The use of ultracaine in dentistry. "Lidocaine" or "Novocaine": which is better, drug compositions, differences, instructions for use and dosage

Ultracaine is a modern remedy for local anesthesia. Widely used in dentistry due to the rapid achievement of an anesthetic effect, with the introduction of a minimal amount, and the duration of action. The drug is well accepted by tissues, but has certain side effects and contraindications.

Ultracaine is one of the most effective anesthetics in dentistry, with a strong effect and a minimum of side effects.

It is used for infiltration anesthesia during dental procedures that cause significant pain. The drug is used to remove the dental nerve, during orthopedic manipulations and surgical interventions.

The pharmacodynamic effect of the drug is 2 times greater than lidocaine and 6 times greater than novocaine. The toxic effect of ultracaine is 2 times lower than the toxicity of lidocaine.

The most important advantages are its high ability to penetrate connective and bone tissue without disturbing the functioning of the heart, which makes it the first choice drug for patients with cardiovascular pathologies.

Video: anesthesia in dentistry

Instructions

Compound

Ultracaine (Articaine) belongs to the drugs of the amide group.

1 ml of Ultracain DS solution contains:

• Articaine hydrochloride - 40 mg;
• Epinephrine hydrochloride - 6 mcg. (In the Ultracain DS forte solution, the amount of adrenaline is 12 mcg);
• Sodium bisulfite - 0.5 mg;
• Sodium chloride - 1.0 mg;
• Water for injections - 1.7 ml.

The solution is transparent, does not contain foreign impurities and odor.

The high quality of glass and rubber parts of the capsule, the high degree of purification of the drug make it possible to avoid parabens and preservatives, which are most often the culprits of allergic reactions.

The ultracaine solution also lacks ethylenediaminetetraacetic acid - EDTA, which is included in some medications to bind heavy metal ions, when the quality of the glass is low and when the solution is insufficiently purified.

Release forms

The drug is available in two forms. In ampoules of 2 ml (100 ampoules per package) and in capsules (cartridges, carpules) of 1.7 ml - 100 ampoules per package.

Photo: Ultracain DS Forte in cartridges

The capsule is graduated in 0.3 ml increments, which is very convenient for the doctor when calculating the volume of the administered drug.

pharmachologic effect

Ultracaine is a local anesthetic. Used for conduction and infiltration anesthesia. It is a combined preparation of a local anesthetic and a vasoconstrictor component.

Articaine hydrochloride is a local amide anesthetic from the tiaprofen group. Epinephrine hydrochloride is a substance that has a vasoconstrictor effect.

The drug has a high degree of anesthesia, which makes it possible to obtain the required degree of anesthesia with minimal administration of the solution. The action is to interact with nerve receptors and block the conduction of impulses in nerve fibers.

The drug begins to act from the first minute after administration. The duration of the anesthetic effect lasts from 45 minutes to 4–5 hours. It is not contraindicated for pregnant women or during breastfeeding. It breaks down mainly in the kidneys and is excreted in the urine.

Indications

Ultracaine DS (adrenaline 1:200000) is used for conduction and infiltration anesthesia for:

• multiple or single tooth extraction;
• preparing the tooth for a crown;
• preparing the dental cavity for medical procedures;
• dental fillings and other standard dental interventions, including patients with severe concomitant pathologies.

DS forte (adrenaline 1:100000) is used for more complex and painful interventions, including:

• operations on bones and mucous membranes;
• operations on the dental pulp (amputation, extirpation);
• removal of a broken tooth and teeth affected by apical periodontitis;
• resection of the apex of the tooth root;
• percutaneous osteosynthesis;
• cyst escision;
• pain relief for inflammatory diseases of the maxillofacial area (ostemyelitis, periostitis).

Dosage

The dose of the drug is set individually depending on the severity and duration of the intervention.

When removing teeth of the upper jaw, taking into account the absence of inflammation, infiltration anesthesia with ultracaine is performed in a dose of 1.7 ml for each tooth. In some cases, the dose of the drug needs to be increased to achieve complete pain relief. When removing several teeth that are located nearby, one injection is usually enough.

