State of adrenaline. Excess adrenaline: symptoms and how to reduce

Fears associated with pain during treatment and tooth extraction are due to the fact that previously there were no high-quality anesthetic drugs. But today, almost all dental clinics use new generation local anesthetics. Modern drugs make it possible to completely eliminate pain not only during the main operation, but even at the time of their administration.

Anesthesiology in dentistry

Anesthesia is the absolute disappearance or partial decrease in sensitivity in the entire body or its individual parts. This effect is achieved by introducing special drugs into the patient’s body that block the transmission of pain impulses from the area of intervention to the brain.

Types of pain relief in dentistry

Based on the principle of impact on the psyche, there are two main types of anesthesia:

Local anesthesia, in which the patient is awake, and loss of sensitivity occurs exclusively in the area of future medical procedures.
General anesthesia (anesthesia). The patient is unconscious during the operation, the whole body is anesthetized and the skeletal muscles are relaxed.

Depending on the method of delivering the anesthetic to the body, dentistry distinguishes between injection and non-injection anesthesia. With the injection method, the anesthetic drug is administered through an injection. It can be injected intravenously, into the soft tissues of the oral cavity, into the bone or periosteum. In non-injection anesthesia, the anesthetic is administered by inhalation or applied to the surface of the mucosa.

General anesthesia in dentistry

General anesthesia is the complete loss of sensitivity of nerve fibers, accompanied by impaired consciousness. In dentistry, anesthesia for dental treatment is used less frequently than local anesthesia. This is due not only to the small area of the surgical field, but also to the large number of contraindications and possible complications.

General anesthesia can only be used in dental clinics that have an anesthesiologist and resuscitation equipment that may be required in case of emergency resuscitation.

General anesthesia in dentistry is only necessary for long-term complex maxillofacial operations - correction of cleft palate, multiple implantations, surgery after injury. Other indications for the use of general anesthesia:

allergic reactions to local anesthetics;
mental illnesses;
panic fear of manipulation in the oral cavity.

Contraindications:

diseases of the respiratory system;
pathologies of the cardiovascular system;
intolerance to anesthetic drugs.

The anesthetic can be delivered by injection or inhalation. The drug most commonly used by dentists for inhalational general anesthesia is nitrous oxide, known as laughing gas. Using an intravenous injection, the patient is immersed in a medicated sleep; for this purpose, drugs are used that have a sleeping pill, analgesic, muscle relaxant and sedative effect. The most common are:

Ketamine.
Propanidid.
Hexenal.
Sodium hydroxybutyrate.

Local anesthesia in dentistry

In dental treatment, local anesthesia is most in demand, aimed at blocking nerve impulses from the surgical field. Local anesthetics have an analgesic effect, due to which the patient does not experience pain, but retains sensitivity to touch and temperature.

The duration of anesthesia depends on how and with what exactly dentists numb the surgical field. The maximum effect lasts for two hours.

Local anesthesia is used for the following procedures:

turning for a bridge or crown;
pin tooth extension;
implantation;
channel cleaning;
surgical treatment of gums;
removal of carious tissues;
tooth extraction;
excision of the hood over the wisdom tooth.

Types and methods of local anesthesia in dentistry

Depending on what area and for how long the sensitivity needs to be deprived, the dentist selects the optimal technology, medicine and its concentration. The main methods of administering anesthetic are:

infiltration;
intraligamentary;
stem;
intraosseous;
applique.

Infiltration method

Used in dental practice and maxillofacial surgery. The advantage of the method is its rapid action, long-lasting analgesic effect, the possibility of repeated administration during a protracted operation, rapid removal of the anesthetic from the body, and deep analgesia of a large area of tissue. About eighty percent of dental interventions are performed under infiltration anesthesia.

The method is used for the following manipulations:

The anesthetic medicine is injected in layers, first under the mucous membrane at the apex of the tooth root, and then into the deeper layers. The patient feels discomfort only with the first injection; the rest are completely painless.

There are two types of infiltration dental anesthesia - direct and diffuse. In the first case, the immediate site of injection of the anesthetic is anesthetized, in the second, the analgesic effect extends to nearby tissue areas.

The following drugs are used for local infiltration anesthesia in dentistry:

Procaine.
Lidocaine.
Mepivacaine.
Ultracaine
Trimekain.

Intraligamentous (intraligamentous) method

It is a modern type of infiltration anesthesia. The dose of the administered anesthetic is minimal (does not exceed 0.06 ml), which makes it possible to treat and remove teeth in pregnant and lactating women.

