the pain threshold of the patient himself, and on the technique of anesthesia by the doctor. According to the rules, one anesthetic cartridge (1.7 ml) must be injected within 40-45 seconds. If the doctor saves time and injects the anesthetic quickly, then it is logical that this will cause pain.

To reduce discomfort from an anesthetic injection, you can ask the doctor to pre-use an anesthetic spray (Fig. 7) to anesthetize the mucous membrane at the injection site (most often Lidocaine spray is used). You can also ask your doctor to inject the anesthetic slowly.

Medicines to relieve fear and anxiety
there are also drugs that can reduce fear and anxiety before the upcoming trip to the dentist. From over-the-counter drugs, Afobazole can be distinguished, which is especially convenient for those who need to make several trips to the dentist, because. this drug is drunk in a course (1 pack for 20 days). The drug has a good calming / anti-anxiety effect, but it does not cause drowsiness. You need to start drinking Afobazole 5-7 days before a visit to the dentist - in this case, the effect of the drug will be higher.

You can also use tinctures of valerian, motherwort, corvalol, valocardin. However, it is also desirable to take these drugs in a course, starting a few days before a visit to the doctor. Plus, these drugs, in addition to the sedative effect, have a hypnotic effect, which is not very good for motorists and working people.

Local anesthetics in dentistry

The most modern are anesthetics based on Articaine. it active substance used in anesthetics such as Ultracaine, Ubistezin, Septanest and others. Anesthetics of the articaine series are superior in efficiency to Lidocaine - 1.5-2 times, and Novocaine - 5-6 times.

A big plus of anesthetics based on articaine is the fact that they also work when you need to anesthetize the area of ​​​​inflammation. Indeed, with purulent inflammation, novocaine generally practically ceases to act, and the activity of lidocaine is noticeably reduced.

Most anesthetics, in addition to the main analgesic component (for example, articaine), also contain vasoconstrictor substances, for example, adrenaline or epinephrine. The latter components, due to vasoconstriction in the injection site, can reduce the leaching of the anesthetic, and this leads to an increase in the strength and duration of anesthesia.

1. Ultracain -

Ultracaine is produced by the French company Sanofi Aventis in 3 possible versions, which will differ in the presence / absence of epinephrine in the composition, as well as its concentration:

• "Ultracain DS forte" - with a concentration of epinephrine 1: 100.000,
• "Ultracaine DS" - with a concentration of epinephrine 1: 200.000,
• "Ultracain D" - without epinephrine, without preservatives.

A separate article is devoted to this most popular anesthetic: "Ultracain - application features, manufacturer's instructions"

2. Ubistezin - instructions for use

A good anesthetic manufactured by 3M (Germany). The composition of Ubistezin is absolutely no different from similar forms of Ultracaine. Two release forms

• Ubistezin (with a concentration of epinephrine 1: 200,000),
• Ubistezin forte (with a concentration of epinephrine 1: 100,000).

→ "Ubistezin forte - instructions for use"

3. Septanest - instructions for use

Septanest has been used in dentistry for a very long time. This anesthetic has 2 formulations with adrenaline concentrations of 1:100,000 and 1:200,000. However, this anesthetic
(unlike Ultracaine and Ubistezin) contains more preservatives (both sodium metabisulfite and EDTA), which have a powerful allergenic effect.

Read a detailed description of the anesthetic and its indications for use here:
→ "Septanest 1:100000 - instructions for use"

4. Scandonest - instructions for use

Anesthetic company Septodont (France) based on Mepivacaine 3%. Does not contain vasoconstrictor components, as well as preservatives. Scandonest in dentistry is mainly used only in patients at risk, who cannot use anesthetics with adrenaline and epinephrine, as well as in patients with bronchial asthma. A complete analogue of Scandonest 3% is the anesthetic Mepivastezin 3%, manufactured by 3M (Germany).

Read a detailed description of the anesthetic and indications for use here:
→ "Scandonest - instructions for use"

Which anesthetic is right for you: summary

• If you have bronchial asthma or very 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.

• If you have thyroid disease, diabetes -
  in this case, it is also undesirable for you 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 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 seven cartridges of anesthetic, inclusive. An example of such anesthetics is "Ultracain DS forte", "Ubistezin forte" and analogues.

Important: but good anesthesia before the intervention is only half the battle, because after treatment the teeth often hurt. About what drugs are best for pain relief at home - read the article:
→ "The best analgesics for toothache"

Anesthesia in dentistry during pregnancy and breastfeeding -

The optimal choice for dental interventions during pregnancy, as well as during breastfeeding, is Ultracain DS (with an epinephrine content of 1: 200,000), or Ubistezin 1: 200,000. Ubistezin during pregnancy is as safe as ultracain. The 1:200,000 concentration of epinephrine that is present in these anesthetics does not affect the fetus, does not cross the placenta, and is not detected in breast milk.