When removing premolars of the lower jaw, an injection of 1.7 ml is also sufficient. In this case, there is no need to perform mandibular anesthesia.

If the desired analgesic effect is not achieved, repeated administration of 1-1.7 ml of solution is recommended. If pain relief is ineffective, a blockade of the lower jaw is indicated.

When preparing a cavity or preparing teeth for a crown, ultracaine solution is used as infiltration anesthesia in a dose of 0.5–1.7 ml for each tooth.

If during a dental procedure there is a need to incise and suturing the palate, 0.1 ml of solution is sufficient for a palatal depot injection.

When performing one dental procedure, the maximum dose of articacaine for an adult is 7 mg/kg body weight. A dose of the drug up to 500 mg (12.5 ml of injection solution) is normally tolerated.

For children over 4 years of age, the dose of the drug is selected individually depending on the patient’s weight and the severity of the manipulation, and the maximum dose should not exceed 5 mg/kg body weight.

Side effects

Side effects can be divided into 2 types: those caused by epinephrine and the body’s reaction to local administration of ultracaine.

Most often, epinephrine in the drug leads to headaches. Sometimes palpitations, increased blood pressure, and arrhythmias are possible.

Complications from other body systems are rarely possible.

• central nervous system. Respiratory dysfunction, including respiratory arrest, impaired consciousness, involuntary muscle contraction, up to the occurrence of generalized convulsions.
• Organ of vision. Blindness, double vision, blurred vision. These side effects are temporary.
• Digestive system. Nausea, vomiting.
• The cardiovascular system. Fall in blood pressure, acute cardiovascular failure, tachycardia, bradycardia, shock.

Allergic reactions to the drug are possible, which manifest themselves as:

• skin itching;
• hives;
• erythema;
• swelling of the glottis, nasal mucosa, lips;
• conjunctivitis.

In severe cases, asphyxia and anaphylactic shock may occur.

In patients with bronchial asthma, signs of hypersensitivity are possible, which manifest themselves in the form of impaired consciousness, wheezing, vomiting, diarrhea, and an attack of bronchial asthma. This is due to the presence of sodium bisulfite in the drug.

Local reactions are observed if the drug administration technique is not followed, or if the solution enters the vascular network. They manifest themselves as ischemic disorders, including tissue necrosis and paresis of the facial nerve.

Contraindications

Ultracaine DS is not used in patients who are allergic to articaine, epinephrine and other components contained in the solution.

Due to the presence of adrenaline in the composition of the drug, its use is contraindicated in patients with tachycardia, tachyarrhythmias, severe arterial hypertension, severe disturbances of cardiac conduction and rhythm, and acute cardiovascular failure.

The use of the drug is also contraindicated for glaucoma, pheochromacytoma, hyperthyroidism and bronchial asthma, and for those patients taking non-selective beta-blockers.

For patients prone to allergic reactions, it is recommended to use ultracaine, packaged in disposable ampoules or cartridges, since the solution from the reusable bottle contains a preservative.

The drug is not used in people with anemia, methemoglobinemia and hypoxia. Due to the lack of clinical experience, the drug is prohibited from being administered to children under four years of age.

Use during pregnancy and lactation

The drug slightly penetrates the hematoplacental barrier, which is its advantage and makes it possible to use it during pregnancy.

Articaine disintegrates very quickly and is excreted from the body, which ensures rapid elimination of the drug and the inability to pass into breast milk in high concentrations. So there is no need to temporarily stop breastfeeding when administering the drug during lactation.

Video: dental treatment during pregnancy

Precautionary measures

To ensure perfect functioning during operation, it is recommended to use special injectors - injection syringes. The most suitable are Unidjekt K and Unidjekt K vario.

Syringe stands provide maximum safety from glass damage. For infiltration anesthesia - Unidjekt K or Unidjekt K vario. For intraligamentary anesthesia - Ultrajekt.