The anesthetic is injected into the periodontal space using a special syringe and under high pressure. The number of injections depends on the number of roots of the tooth. Sensitivity to pain disappears instantly without causing a feeling of numbness, so the patient can speak freely and does not experience discomfort after the operation.

Restrictions on the use of the method are:

The duration of the manipulation is more than 30 minutes.
Fang manipulations. Due to their anatomical features, it is not always possible to anesthetize them intraligamentously.
Inflammatory processes in the periodontium, periodontal pocket, gumboil.
Root cyst of the tooth.

The intraligamentous anesthesia method is the most painless and safe in dentistry, therefore it is often used in pediatric practice.

Ease of implementation, painlessness, safety and high efficiency make the method popular among dentists. The cost of this procedure is higher than the infiltration procedure due to the high prices of injectors.

The following drugs are used for intraligamentous anesthesia during dental treatment:
Trimekain.
Lidocaine.

Ultracaine.

Stem (conductor) method

Distinctive features of the stem method of pain relief are the power and long duration of the effect. It is used during long-term surgical operations and in situations where it is necessary to block sensitivity in the tissue area of the entire lower or upper jaw.

Indications for conduction anesthesia are:
high intensity pain syndrome;
neuralgia;
removal of cystic formations;
endodontic treatment;
severe injuries to the jaw and zygomatic bone;
curettage;

The injection is injected into the area of the base of the skull, thanks to which two jaw nerves can be blocked at once - both the upper and the lower. The injection is performed by an anesthesiologist and exclusively in a hospital.

Unlike all other methods of local anesthesia, stem anesthesia does not act on nerve endings, but completely on a nerve or group of nerves. The anesthetic effect time is one and a half to two hours. Novocaine and Lidocaine are considered the basic drugs; in modern anesthesiology, more effective agents are used.

Application method (surface, terminal)

It is used primarily in pediatric dental practice to desensitize the place where the anesthetic injection will be given, which ensures an absolute absence of pain. It is used as an independent method in cases where it is necessary:

For topical anesthesia in dentistry, painkillers are used in the form of spray, ointment, paste and gel. Most often, dentists use ten percent Lidocaine in an aerosol as an analgesic. The drug penetrates 1–3 mm deep into the tissue and blocks nerve endings. The effect lasts from several minutes to half an hour.

Intraosseous (spongy) method

It is used for anesthesia of lower molars, during the extirpation of which infiltration and conduction anesthesia are ineffective. Instantly eliminates the sensitivity of one tooth and the adjacent gum area. The advantage of this method in dentistry is strong pain relief with small doses of the drug.

Classical intraosseous anesthesia has not received widespread use in anesthesiology due to the complexity of its implementation and the traumatic nature.

The essence of the method is to inject an anesthetic into the spongy layer of the jawbone between the roots of the teeth. Infiltration anesthesia is preliminarily performed. After the gums are numb, the mucous membrane is dissected and the cortical plate of the bone is trepanned using a drill. The bur is buried 2 mm into the spongy tissue of the interdental septum, after which a needle with an anesthetic is inserted into the formed canal.

Contraindications to local anesthesia

Before prescribing local anesthesia to a patient, the dentist must find out whether there are any contraindications to its administration. The doctor must take special precautions when prescribing anesthesia for children and expectant mothers.

Contraindications to local anesthesia are:

history of allergic reactions to drugs;
diseases of the cardiovascular system;
suffered a stroke or heart attack less than six months ago;
diabetes;
hormonal disorders and pathologies of the endocrine system.

Modern anesthetics (painkillers) in dentistry

With the advent of local anesthetics and new generation technologies, the usual Novocaine is almost never used in dentistry, especially in Moscow and other large cities. Despite possible complications and a high percentage of allergic reactions, lidocaine remains the main local anesthetic in regional clinics.

When visiting the clinic, you need to provide the attending physician with a complete and reliable history so that he can eliminate all risks and choose the right drug. Most dental clinics use carpule technology to administer anesthetics, which consists in the fact that the active substance is contained in a special disposable carpule, which, without opening manually, is inserted into a syringe. The dose of the drug in the capsule is designed for one administration.

Modern drugs for local anesthesia are based on the drugs Articaine and Mepivacaine. In the form of carpule capsules, Articaine is produced under the names Ultracaine, Septanest and Ubistezin. The effectiveness of drugs based on it exceeds the effectiveness of lidocaine by 2, and novocaine by 5–6 times.