It is impossible to completely abandon the content of adrenaline in anesthetic in pregnant and lactating patients, because. epinephrine constricts the blood vessels in the injection area and therefore slows down the absorption of the anesthetic itself into the blood, and this in turn leads to a marked decrease in the concentration of the anesthetic in the blood. But the higher the concentration of the anesthetic in the blood, the greater the chance of the anesthetic to penetrate the placenta.

Some doctors use anesthetics Scandonest or Mepivastezin for pain relief in pregnant women (they do not contain either adrenaline or epinephrine). However, as you already understood, it is undesirable to use such anesthetics in pregnant and lactating women, because. due to the lack of a vasoconstrictor component, they are absorbed into the blood very quickly, which means that there will be a high concentration of anesthetic in the blood, which will allow the drug to cross the placenta. In addition, both Scandonest and Mepivastezin are 2 times more toxic than novocaine.

READ ALSO:

ratings, average:

Ubistezin - combined medicine for local anesthesia for minor surgical interventions, including in dentistry.

Release form and composition

The dosage form of Ubistezin is a solution for injection: a clear, colorless and odorless liquid (1.7 ml each in cartridges sealed with stoppers on both sides; in a can, 50 cartridges each).

Composition of Ubistezin (1 ml of solution):

• active substance: articaine hydrochloride - 40 mg, epinephrine hydrochloride - 0.0061 (equivalent to epinephrine - 0.005 mg);
• auxiliary components: sodium sulfite (equivalent to SO2 - 0.31 mg), sodium chloride, water for injection.

Pharmacological properties

Pharmacodynamics

Ubistezin is a combined drug, the action of which is due to the properties of its constituent components:

• articaine: a local anesthetic of the thiafene group, the hallmark of which is the rapid onset of its action (0.5-3 minutes after administration), lasting up to 45 minutes. In comparison with lidocaine, the effect of articaine is 2 times stronger, in addition, it has less toxicity and faster elimination from the body. Does not slow down wound healing. Approved for use in children from 4 years of age and in elderly patients;
• epinephrine: a vasoconstrictor that prolongs the effect of an anesthetic by constricting blood vessels and slowing down its absorption. Also, vasospasm leads to tissue hypoxia, suppressing the excitability of nerve endings, thereby reducing pain sensitivity. At the same time, the amount of epinephrine in Ubistezin is quite small and does not cause such disorders in the cardiovascular system as an increase in blood pressure (BP) and tachycardia.

Pharmacokinetics

The penetrating power of articaine is high. Communication with plasma proteins is 95%. The substance practically does not penetrate the placental barrier, is not excreted in breast milk. The half-life is 22-25 minutes.

Indications for use

According to the instructions, Ubistezin is indicated for infiltration and conduction anesthesia (especially in patients with somatic diseases), for example, with uncomplicated extraction or grinding of teeth, fillings, blocks of the trigeminal nerve, stellate ganglion, external genitalia, brachial plexus.

Contraindications

Absolute contraindications:

• deficiency of cholinesterase activity;
• hemorrhagic diathesis;
• liver failure in severe form;
• porphyria;
• hypertrichosis;
• angle-closure glaucoma;
• heart disease (condition after myocardial infarction or coronary artery bypass grafting, unstable angina pectoris, severe, uncontrolled arterial hypertension or hypotension, uncontrolled severe heart failure, tachycardia, uncontrolled severe cardiac conduction disturbances);
• inflammation at the site of the proposed anesthesia;
• bronchial asthma with increased sensitivity to sulfites;
• cardiogenic shock;
• age up to 4 years;
• increased sensitivity to the components in the composition of Ubistezin, sulfites.

Relative contraindications:

• arterial hypertension, atherosclerosis, angina pectoris, intraventricular and atrioventricular block I degree, chronic heart failure;
• pheochromocytoma;
• blood clotting disorders;
• epilepsy;
• diabetes;
• bronchial asthma;
• liver / kidney failure;
• elderly age;
• general severe and weakened condition.

Instructions for use Ubistezin: method and dosage

In the case of uncomplicated tooth extraction, 1.7 ml of Ubistezin is injected into the submucosa in the region of the transitional fold from the vestibular side (for each tooth). In some cases, to achieve complete anesthesia, an additional injection of 1-1.7 ml of the drug is possible.