The drug cannot be administered intravenously (intravascularly). To avoid intravascular injection, an aspiration test must be performed. Injection pressure should correspond to the sensitivity of the tissue.

To prevent the transmission of infections, it is important to ensure that each solution is taken from the vials using a sterile syringe and needle. The use of one solution cartridge is unacceptable for several patients.

Do not use solution from damaged cartridges.

Overdose

In case of an overdose of the drug, the following may appear:

• motor excitation,
• dizziness,
• disturbances of consciousness.

In this case, the drug injection is stopped immediately. The patient is placed horizontally, access to fresh air and airway patency are ensured. Blood pressure and heart rate must be measured.

Venous access and crystalloid infusion are advisable, even in patients with less severe signs of overdose.

If respiratory function is impaired, oxygen is used. In severe cases, artificial respiration and tracheal intubation with subsequent connection to a ventilator are indicated.

If involuntary muscle twitching or generalized convulsions occur, intravenous administration of short and ultra-short barbiturates is indicated.

When shock develops, complex therapy is provided, including the administration of plasma substitutes, albumin, glucocorticosteroids, with constant monitoring of heart and lung function.

With the development of arterial hypertension, peripheral vasodilators are administered. For tachycardia and tachyarrhythmia, beta-adrenergic receptor blockers are administered intravenously.

Interaction with other drugs

When using ultracaine in combination with monoamine oxidase inhibitors and tricyclic antidepressants, the vasoconstrictor effect of adrenaline may be enhanced.

It is not used in patients taking beta blockers.

When combining the drug with heparin, acetylsalicylic acid and other anticoagulants, the risk of bleeding increases.

The use of halothane and other narcotic drugs for inhalation anesthesia simultaneously with ultracaine can lead to the development of arrhythmia.

Prices

FAQ

What is the duration of action of the drug?

The drug begins to act 1–3 minutes after administration. With infiltration anesthesia, sensitivity returns after 3-4 hours, with conduction and subperiosteal anesthesia - after 4-5 hours.

It is rare that dental surgery takes place without pain. And this is the most pressing problem in dentistry today. The technique began to be used more than a century ago. At the end of the 18th century, cocaine was used for these purposes, and novocaine was introduced in 1906. Of course, it was not very effective, but it significantly reduced the intensity of the unpleasant sensations.

It was the low efficiency that forced the search to continue. This is how lidocaine was born. It was much stronger, but it did not satisfy the practicing doctors, since complete pain relief was still not possible to achieve. Periodic allergic reactions were observed to novocaine, and lidocaine turned out to be more toxic than its predecessor.

In 1976, a new drug appeared - ultracaine. This was a breakthrough in dentistry. An anesthetic from the amide group, as it turned out, outperformed both novocaine (six times) and lidocaine (twice). In addition, it is less toxic and is able to penetrate bone and connective tissue without affecting the functioning of the heart.

Ultracaine has established itself quickly and firmly in dentistry. Thanks to the high degree of purification of this anesthetic, it became possible to abandon antibacterial preservatives that cause such frequent allergic reactions.

In 1995, the German company Hoechst proposed the use of improved ultracaine in dentistry. Its price was slightly higher, but the improved quality made it possible to use the anesthetic in daily practice, and very effectively.

A group of young dentists observed the effect of ultracaine when treating patients (Ultracaine DS-Forte was used). Of the 1275 patients, 647 had a carious process, 389 had pulpitis, and 239 had apical periodontitis. The age of patients is 18-50 years.

Patients with contraindications were excluded - tachycardia, narrow-angle glaucoma, tachyarrhythmia, bronchial asthma, paragroup allergies.

The effectiveness of anesthesia was assessed clinically. With anesthesia, pain relief occurred two to three minutes after the injection; with pain relief, it occurred faster, after 30-60 seconds; and with subperiosteal injection, within 20 seconds after the administration of ultracaine. After 30 minutes, the strength of the anesthetic was the same as the initial one. Sensitivity was restored after 180-300 minutes (depending on the type of anesthesia). No side effects were noted in any of the observed patients. That is why ultracain in dentistry received the most approving reviews, both from patients and doctors themselves.