In addition to Articaine itself, the carpul contains adrenaline (epinephrine) and an auxiliary substance that promotes vasoconstriction. Due to vasoconstriction, the period of action of the anesthetic is prolonged, and the speed of its spread into the general bloodstream is reduced.

Patients with endocrine disorders, bronchial asthma and a tendency to allergic reactions in dentistry are usually prescribed anesthetics without adrenaline. If powerful pain relief is required, it is permissible to use Ultracaine D with a minimum concentration of epinephrine.

Anesthesia without adrenaline in dentistry

Mepivacaine is used to treat patients with contraindications to adrenaline in dentistry. A drug with this active ingredient, marketed under the name Scandonest, is less effective than Articaine. But it does not contain epinephrine, so Scandonest is suitable for administration to children, pregnant women, people with heart disease, and individual intolerance to adrenaline.

For diseases of the endocrine system, Scandonest and drugs without adrenaline are more often used. It is unacceptable to use products with vasoconstrictor components for hypertension.

The type of anesthesia dentists use determines not only the degree of painlessness of the medical intervention, but also the list of consequences that will have to be encountered after the operation. Modern means minimize the risks associated with incorrect administration of the drug, incorrect dosage and the occurrence of allergic reactions to the anesthetic.

The symptoms of the release of adrenaline into the blood are known to everyone. Mobilization of mental and physical abilities, the appearance of a surge of strength and a feeling of vigor during extreme situations is the result of the effect of the hormone on the body.

The process of adrenaline release into the blood and its causes

Adrenaline (epinephrine) is the main neurotransmitter and hormone produced by the adrenal medulla.

The precursor substance to adrenaline is norepinephrine.

Catecholamines are the joint name for norepinephrine and adrenaline.

Under normal conditions, the content of adrenaline in the body is low and can fluctuate:

0–110 pg/ml – when a person is lying down;
0–140 pg/ml – worth it.

However, it is possible that the release of the hormone into the blood will increase from 6 to 10 times when situations arise related to:

any stress (neuropsychic, temperature, fasting, etc.);
feelings of anxiety and danger;
strong emotional experiences;
various injuries and burns;
fears;
shock states;
borderline situations that threaten human life;
extreme situations (rides on attractions, motorcycle racing, etc.).

These factors cause a reaction in a part of the brain - the hypothalamus, which, by triggering certain processes, leads to an instant adrenaline surge - the production of a hormone by the adrenal glands with its further release into the blood and distribution to all parts of the body through each nerve ending. As a result, a person quickly adapts to negative factors.

The duration of the adrenaline surge does not exceed several minutes, and after the situation normalizes, the amount of epinephrine begins to decrease.

The resulting response of the body to the changed chemical composition of the blood due to increased adrenaline levels is manifested:

mobilization of all the forces of the body in case of dangerous situations;
narrowing of blood vessels in the abdominal organs, skeletal muscles and skin with simultaneous dilation of blood vessels in the brain and heart. As a result, there is an increased blood supply to these organs with arterial blood, which provides them with increased nutrition in stressful situations and increases brain activity;
increased blood pressure;
increased pulse and heart rate;
dilated pupils;
an increase in the level of glucose, a key source of energy for the body, and a decrease in its absorption by the liver and muscles. Sugar is preferentially sent to the brain to stimulate its functions;
temporary blocking of allergic reactions and inflammatory processes;
decreased muscle activity of the gastrointestinal tract, suspension of urinary functions;
increased muscle activity, and, as a result, performance;
an increase in the level of white blood cells and platelets, which helps to eliminate bleeding more quickly;
suspension of fat synthesis while simultaneously increasing their breakdown to ensure physical endurance;
decreased release of the hormone insulin;
eliminating spasms of bronchioles;
preventing swelling of the mucous membranes throughout the body.

As a result, in extreme situations a person becomes collected, cheerful and ready to take decisive action.

On a physical level, increased adrenaline levels can be felt:

rapid heartbeat;
shortness of breath, lack of air, rapid breathing, inability to take a deep breath;
increased sweating (especially palms and armpits);
reduced visual acuity (surrounding things become blurry or “foggy”);
headache, pain in the chest area.

The manifestations are quite general, but in certain situations, based on your feelings, you can predict the process of adrenaline release.

Determining the amount of epinephrine in the blood

The release of adrenaline into the blood is a normal process that occurs in emergency situations. However, a prolonged increase in the level of epinephrine or, conversely, its deficiency in the blood negatively affects human health and may indicate pathological processes in the body.