With palatine incisions and sutures, about 0.1 ml of Ubistezin is injected in order to create a palatine depot. In the absence of inflammation and the need to remove the lower premolars, mandibular anesthesia can be dispensed with, as a rule, infiltration anesthesia (1.7 ml per tooth, or up to 3.4 ml if necessary) is sufficient. Blockade of the mandibular nerve is carried out only in the case when it was not possible to achieve complete anesthesia.

To prepare a tooth for filling or processing under a crown (except for the lower molars), the drug is used at a dose of 0.5-1.7 ml / tooth, depending on the depth and duration of the procedure. Intrapulpal anesthesia lasts at least 45 minutes, soft tissue anesthesia - 120-240 minutes.

For tonsillectomy, 5-10 ml of the drug is injected per tonsil, for suturing the perineum - 5-15 ml, for conduction anesthesia - 1-30 ml (depending on the location and volume of anesthesia).

Side effects

• nervous system: headache; muscle tremor; involuntary muscle twitches, up to generalized convulsions; disturbance of consciousness, up to its loss; respiratory failure, up to its stop;
• digestive organs: nausea / vomiting, diarrhea;
• cardiovascular system: moderate hemodynamic disturbances (decrease in blood pressure, tachycardia, bradycardia, depression of cardiovascular activity);
• allergic reactions: redness, itching of the skin, conjunctivitis, rhinitis, angioedema, anaphylactic shock;
• local reactions: inflammation or swelling at the injection site, the appearance of ischemic zones at the injection site (in case of unintentional intravascular injection, up to tissue necrosis).

Overdose

Symptoms of an overdose of Ubistezin: dizziness, restlessness, tachycardia, bradycardia, impaired consciousness, decreased blood pressure.

Therapy of the condition: stopping the administration of the drug, giving the patient a horizontal position, ensuring free airway patency; in the process, it is necessary to control the heart rate (HR) and blood pressure.

Treatment of special conditions in case of overdose:

• respiratory failure: artificial lung ventilation, oxygen;
• convulsions: intravenous (in / in) the introduction of barbiturates;
• shock: the introduction of electrolytes, glucocorticosteroids;
• vascular collapse: intravenous injection of adrenaline - 0.1 mg;
• tachycardia: intravenous administration of selective beta-blockers;
• increased blood pressure: peripheral vasodilators.

special instructions

It is forbidden to administer Ubistezin intravenously, as well as to use the drug at the site of inflammation. The anesthetic contains sulfites, which can increase the anaphylactic reaction.

Only new and sterile syringes and needles should be used each time the solution is taken. An opened cartridge must not be reused due to the risk of hepatitis. It is also unacceptable to use the drug from a damaged cartridge.

Influence on the ability to drive vehicles and complex mechanisms

In connection with preoperative anxiety and stress, the decision to allow the patient to drive vehicles and other complex mechanisms, the doctor makes in each case individually.

Use during pregnancy and lactation

Due to the lack of data on the efficacy and safety of the drug during pregnancy, its use in this period is possible only if the expected benefit to the mother outweighs the possible risk to the fetus.

If it is necessary to use Ubistezin during lactation, it is recommended to skip one feeding after anesthesia, replacing it with an artificial one. Milk should be expressed and not used.

• body weight 20–30 kg: 0.25–1 ml;
• body weight 30–45 kg: 0.5–2 ml.

The maximum daily dose of the drug should not exceed 7 mg of articaine kg of body weight (1 ml of the solution contains 40 mg of articaine).

• 20-30 kg - 3.5 ml;
• 30-40 kg - 5.25 ml;
• 40-45 kg - 7.0 ml;
• 45-50 kg - 7.9 ml;
• 50-60 kg - 8.7 ml;
• 60-70 kg - 10.5 ml;
• 70-80 kg - 12.2 ml.

In children, infiltration anesthesia may be used instead of conduction anesthesia due to lower bone density.

For impaired renal function

Patients with renal insufficiency may require a dose reduction.

In violation of liver function

Patients with hepatic insufficiency may need to reduce the dose of the drug.

Use in the elderly

Elderly patients with heart and kidney disease are recommended a reduced dose of the drug due to the risk of its cumulation.

drug interaction

The use of Ubistezin in combination with non-selective beta-blockers, monoamine oxidase inhibitors, tricyclic antidepressants is contraindicated.

Ubistezin is used with caution in combination with phenothiazine, cardioselective beta-blockers, antiplatelet agents and anticoagulants.

Vasoconstrictor drugs enhance and prolong the action of Ubistezin.

Analogues of Ubistezin are Alfakain, Brilokain-adrenaline, Ultracain D-S, Primakain, Ultracain suprarenin, Cytokartin, etc.