The positive qualities of the drug are due to its very low fat solubility (for lidocaine, for example, it is 2.5 times higher) and excellent protein binding, which affects the duration and strength of anesthesia. Ultracaine is eliminated from the body faster than previous anesthetics. With submucosal administration, the estimated half-life is approximately 22 minutes. As for the effect on the liver, unlike lidocaine, procaine, bupivocaine, ultracaine (complex amides), which are destroyed in the liver, ultracaine does not cause complications, so the drug can be recommended even during pregnancy.

The drug contains the following active ingredients: articaine hydrochloride And adrenaline hydrochloride . The drug also contains additional substances: sodium chloride , sodium metabisulfate , purified water .

Ultracaine in carpules and ampoules does not contain a preservative, so the risk of development in patients is reduced to a minimum.

Release form

Ultracain is contained in ampoules or in bottles 2 ml each, the drug can also be packaged in cylindrical carpules 1.7 ml each. Thanks to several packaging options, a variety of local .

Ultracaine (INN: Articaine + ) is available in three forms: Ultracain D(does not contain epinephrine/adrenaline), Ultracaine D-S Forte(concentration of epinephrine in the composition is 1:100000), Ultracaine D-S(concentration of epinephrine in the composition is 1:200000).

Accordingly, the difference Ultracaina And Ultracaina D-S, as well as the difference Ultracaina And Ultracaina Forte– in concentration epinephrine .

pharmachologic effect

Ultracain has a local anesthetic pharmacological effect. Under its influence, the depolarization of the nerve ending membrane is blocked, which, in turn, prevents irritation and conduction of the nerve impulse.

The effect of the product is determined by the components that are included in its composition.

Pharmacodynamics and pharmacokinetics

The product begins to act immediately after it is administered. The period that anesthesia lasts is from 1 to 3 hours. It should be noted that in an acidic environment the effectiveness of the product is reduced.

In dental practice, the drug is widely used as a local anesthetic; its use minimizes the risk of side effects. Ultracaine does not stop regeneration processes and prevents an increase in blood pressure.

It is excreted from the body in urine within 5 to 10 hours.

Indications for use

The drug is indicated for use for infiltration and conduction anesthesia during operations and diagnostic interventions to relieve pain.

Ultracaine in dentistry prescribed for a variety of procedures, including filling and extraction of teeth, during the installation of crowns, during preventive procedures, and treatment of wounds. It is also practiced to administer surgical interventions carried out in the nasopharynx.

Contraindications

The following contraindications are defined for the use of Ultracaine:

• high level of sensitivity;
• B12 deficiency anemia ;
• paroxysmal ventricular or atrial fibrillation ;
• methemoglobinemia ;
• closed angle;
• intolerance by the body to sulfo groups (especially in people who are sick).

Relative contraindications (the drug may be used with caution) are noted in the following cases:

• at cholinesterase deficiency ;
• at ;
• at ;
• at ;
• at ;
• at anemia ;
• at arterial hypertension .

It is also used with caution when treating children (it is not advisable to use the drug for children under 4 years of age), as well as for paracerebral blockade .

Side effects

When using Ultracaine, the following side effects may occur:

• In functions central nervous system: , disturbances of consciousness, , breathing problems, convulsions.
• In functions Gastrointestinal tract: vomit , , nausea .
• In functions sense organs: diplopia , in rare cases - transient visual impairment.
• In functions of cardio-vascular system: downgrade , bradycardia , , .
• Allergic manifestations: itching and redness of the skin, , , swelling.

When Ultracaine is used in dentistry, side effects may be as follows: inflammation or swelling at the injection site, development of ischemic zones in the place where the drug was injected. If the insertion technique is incorrect, nerve damage may occur.

Those side effects that are associated with the influence ( arrhythmia , tachycardia , increased blood pressure), are rarely observed if the concentration of adrenaline in the drug is relatively low (1: 200,000 and 1: 100,000).