Determining the concentration of adrenaline in the blood is somewhat difficult, since the hormone is eliminated very quickly

To determine the concentration of the hormone in the blood, it is necessary to take a blood test from a vein or urine (one-time or daily). The choice of the optimal research method remains with the doctor.

A few days before the procedure, a person must begin to follow some rules:

give up bad habits (smoking, drinking alcohol, coffee) and eating foods that stimulate the synthesis of serotonin (dairy products, chocolate, bananas);
not be exposed to stressful situations and painful influences;
eliminate excessive physical activity;
stop therapy with decongestant and antiallergic drugs containing sympathomimetics.

If you take the test after stressful situations or physical activity, you must inform the specialist.

Increased adrenaline levels

Constant stress or frequent extreme situations cause a steady increase in the hormone in the blood and the transformation of its protective and adaptive functions into pathological ones. The body’s compensatory capabilities are depleted and symptoms appear, characterized by:

an increase in blood pressure, which negatively affects the cardiovascular system and can lead to frequent nosebleeds, the development of heart attacks and strokes;
violation of the frequency, rhythm and contractions of the heart;
decreased activity and exhaustion of the body due to increased production of norepinephrine. Chronic fatigue, sleep problems, mental disorders, and emotional instability occur. A person loses a lot of weight, becomes irritable, prone to panic attacks, loses perseverance;
impairment of the functional abilities of the adrenal medulla, which can provoke renal failure, which can even lead to cardiac arrest;
a gradual increase in blood clotting, which causes a risk of thrombosis;
excessive stress on the thyroid gland, causing gradual disruptions in its functioning;
shortness of breath, dizziness.

An increase in hormone levels provokes the active production of glucose, leading to an excess of energy that seeks a way out without the presence of stressful situations, and causes nervous breakdowns

Increased levels of adrenaline can occur with the following pathological changes in the body:

chronic alcoholism;
myocardial infarction;
traumatic brain injuries;
manic-depressive syndrome in the manic phase;
ketoacidosis due to diabetes mellitus;
tumor processes in the adrenal medulla (pheochromocytoma).

If the above symptoms appear, it is recommended to consult a doctor to prescribe appropriate tests to determine the amount of adrenaline and, if necessary, normalize it.

Decreased hormone levels

Fluctuations in the amount of adrenaline towards a decrease are also extremely undesirable. Lack of the hormone leads to:

depression, apathy;
lowering blood pressure;
constant feelings of drowsiness and fatigue;
muscle flaccidity;
weakening of memory;
poor digestion and constant cravings for sweets;
absence of any reactions to stressful situations;
mood swings accompanied by short-term positive emotions.

Lack of adrenaline in the blood causes depression

As a separate endocrine pathology, low levels of epinephrine are not isolated and are observed in the following situations:

when undergoing drug therapy with Clonidine to lower blood pressure;
renal pathologies;
heavy bleeding;
anaphylactic shock;
diabetes mellitus

Insufficient production of adrenaline prevents the concentration of a person’s emotional and physical strength during extreme situations.

How to increase hormone levels

A violation of the emotional state causes a person to quarrel, conflict, and create conflict situations.

Also, the constant search for extreme situations, provoking quarrels and conflicts to release the hormone into the blood leads to the development of adrenaline addiction.

Compensating for a lack of adrenaline with alcoholic beverages, narcotic and psychotropic substances is strictly prohibited

You can increase the hormone level by:

strong physical activity;
extreme sports or martial arts;
sex;
watching thrillers or horror films, etc.;
video games;
cups of coffee.

All measures to increase the level of the hormone in the blood should not pose a health risk

The use of medications is also possible.

Treatment of insulin deficiency with hormonal drugs leads only to temporary results

The drug Adrenaline is available in tablets and solution form for intramuscular, intravenous and subcutaneous injections.

The medicine has hyperglycemic, bronchodilator, hypertensive, antiallergic, vasoconstrictor effects and is used to eliminate many, including life-threatening, conditions (cardiac arrest, anaphylactic shock, etc.).

The numerous side effects and contraindications of the drug preclude its use without a doctor’s prescription.

The drugs Epiject and Epinephrine have identical effects.

Decreased adrenaline levels

Knowing what adrenaline is and the symptoms of its increase, you can normalize the level of the hormone without the use of drug therapy.

You can reduce the amount of adrenaline in the blood by normalizing your emotional state

To reduce the level of epinephrine in the blood and restore the emotional state, the following methods are used:

We must not forget about nutrition. Adding foods containing vitamin B1 (yeast, grains, eggs, bananas), as well as protein foods, meat, dairy products, juices, nuts, greens, potatoes and rice to your menu will help cope with stress. Consumption of processed foods, coffee, alcoholic and energy drinks is not recommended.