Terms and conditions of storage

Store away from light, at a temperature not exceeding 25 °C. Keep away from children.

Shelf life - 2 years.

Terms of dispensing from pharmacies

Released by prescription.

Reviews about Ubistezin

Reviews about Ubistezin when used in dentistry are mostly positive. The drug quickly and reliably anesthetizes, its toxic effect is less than that of other anesthetics, due to its rapid elimination.

The price of Ubistezin in pharmacies

The estimated price for Ubistezin 4% for 50 cartridges in a can is 1,840 rubles.

Dental treatment during pregnancy can be accompanied by certain difficulties.

First of all, it is advisable to refrain from serious interventions in the first trimester of pregnancy.

Treatment of shallow caries can be carried out on early dates, but sometimes there are situations when it is necessary complex treatment with anesthesia.

When is anesthesia needed?

Anesthetic drugs in the treatment of teeth in pregnant women are necessary in the following cases:

• nerve removal;
• pulpitis;
• deep caries;
• removal of a tooth;
• periodontitis;
• preparation for prosthetics.

The dentist will tell you about the treatment of teeth during pregnancy.

What is possible and impossible for expectant mothers?

• lidocaine – a large number of contraindications, including shortness of breath, muscle spasms and low blood pressure, make this drug undesirable in the arsenal of anesthetics for pregnant women;
• novocaine- may be allowed in some cases, especially if the patient suffers from high blood pressure.

During pregnancy for treatment can be used anesthesia with low or no adrenaline:

1. Ultracain- practically harmless, used during pregnancy, not burdened by pathological processes. In case of overdose, headaches, arrhythmias, cardiopalmus. Available in three forms with different concentrations of adrenaline.
2. Ubistezin- an analogue of ultracaine with high efficiency. Differs in low toxicity and speed.
3. Primakain- does not have a harmful effect on the fetus if the dosage is observed. Not recommended for use in the last trimester.
4. Septanest- rarely used for anesthesia during pregnancy due to the high amount of preservatives.
5. Mepivastezin (Scandonest)- high-quality means of European production. Does not have a vasoconstrictive effect. It is used in cases where adrenaline anesthetics are completely contraindicated or there are pregnancy pathologies. It is characterized by increased toxicity, which is especially important when determining the dosage.

How to choose a good anesthetic for pregnant women

The choice of anesthetic drug directly depends on the condition of the patient and the type of operation. In the absence of contraindications, adrenaline-containing drugs of low concentration can be prescribed to pregnant women.

The best anesthetics for dental treatment during pregnancy are Ubistezin and Ultracain, which are the most effective and least toxic.

For heart diseases, you can use "Ubistezin" at a concentration of 1: 200,000. In case of endocrine diseases, it is not recommended to use adrenaline anesthetics, it is better to give preference to Mepivastezin or Ultracain-D.

What are women most interested in?

Answers to the most burning questions.

Is it possible to do dental anesthesia during pregnancy?

Yes, you can. In this case, it is necessary to choose a safe drug and it is desirable to carry out treatment in the second trimester.

Is it possible for pregnant women to extract teeth with anesthesia?

Yes, tooth extraction surgery involves the use of anesthetics that are safe for the mother and fetus. It can be carried out at any time according to indications.

Can Ultracaine be used by pregnant women?

The main component of the drug is an analogue of adrenaline. It usually does not cross the placenta, and therefore is safe for the embryo. However, at higher doses, it can cross the placenta. For this reason, when carrying a child, the medication should be used only in the most extreme cases.

The following situations can be distinguished in which a pregnant woman is shown to consult a doctor and allow the use of the medicine:

• Getting rid of dental caries;
• periodontal disease;
• Removal of a tooth;
• Removal of the inflammatory process of the gums;
• Installation of braces.

In these cases, during pregnancy, it is better to postpone contacting a doctor:

• Dental prosthetics;
• Removal of tartar;
• Dental implantation.

When carrying a child, it is used as an anesthetic and analgesic in dental procedures. Follow the instructions exactly and follow the dosage.

Composition and form of release

The composition of the drug includes articaine hydrochloride and epinephrine. One ml of the solution contains 10-20 mg of the substance.

The medication is available in three forms:

• Ultracaine DS forte (contains a concentration of epinephrine 1 to 100,000). Suitable for long term pain relief. It is used for operations in the oral cavity, depulpation. Among the contraindications, it is worth noting high blood pressure, heart disease, thyroid gland, bronchial asthma;
• Ultracaine DS (epinephrine 1 to 200,000). Ideal for use during pregnancy, breastfeeding, heart disease. Among the contraindications can be noted bronchial asthma and thyroid disease;
• Ultracaine (does not contain epinephrine and adrenaline). Suitable for people with allergic reactions, bronchial asthma, thyroid diseases. Along with a gentle effect, the drug also has its drawbacks. Its action lasts only 20 minutes.