Instructions for use of Ultracaine (Method and dosage)

The instructions for Ultracaine stipulate that the drug is injected subcutaneously in 5-10 ml doses. But before using the product, the patient needs to undergo all the necessary diagnostic procedures. After the surgical intervention has been performed, the patient is clearly monitored, as well as the condition of his central nervous system and respiratory system.

Instructions for use of Ultracaine in dentistry stipulates that when filling or removing teeth, 1.5 ml of the product is injected into the palatal suture. The highest dose for an adult should not be more than 7 mg; for children after the age of four, a dose of no more than 5 mg of the drug is indicated. After anesthesia, oral sensitivity is gradually restored over a period of time. You can eat food approximately 2-3 hours after the anesthesia.

At infiltration anesthesia Ultracaine is used in the following doses: when tonsillectomy 5-10 ml of product is used for each tonsil; when reducing fractures, 5 to 20 ml of Ultracaine can be used; when applying a perineal suture - 5-15 ml.

At conduction anesthesia depending on the type of intervention, from 1 to 30 ml of the product can be administered.

Overdose

In case of overdose, the following symptoms are observed: disturbances of consciousness or loss of consciousness , changes in the breathing process , until it stops, muscle twitching, convulsions , nausea And vomit , sudden drop in pressure , shock , heart failure .

Further treatment is carried out depending on how serious the disorders are. The patient is given oxygen, artificial respiration, or endotracheal intubation , in which ventilation of the lungs is controlled.

Centrally acting analeptic drugs should not be used. If a person experiences muscle twitching or generalized convulsions, short-acting or ultra-short-acting barbiturates are administered intravenously. In case of blood flow disturbances and manifestations of shock, electrolyte and plasma-substituting solutions are administered intravenously, as well as glucocorticoids .

If increasing bradycardia is noted, the patient is at risk of vascular collapse; intravenous administration of 0.25–1 ml of a solution of 0.1 mg/ml adrenaline is practiced. At antiarrhythmic drugs are used.

If people who are sick , after using Ultracaine, blood pressure rises, it is necessary to use peripheral vasodilators.

Interaction

When used simultaneously tricyclic antidepressants , MAO inhibitors, there is an increase in the hypertensive effect of the drug.

When taking vasoconstrictor drugs, the local anesthetic effect increases articaina .

With simultaneous treatment non-selective beta-blockers the risk of manifestation increases bradycardia And hypertensive crisis .

Under the influence of Ultracaine, the influence of other local analgesics increases, and as a result, depression of the nervous system is noted.

Terms of sale

Ultracain can be purchased at a pharmacy with a doctor's prescription.

Storage conditions

The product must be stored at a temperature not exceeding 25 °C. Ultracaine should be kept away from children.

Best before date

Can be stored for 5 years

special instructions

The drug cannot be administered intravenously. To avoid intravascular injection, you need to perform aspiration test . The injection pressure must correspond to the sensitivity of the tissue.

Do not inject drugs into the area of ​​inflammation.

Eating after dental procedures performed with Ultracaine anesthesia is possible only after sensitivity has been completely restored.

To prevent infection, you need to use only new sterile needles and syringes each time you take the solution from the vials. If the bottle has been opened, it must be used strictly according to the instructions and used for two days.

Whether a patient who has undergone anesthesia using Ultracaine can drive a vehicle or work with precision machinery must be determined by a doctor.

In patients suffering , the drug can provoke acute attacks and breathing problems.

Analogues

Level 4 ATX code matches:

In terms of active ingredients, analogues of Ultracaine are: Artikain , Artifrin , Primacaine with adrenaline , Cytokartin And Septanest with adrenaline , Articaine with adrenaline .

One drug group includes drugs Lycaine , and etc.

Which is better: Ultracaine or Lidocaine?

The drug Lidocaine is also used for anesthesia during dental procedures. It rarely causes allergic reactions, although it has a number of contraindications. However, Ultracaine is a less toxic agent that allows for more durable anesthesia.