In severe cases, to reduce adrenaline levels, it is advisable to prescribe medications:

Moxinidine;
Reserpina, Octadina;
Beta-blockers (Anaprilina, Atenol, Obzidana);
Elenium, Phenazepam, Seduxen.

The use of each drug must be approved by the attending physician.

Despite the fact that adrenaline is a unique hormone that allows you to mobilize the body's physical and mental resources and cope with difficult situations, its fluctuations can cause undesirable health consequences. Paying close attention to your body, identifying negative manifestations and contacting a specialist will help you deal with the problem in a timely manner.

Adrenaline is one of the hormones produced in the human body. It is secreted by the adrenal glands in situations that people call stressful. In other words, this hormone helps to mobilize and gain additional physical and psychological capabilities to overcome the situation. Without adrenaline, a person will never experience that surge of strength that helps to cope with all sorts of difficulties in this life. But at the same time, we cannot allow the level of adrenaline in the blood to be constantly elevated; this has a very negative effect on health.

How to get out of such a situation when stress is inevitable and needs to be overcome, but at the same time you want not to lose your health? How can you reduce your adrenaline levels without losing your ability to act actively in emergency situations?

A hormone without which it is impossible to survive

When a person finds himself in a situation called stressful, he needs to find a way out as quickly as possible and use his capabilities as effectively as possible. In this case, the adrenal glands release adrenaline into the blood - a powerful stimulant of brain activity, which allows you to mobilize all the body’s forces in the shortest possible time to solve the problem that has arisen. This hormone allows you to become a “superman” for a while and cope with such a load, psychological or physiological, that you are unlikely to cope with in your normal state.

The purpose of adrenaline is to mobilize a person, “spur” his hidden strengths and capabilities in order to overcome an extreme situation and help him survive in it. This mediator substance is released during dangers, injuries, during some extreme natural disasters, during sports competitions, and the like. For such a reaction to occur, nature provided adrenaline receptors, which are equipped with all cells of the human body. An increase in adrenaline levels in the blood gives cells the opportunity to respond to something in a new way. This is the human ability to survive.

But the effect of adrenaline is limited in time, since its purpose is to “turn on” the body and give it superpowers. Therefore, adrenaline as a drug is used in anti-shock medicine, when it is necessary to start fading or stopped body functions.

Causes

The release of adrenaline is a reaction to stressful situations:

danger,
state of shock
serious injury
unexpected psychological shock
extreme environment,
strong pain,
significant increase or decrease in human body temperature,
playing some sports.

With some diets, you can also observe periodic adrenaline surges - for example, with a low-carbohydrate diet. The reason is that for the body, an insufficient supply of nutrients is also a stressful situation. And it causes the adrenal glands to produce adrenaline in the hope that in this way additional resources will be found that will help increase blood glucose.

Symptoms

When adrenaline is released in the body, certain physiological mechanisms are triggered:

the frequency and strength of heart contractions increases, which allows blood to be “supplied” more actively and in larger volumes to the tissues;
a change occurs in the musculature of blood vessels;
the intestinal muscles relax;
pupils dilate.

If adrenaline is released into the blood for a long time, enlargement of the myocardium and skeletal muscles may occur. Against the background of intense protein metabolism, the body may begin to deplete.

A person can also determine an adrenaline surge based on subjective sensations. The symptoms are as follows:

tachycardia,
sudden release of large amounts of sweat,
breathing problems (shortness of breath, rapid breathing),
impaired vision sharpness due to a spasm of accommodation (the lens of the eye loses the ability to “sharpen”),
headache and heart pain.

With frequent and violent release of adrenaline, a person begins to experience chronic fatigue, it is already difficult for him to do routine work, and he develops insomnia. Along with this, there is an increase in the pain threshold: the body becomes less sensitive to pain.

All this has an extremely negative impact on health, and if a person observes these symptoms, it means it’s time to think about how to reduce adrenaline in the blood. If it constantly stands out, then:

hypertension develops;
the processes of inhibition intensify, since, in contrast to adrenaline, the production of norepinephrine begins to bring the body into a state of hormonal balance;
the risk of stroke or heart attack increases in a completely healthy person due to a sharply increasing load on the heart and blood vessels;
and worst of all, a condition called adrenal insufficiency can occur, which can lead to cardiac arrest.

In addition, excess adrenaline has the same effect on the body as large doses of alcohol. With all the ensuing consequences.