During pregnancy, Ultracaine DS is used. It is both effective and gentle at the same time.

The drug is available in ampoules of 5 and 20 mm. One package contains 5 ampoules.

Instructions for use

Before using the product, it is recommended to test for sensitivity. The injection is injected subcutaneously in the amount of 5-10 ml. After the procedure, you need to check your blood pressure, condition respiratory system, CNS.

During dental intervention, 1.5 ml of Ultracaine is injected into the palatine suture. The maximum dosage is 7 mg. During pregnancy, a sparing dose should be used. Sensitivity is restored after a few hours. After a couple of hours, food is allowed.

Other procedures require different dosages:

Tonsillectomy. One tonsil will require 5-10 ml of medication, when working with fractures - 5-20 ml, when suturing in the perineal area - 5-15 ml;
Conduction anesthesia. The dosage depends on the type of operation. 1-30 ml of solution can be used.

In the first trimester, it is not recommended to use the remedy, since at this time the formation of the placenta, which protects the fetus from unwanted elements, has not yet been completed.

Contraindications

There are contraindications to the use of the drug:

• Increased level of sensitivity;
• B-12 deficiency anemia;
• hypoxia;
• Paroxysmal ventricular tachycardia;
• Angle-closure glaucoma;
• Atrial tachyarrhythmia;
• Intolerance to sulfonyl groups, especially in the presence of asthma;
• Methemoglobinemia.

With caution, you need to use the drug in the presence of the following diseases:

• Cholinesterase deficiency;
• Anemia;
• kidney failure;
• Bronchial asthma;
• Arterial hypertension;
• Diabetes.

With caution, it is worth using the medication in the treatment of children.

Analogue in its structure is Artikain. Impact analogues:

• Alkain;
• Benoxy;
• Luan;
• Novocaine;
• Fastin;
• Emla.

Before use, you should see if it is possible to use the remedy during pregnancy. During childbearing the best option is Ultracaine in a certain dosage.

po-pregnancy.ru

Application

Characteristic:

• Ultracaine in dentistry is a strong local anesthetic that has found wide application.
• The medicine is well suited to eliminate pain during dental procedures (nerve removal, orthopedic manipulations, and so on).
• 2 times stronger than lidocaine.
• Stronger than novocaine 6 times.
• It penetrates well into the bone and connective tissue without negative effects on the heart muscle.

Composition and chemical properties

1 milliliter of solution contains:

• Epinephrine - 6 mcg. There are also modifications of the drug that contain a larger amount of epinephrine (for example, Ultracaine D-S forte contains 12 micrograms of this substance).
• Articaine - 40 mg.
• Sodium bisulfite - 0.5 mg.
• Sodium chloride - 1.0 mg.
• Water - 1.7 ml.

The solution is odorless; usually the drug is completely transparent. Storing in high-quality glass capsules eliminates the use of parabens and preservatives, which often cause allergic reactions. The composition of ultracaine in glass capsules does not include the substance EDTA, which is necessary for the binding of metal ions in some preparations.

Release form

There are two forms of release:

• In glass capsules of 2 ml with a graduation of 0.3 ml (10 capsules in one box).
• In 1.7 ml cartridges with 0.3 ml graduations (100 cartridges in one box).

Pharmacology

Ultracaine is a drug for local anesthesia. There are several modifications of ultracaine with minor differences. The components are divided into three groups:

• Articaine hydrochloride is a local anesthetic (thiaprofen group).
• Epinephrine hydrochloride is a vasodilator.
• Sodium bisulfite, sodium chloride, water - excipients.

The drug begins to act half a minute after administration. Its effect is based on blocking the transmission of nerve impulses in the injection area. Transmission blockage results in loss of sensitivity. The action of the drug lasts from 1 to 5 hours. The breakdown of ultracaine occurs in the kidneys; the breakdown products of ultracaine are excreted in the urine.

Indications

Ultracaine D-S with a standard concentration of epinephrine hydrochloride is used for:

• Extraction of teeth (one or more).
• Crown installation.
• Carrying out various medical procedures.
• Filling of teeth.
• Carrying out certain other standard dental procedures (including patients with serious comorbidities).