You can accurately determine whether increased adrenaline is occurring using blood and urine tests. The accuracy of the analysis is ensured if certain requirements are met for three days before taking the tests:

not to drink,
no smoking,
do not drink alcohol or medications containing alcohol,
avoid stress and heavy physical activity,
do not take caffeine, nitroglycerin and some other drugs (the doctor must give a complete list),
and also avoid eating bananas and chocolate.

How to reduce

You can avoid constant adrenaline surges and the harmful effects of adrenaline on the body both without the help of medications and using medications.

If you try to do without medications, then, first of all, you need to protect yourself from unnecessary stressful situations, from unnecessary increased stress, both physiological and psychological. The popular wisdom that says: don’t get into trouble is very appropriate here. You cannot force the body to always work at its limit; you need to provide it with adequate rest, sleep and nutrition.

You definitely need to switch to a healthy lifestyle with an established sleep and nutrition schedule. And even such seemingly little things as regular exercise every morning and a walk in the fresh air before bed have an extremely beneficial effect on the body. If you wish, you can do yoga and auto-training. This will help cope with stress, which, of course, is unlikely to be completely avoided.

If you need a medicinal solution to the problem, then only a doctor should prescribe medications. Self-medication can cause irreparable harm to health, and, in addition, medications can reduce the effect of adrenaline, but do not block its production by the adrenal glands. Therefore, it is much better to drink herbal teas with mint, motherwort, and also take baths with herbal infusions before bed.

Anesthesia without adrenaline has been used in dentistry for quite a long time; it allows painless treatment even for those patients who have contraindications to common means of local anesthesia.

What is Adrenaline

Adrenalin is a hormone of the adrenal medulla.

It is usually obtained from the adrenal gland of cattle, and also synthetically from pyrocatechol. In addition to free adrenaline, various compounds can exist in the body.

The effect of adrenaline on the body causes reactions similar to the phenomena observed during stimulation of the sympathetic nervous system, accompanied by the release of sympathins - chemical mediators (conductors) of sympathetic nerve impulses.

Adrenaline is highly active in minute concentrations.

In medical practice, a solution of hydrochloric salt of adrenaline (Adrenalinum hydrochloricum solutum) is used in a concentration of 1: 1000.

The main pharmacological effect of adrenaline is the stimulation of the sympathetic nervous system (constriction of blood vessels in almost all areas of the body, with the exception of the vessels of the lungs, increased blood pressure, relaxation of the tone of the bronchial muscles, etc.). The use of adrenaline together with anesthetic substances in surgical practice is based on its local vasoconstrictor effect.

Adrenaline itself does not have any analgesic power, but only causes, as mentioned earlier, a narrowing of small vessels and capillaries.

It should be pointed out that the high concentration of adrenaline used by some practitioners for conduction and infiltration anesthesia in dental practice - 1 drop (1: 1000) per 1-2 ml of novocaine solution sometimes causes unpleasant phenomena even without the solution entering the vein: heartbeat, increased pulse rate, dizziness, fainting and sometimes even collapse. Slow injection of a fresh adrenaline solution heated to body temperature significantly reduces the toxic effect of the drug.

A weaker concentration of adrenaline during conduction and infiltration anesthesia in the dentofacial area (1 drop per 5-15 ml of solution) is less likely to cause unpleasant phenomena associated with the toxicity of the substance.

There are, however, people who are very sensitive to adrenaline and even when injecting the slightest dose of it, they react with general toxic phenomena (increased pulse, palpitations, pale face and even collapse).

Many times they tried either not to use adrenaline at all, or to replace it with less toxic substances, such as eserine, ephedrine, etc. But the elimination of adrenaline led to a decrease in the analgesic effect and to an increase in the toxicity of the anesthetic.

It should only be emphasized that for pain relief, adrenaline must be added to the anesthetic substance in the weakest concentrations. For conduction anesthesia, one drop per 5-10 ml of anesthetic solution is sufficient, and for infiltration anesthesia, one drop per 10-15 ml of solution is sufficient. When it is necessary to use a large amount of anesthetic solution, take one drop of adrenaline (1: 1000) for an even larger amount of anesthetic solution (one drop per 20-25 ml).

Indications and features of use

Local anesthesia without adrenaline in dentistry is used in the following situations:

If the patient has high blood pressure or cardiac dysfunction (heart disease, heart rhythm disturbances, failure, etc.). Moreover, for moderate hypertension, anesthetics with a reduced concentration of adrenaline are recommended; for severe hypertension, anesthetics with its complete absence are recommended.
For dental treatment of children under 5 years of age.
Women during pregnancy and lactation. Experts still recommend using drugs containing low concentrations of adrenaline so that the anesthetic is absorbed into the blood more slowly and does not penetrate the hematoplacental barrier.
When treating patients with pathologies of the endocrine system, including those due to age (menopause in women) and those requiring thyroid hormone replacement therapy.
Women during menstruation.
Patients who are likely to develop adverse reactions: against the background of stress, while taking antidepressants or drugs that block beta-adrenergic receptors (some drugs to lower blood pressure and certain heart medications).

If the patient has one of these conditions or there is a suspicion that an adverse reaction to the anesthetic may develop, be sure to warn the dentist about this before starting treatment.

Anesthetics without adrenaline

This group of anesthetics includes Scandonest and Mepivastezin (Mepivacaine).

They have a moderate vasodilator effect, so they are used without a vasoconstrictor. After administration of the drug, anesthesia occurs quickly (3–5 minutes), the effect lasts 3–40 minutes for pulp anesthesia, and up to 3 hours for soft tissue anesthesia. It is used for all types of manipulations, as well as during maxillofacial operations. Indicated for children weighing at least 15 kg.

Scandonest has the following side effects:

headaches, dizziness;
change in heart rate;
allergic reactions;
hypotension;
disturbances in the gastrointestinal tract.

For patients with a complicated medical history, the elderly, pregnant and lactating women, the drug is prescribed with caution, as it penetrates into the blood.

It poses less danger during infiltration anesthesia (the drug is injected directly into the site of the intended manipulation).

Ultracaine (Articaine) is used for local and general anesthesia and is considered a leader.

It is reliable and is used for pain relief in children, the elderly and pregnant women.

There are 3 versions of the drug available:

Ultracaine D, which does not contain preservatives and epinephrine;
Ultracaine DS, with epinephrine;
Ultracaine DS forte, with increased vasoconstrictor content.

Ubistezin is similar to Ultracain in composition and properties. Suitable for patients of all ages, except children under 4 years of age. The effect of the drug appears 1-3 minutes after injection and lasts 45-240 minutes - this depends on the type of anesthesia. The patient's health status dictates the choice of drug form.

Both drugs labeled “D” (without adrenaline) are used for the following diseases:

bronchial asthma;
tendency to allergies;
thyroid diseases;
diabetes;
hypertension;
cardiac decompensation.

For high blood pressure, moderate heart disease, and pregnant and nursing mothers, Ubistezin and Ultracain labeled “DS” can be used, since a low concentration of the vasoconstrictor will not cause as much harm as the penetration of the anesthetic into the blood.

Preparing for adrenaline-free anesthesia

As already noted, adrenaline increases the duration of anesthesia.

Without it, it is impossible to provide high-quality pain relief and carry out long-term manipulations. To eliminate the latter problem, treatment is divided into stages, each of which is anesthetized separately.

To reduce pain, it is recommended to prepare for a visit to the dental office. To do this, 5–7 days before the manipulations, they begin to take a sedative that does not have a hypnotic effect. You can drink valerian extract, Barboval or Corvalol no earlier than 3 days before. Half an hour before the start of treatment, you can inject a tranquilizer intramuscularly prescribed by a doctor, or ask the doctor to treat the injection site of the anesthetic with an anesthetic spray.

The use of an anesthetic that provides incomplete pain relief will cause the patient to feel fear. And this will cause an increase in the concentration of natural adrenaline in the body, which will cause the risk of possible complications.

Mepivastezin - conduction anesthesia in dentistry

Many anesthesia products contain a small dose of adrenaline. It is needed to reduce bleeding during interventions and to increase the duration of anesthesia. Adrenaline constricts blood vessels, which ultimately prevents the active substance from being removed from the injection site. For some reason, many are afraid of its presence in anesthetic drugs, but this is completely in vain. In fact, adrenaline is not dangerous at all.

Of course, some people may have one or another individual reaction to it. For example, over a period of time there may be a change in mood from whiny to cheerful and vice versa. But this condition passes quickly enough.

Is adrenaline so harmless?