Ultracaine D-S with an increased concentration of epinephrine hydrochloride is used for:

• Operation on the mucous membrane and / or on the bone.
• Operation on dental pulp.
• Removal of broken teeth.
• Extraction of teeth affected by periodontitis.
• Resection of the upper part of the tooth root.
• As an anesthetic for inflammation of the jaws or face.

Dosage

The dosage directly depends on the depth and duration of the intervention. The decision on the dosage should be taken by the dentist on an individual basis. Exist general recommendations regarding dosage:

• To remove one tooth (or several teeth that are close to each other), the optimal dosage is 1.7 ml. If you need to remove several teeth that are far apart, you need to inject 1.7 ml of ultracaine for each tooth. If, after the administration of the drug, the analgesic effect is not achieved, it is necessary to additionally introduce 1.7 ml of ultracaine per tooth. If, after this, the analgesic effect is not achieved, it is necessary to abandon ultracaine and carry out a complete blockade of the jaw (for this you need to use other drugs).
• When preparing teeth for a crown, you will need about 1 ml of ultracaine per tooth.
• Sometimes during an operation on the teeth, it becomes necessary to cut or suture the palate. In this case, it is necessary to anaesthetize the palate with 0.1 ml of ultracaine.
• The maximum allowable dose of ultracaine is 7 mg per 1 kg of body (doses up to 12.5 ml of ultracaine are best tolerated).
• For children, the maximum allowable dose of ultracaine is 5 mg per 1 kg of body.
• Ultracaine injections are prohibited for children who are under 4 years old.

Overdose

If the doctor injected too much of the drug, an overdose may occur. It is characterized by the following symptoms:

• motor excitement.
• Violation of consciousness.
• Dizziness.

If the patient has the above signs of an overdose, the following should be done:

• Immediately stop the introduction of the drug into the body.
• It is necessary to provide access to fresh air to the patient.
• If violated respiratory function, it is necessary to connect a person to an oxygen mask. If breathing has stopped completely, it is necessary to perform artificial respiration, intubate the trachea and connect to an artificial respiration apparatus.
• In some patients with an overdose, involuntary muscle twitches appear - in this case, small and ultra-low doses of barbiturates must be introduced into the body.
• At anaphylactic shock you need to enter into the body drugs based on plasma substitutes, albumin and glucocorticosteroids; it is also necessary to monitor the respiratory and cardiac systems.
• With arterial hypertension, vasodilators must be introduced into the body.
• With tachycardia, beta-adrenergic blockers should be administered.

Side effects

Usually the drug at normal dosage is well tolerated. But sometimes there are side effects:

• An increase in blood pressure is a reaction to the introduction of epinephrine into the body.
• Very rarely, complications from the central nervous system (impaired breathing, impaired consciousness, the appearance of involuntary muscle contractions), the visual system (blindness, impaired clarity and double vision), digestive system(vomiting, nausea), cardiac system (drop in blood pressure, tachycardia and some other disorders).
• An allergy to the components of the drug may occur - erythema, pruritus, urticaria, conjunctivitis, various edema, and so on.
• If the patient is sick with bronchial asthma, such painful reactions as vomiting, diarrhea, acute asthma attack, impaired consciousness, respiratory failure, and some others are possible. This is due to the content of sodium bisulfite in the preparation.

Contraindications

The medicine is contraindicated:

• If there is an allergy to the components of the drug (articaine, epinephrine and others). Often, patients are unaware that they are allergic to ultracaine components. To avoid misunderstanding, dentists often prescribe several tests for allergens before surgery.
• It is worth giving preference to ultracaine in ampoules, since it does not contain preservatives that can cause allergies in some patients.
• Due to the presence of epinephrine hydrochloride, ultracaine is contraindicated in all patients with diseases of the cardiac system such as tachycardia, tachyarrhythmia, arterial hypertension, and in acute heart failure.
• The drug is contraindicated in all patients who suffer from diseases such as anemia, methemoglobinemia, hypoxia, glaucoma, pheochromocytoma, hyperthyroidism and bronchial asthma.
• The drug is contraindicated if the patient is taking non-selective beta-blockers.
• It is forbidden to administer the drug to patients under 4 years of age (since there is no clinical experience of administering the drug to such patients).

Ultracaine in dentistry during pregnancy

• The drug can be used during pregnancy, since ultracaine cannot cross the hematoplacental barrier.
• The drug can be used during lactation, since ultracaine quickly breaks down and is excreted from the body without getting into breast milk.

Precautionary measures

The following precautions must be observed:

• It is forbidden to administer the drug intravenously.
• It is forbidden to use a solution from damaged ampoules.
• Doctors recommend using Unidjekt K injectors for injection.
• To avoid infection, it is necessary to ensure that the drug is taken using sterile needles. If after the operation there is a substance left in the ampoule, the ampoule must still be discarded.
• Food should be taken after full recovery of sensitivity.

Interaction

Ultracaine interacts with other drugs as follows:

• When ultracaine is combined with monoamine oxidase inhibitors and tricyclic antidepressants, the vasoconstrictive effect is enhanced.
• The drug is very poorly combined with beta-adrenergic blockers.
• The combination of ultracaine with heparin, acetylsalicylic acid and other anticoagulants significantly increases the risk of bleeding in the patient.
• The combination of ultracaine with halothane and some other narcotic inhalation drugs for anesthesia markedly increases the risk of arrhythmia in the patient.

Price

On the market pharmaceuticals ultracaine is presented as follows:

Conclusion

Ultracaine in dentistry is a good local anesthetic. It is widely used in dentistry for dental operations. It is several times stronger than lidocaine and novocaine. Due to its composition, ultracaine has little effect on the cardiovascular system. The drug must be used by a doctor.

The composition of ultracaine includes articaine hydrochloride (a local anesthetic of the thiaprofen group), epinephrine hydrochloride (has a vasodilating effect) and several excipients (water, sodium bisulfate, sodium chloride). different versions the drug is used in such cases - tooth extraction, crown installation, various medical manipulations, operations on the mucous membrane and / or bones, operations on the dental pulp, resection of the upper part of the tooth root, as an anesthetic for inflammation of the jaws or face, and so on.

The optimal dosage of the drug for the removal of one tooth is 1.7 ml. If numbness does not occur after the administration of the drug, you can enter 1 more dose of the drug. If numbness does not occur even after that, you should consider choosing another drug. In case of an overdose, symptoms such as motor agitation, impaired consciousness and dizziness are observed. In this case, you should immediately stop the administration of the drug, place the patient in a horizontal position and provide access to fresh air. The drug should not be taken by people who are allergic to the components of the drug. It is also forbidden to administer the drug to patients who take non-selective beta-blockers.

The drug is rapidly excreted from the body and does not cross the hematoplacental barrier, so it can be used during pregnancy and lactation. It is forbidden to administer the drug intravenously (leads to partial necrosis of soft tissues). For safety reasons, ultracaine should not be administered from the same ampoule to different patients. The drug is produced by the French company Sanofi-Aventis in the form of capsules and cartridges. For 10 capsules of 2 ml of ultracaine, you will have to pay 440 rubles, for 100 cartridges of 1.7 ml - 3300 rubles.

Pharmacological features of the drug

The active substance of the drug Ultracaine is a local anesthetic Articaine, which has a low systemic toxicity. This significantly reduces the likelihood of systemic action of the drug and the development of side effects, and also allows the use of Ultracaine during pregnancy.

In addition to the monocomponent agent, dentists also have Ultracaine D-S in their arsenal, which is a combination drug that, in addition to the anesthetic (Articaine), contains a vasoconstrictor (Ephedrine). This combination allows you to perform effective anesthesia for up to forty-five minutes. Ultracaine D-S contains a low concentration of Ephedrine, which does not lead to the development of a systemic vasoconstrictor effect (increased blood pressure, tachycardia), which also makes possible application drug during pregnancy.

For long-term pain relief, for example, during operations on bone structures, the drug Ultracain D-S forte is used, which provides a slow release active components and allows you to extend the anesthetic effect up to four hours.

Metabolism and elimination of the drug

From the place of anesthesia, Ultracaine is absorbed into the blood, where the main part of the drug is utilized by specific plasma enzymes, about ten percent of the active substance is inactivated in the liver. Ultracaine is excreted in an inactive form by the kidneys. Articaine during pregnancy penetrates the hematoplacental barrier, but does not have a toxic effect on the fetus.

The half-life of the drug is thirty minutes, that is, during the first hour, the human body leaves the main part of the administered dose of the drug. The pharmacokinetics of the drug allows you to use it repeatedly at short intervals. The drug Ultracain D-S forte is excreted from the body within four hours, so it is less often used during pregnancy.

Indications for use

For Ultracain and Ultracain D-S:

• Infiltration and conduction anesthesia in dentistry.
• Treatment of a carious cavity.
• Prosthetics and cosmetic procedures on teeth and oral mucosa.

Ultracaine and Ultracaine D-S are also used in gynecology and obstetrics for lumbar anesthesia, including during pregnancy. However, during pregnancy, the drug should be administered in minimal doses and with increased caution.

For Ultracain D-S forte:

• Infiltration and conduction anesthesia.
• Operations on the mucous membrane.
• Opening of abscesses and phlegmons.
• Operative interventions on bone tissues.