Adrenaline is used in anesthesia in small quantities and is therefore, in principle, harmless. Of course, one should take into account the presence of certain chronic diseases in a person. For example, if there are vascular or heart diseases (especially conduction disorders, ischemic heart disease, cardiosclerosis), then drugs containing adrenaline can be harmful. They increase the work of the heart, which, against the background of oxygen deficiency, aggravates myocardial hypoxia. And this can sometimes lead to complications. In the presence of such diseases, it is recommended to use anesthetics without adrenaline. In these cases, the administration of the anesthetic is shown to be slower than in the case of ordinary patients. In case of heart rhythm disorder, catecholamines can cause arrhythmia or intensify it. So it is better to use lidocaine, which reduces arrhythmia. Adrenaline can also cause an exacerbation of the disease in people suffering from arterial hypertension. Its use is not recommended during interventions for pregnant women and young mothers, breastfeeding, small children (or it is important to at least reduce its content).

Why you should choose the “new century” clinic

Modern dentistry is at the same time science, art, personal skill of the doctor and high technology - all this is the “NEW AGE” dental clinic
We strive for development and work for the benefit of your health
Our clinic combines the latest technologies and a humane, sincere attitude towards those who turn to us for help.
Our goal is not only to treat the patient’s teeth efficiently and painlessly, but also to surround him with attention and care.

Anesthesia in dentistry without the use of adrenaline

Adrenal-free local anesthesia in dentistry is used if the patient has a tendency to increase blood pressure or if his heart function is impaired, for example, if there is heart failure. If hypertension is moderate, you can simply slightly reduce the content of the substance in the anesthetic drug. The same goes for pregnant women.

Anesthesia in dentistry using adrenaline

We can say that rumors about the dangers of adrenaline are greatly exaggerated. So it can be used by everyone, except that you should approach it with caution in the cases listed above.

Anesthesia without adrenaline does not last very long, it can be considered that it is almost non-existent. At the same time, dental treatment can sometimes be quite painful. With high-quality anesthesia, pain areas are blocked, and pain is ultimately not felt. And this is exactly what the patient needs.

At the NEW CENTURY clinic, doctors can perform any dental surgery using any method of anesthesia, depending on the patient’s choice - with or without adrenaline. The clinic is located in two places - near the Prospekt Prosveshcheniya and Devyatkino metro stations. Come, we will be glad to see you.

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Reviews from patients at the NEW AGE clinic

Name: Olga Victorovna

Attending doctor:

She underwent treatment at the New Century clinic in Devyatkino with doctor Natalya Vladimirovna Muravyeva. I liked the doctor - kind, patient, attentive, explained everything clearly, and didn’t leave a single question unanswered. I really liked the clinic as a whole, beautiful design, friendly girls at the reception. I am very pleased with the treatment. Now I will get prosthetics in this clinic

Name Belousova Kristina

Attending doctor:

I had caries treated by doctor Veronika Tamerlanovna Kozaeva. Before that, I received prosthetics from Mazur. I liked everything very much!

Name: Olga Victorovna

Attending doctor: Muravyova Natalya Vladimirovna

This is not the first time I have had my teeth treated by Natalya Vladimirovna Muravyeva, I always like everything very much. This time I brought a friend for treatment. Since there was no one to leave the children with, we took them with us, we were very worried where they would wait for us during treatment. As it turned out, they worried in vain. The clinic has a wonderful children's corner with games and entertainment for children. Our kids had a good time, I'm looking forward to seeing you. And then they were also given toys and refrigerator magnets! Overall, my friend and I were very pleased.

Name: Elena Leonidovna

Attending doctor: Borodulina Nina Vladimirovna

For me, a NEW AGE is a family clinic, my daughter received treatment and prosthetics, now it’s my turn! Nina Vladimirovna prepared her teeth for prosthetics! All liked it! The doctor did everything efficiently and without pain. I will be getting prosthetics from Veronica Kalinovskaya, she is a very good orthopedic doctor! I recommend the NEW CENTURY clinic to everyone!

Name: Mom Olga

Attending doctor: Kozaeva Veronika Tamerlanovna

For us, the NEW AGE clinic is a real family dentistry. My daughter is being treated by the wonderful doctor Veronica Tamerlanovna, the head physician Veronica Vitalievna Kalinovskaya is beyond praise, a very worthy implantologist Daniil Aleksandrovich Razumeiko! I recommend to everyone! The clinic is very good!

Name: Alisa Mikhailovna

Attending doctor: Kostyuchenko Evgenia Sergeevna

I would like to say thank you to Dr. Evgenia Sergeevna for her professional approach to business and responsiveness! I had a teeth cleaning procedure, I really liked everything, I will recommend it to my friends!

Name: Tatiana

Attending doctor: Borodulina Nina Vladimirovna

I truly enjoyed visiting the NEW CENTURY clinic! all at the highest level! I would like to express my gratitude to Nina Vladimirovna Borodulina, she is a wonderful person and a professional doctor!!!