Side effects and contraindications

The widespread use of the monocomponent drug Ultracaine has confirmed its high safety, as well as the possibility of use during pregnancy. The use of Articaine is contraindicated in the presence of allergic reactions and hypersensitivity.

Ultracaine D-S and D-S forte has a wider list of adverse reactions: change heart rate, blood pressure, cardiogenic shock, nausea, vomiting, tremor, dizziness, increased sweating, allergic reactions.

Therefore, the use of these forms is limited in patients:

• suffering from severe cardiovascular diseases;
• with impaired liver and kidney function;
• suffering from diabetes;
• with chronic pulmonary pathology;
• in children under four years of age;
• in the first trimester of pregnancy.

Complications of anesthesia

• Damage to the nerve fiber with a needle can lead to the development of neuritis, a prolonged pain syndrome.

• Intravascular administration of Articaine is dangerous, which can lead to an increase in systemic action and the development of severe adverse events in the cardiovascular and nervous systems, which is especially dangerous in patients with chronic pathology of the cardiovascular system and during pregnancy. Together intravenous administration a zone of ischemia and tissue necrosis can form.
• Damage to the vessel can lead to the development of hematoma and bleeding.
• Visual impairment, double vision, nystagmus may be the result of the spread of the anesthetic to the area of ​​the nerve fibers that innervate the visual analyzer. The phenomenon is reversible, visual function will be restored after the drug is removed.

Is it possible to do anesthesia during pregnancy?

Can't stand the pain. This is stressful for both the expectant mother and the child. Anesthesia is simply indispensable during the following procedures:

• dental treatment, including endodontic - the dental nerve reacts to the slightest mechanical impact, causing acute pain;
• tooth extraction - when a tooth is extracted from the alveoli, nerve endings are damaged, and, of course, unbearable pain occurs. And if you do not use an anesthetic, pain shock may occur;
• prosthetics - the installation of a prosthesis requires the preparation (grinding) of the enamel, this is a rather unpleasant and painful procedure.

However, any type of anesthesia is potentially dangerous during childbearing. The use of various medications, including anesthetics, can adversely affect the development of the fetus.

Therefore, at the appointment with the dentist, the patient is obliged to warn the doctor about her pregnancy, and also to name the exact date. Then the doctor will be able to select special anesthetics, the active substances of which do not overcome the placental barrier and do not harm the baby.

Features of anesthesia in dentistry for pregnant women

Safe drugs for local anesthesia

Local (local) anesthesia is the safest type of anesthesia. It is used for women during pregnancy. As a rule, Lidocaine solution is used for injection. This drug in small doses can cross the placenta in early pregnancy, but it is quickly excreted from the baby's body and does not cause harm.

Also during pregnancy, Novocain can be used, but the dosage is usually reduced.

Anesthetics Ultracaine and Primacaine containing adrenaline are very popular in dentistry. However, they cannot be used during the period of bearing a child. Accidental release of adrenaline into the bloodstream can cause a sharp vasoconstriction and disrupt blood flow to the placenta.

The dosage of the drug depends on the weight of the patient, her pain threshold and complexity of the planned procedure. As a rule, women are injected with 1 ampoule or half, and with excess weight - 2 ampoules. The duration of the painkiller is from 40 minutes to 2 hours.

Contraindications to anesthesia during pregnancy

The main contraindications for local anesthesia:

• neurological diseases;
• blood clotting disorder;
• acute inflammation of the mucosa in the injection area.

Third trimester also dangerous period for dental procedures. It is especially not recommended to carry out any operations at the 9th month, since there is a high risk of increased uterine tone and premature birth.

anesthesia during pregnancy

Is anesthesia harmful during pregnancy? The doctors say yes. This type of anesthesia can lead to a sharp decrease in blood pressure in a pregnant woman, while blood oxygen saturation worsens.

Dangerous consequences of general anesthesia:

• teratogenicity (violation of the development of tissues and organs of the child, which can cause congenital deformities);
• intrauterine fetal asphyxia (suffocation), which occurs due to maternal hypoxia (oxygen starvation);
• increased risk of miscarriage.

Operations under anesthesia are carried out in extreme cases, when there is a threat to the life of the mother. Superficial sedation (inhalation of nitrous oxide) is also contraindicated. Therefore, only local anesthesia is used for dental treatment.

If a woman is afraid of injections, then you can first anesthetize the mucosal area with an anesthetic gel, and only then inject into the gum.

Private dental clinics have a large selection of anesthetic drugs indicated during pregnancy. If you are looking for reliable dentistry, we suggest using the convenient search engine of our website.