For children

Use with caution in childhood; not recommended for use in children under 4 years of age.

With alcohol

Despite the fact that the instructions for the drug do not describe how alcohol and Ultracaine interact, it is not advisable to use alcohol before or after administration of the drug, even in small doses.

Ultracaine during pregnancy and lactation

It is advisable to use Ultracaine in a form where the concentration of epinephrine is 1:200,000, since in such a concentration it does not penetrate the placenta. This drug can be used during pregnancy only according to indications and under the strict supervision of a doctor.

Articaine can pass into breast milk in low concentrations, so lactation after anesthesia can not be stopped.

Very often people do not have enough time to visit the dentist. To maintain dental health, you need to have your mouth examined at least twice a year. This allows you to promptly eliminate emerging dental problems. But there are often cases when a person comes in with severe sensations of pain. During the examination, an advanced stage of pulpitis or caries is detected. In this case, treatment without anesthesia is almost impossible, since the dentist is faced with exposed nerves of an already diseased tooth.

Until relatively recently, this issue was resolved with the help of arsenic. It was placed in the cleaned tooth cavity and covered with a temporary filling for a few days. The effect of arsenic has a detrimental effect on the nerves, which allows the doctor to subsequently clean the tooth and perform a filling.

Today, anesthesia in dentistry consists of something else. Ultracain has completely changed the concept of local anesthesia in dental treatment. Now you can cure a bad tooth in one go.

Instructions for use

Ultracaine is a medical drug that belongs to the group of anesthetics for local use or complexly for conduction anesthesia. It reduces the patient's pain well. The pharmacological effect of this drug is explained by its vasoconstrictor properties and analgesia. Ultracain is used for tooth extraction, as well as for preparatory work in the oral cavity for operations.

Ultracaine contains 12 mg of adrenaline hydrochloride and 40 mg of artacaine hydrochloride. These substances reach the nerve endings, which creates an analgesic effect for five minutes. The vasoconstrictor effect provides a local effect of the drug. The drug withdrawal time is 6-11 hours. During this time, the body is cleansed, and the residues are released through the bladder and kidneys.

Side effects during the use of ultracaine are minimal, therefore it is successfully used in dentistry as an effective pain reliever. The use of ultracaine does not affect the cardiovascular system. Among the side effects, a slowdown in reaction is noted, therefore, after using it, driving a car or work that is related to the speed of reaction is not recommended.

During pregnancy, this remedy can be used for dental treatment because it contains a minimal amount of epinephrine. Ultracaine does not have the ability to pass through the placental shield, that is, it cannot in any way affect the development of the fetus. However, use in a pregnant woman and during breastfeeding should be justified and carried out under the strict supervision of a physician.

The medicine is not administered intravenously, nor is it injected into the inflamed area. The injection is given in a nearby place.

Eating is possible only after ultracaine ends its effect, this is indicated by return of sensitivity.

The instructions for using ultracaine also determine age restrictions. You can start using the drug from the age of 4 years. After performing the injection, monitoring of the reaction from the side of the nervous system and changes in intravenous pressure readings is required. Ultracaine is administered in the following dosages per tooth:

• Simple tooth filling – 1 ml;
• Filling and removal with complications – 1.5 m l.

If the medicine is used in a complex of conduction anesthesia, then the drug is administered in a volume of no more than 30 mg. The volume will depend on the extent of the dental intervention.

The main thing that the drug did not enter the vessel. You need to check with a test aspiration. It is necessary that the pressure of the product corresponds to the sensitivity of the tissues. The highest permissible dosage for performing local anesthesia in one session:

• Children – 5 ml;
• Adults – 7 ml.

Concomitant use of the drug with anticoagulants and inhibitors is unacceptable. During their simultaneous use, an enhanced hypertensive effect of ultracaine is noted.

With the simultaneous use of vasoconstrictors, the anesthetic effect of the drug increases. The risk of hypertensive crisis also increases when the drug is used simultaneously with beta-blockers. Under the influence of ultracaine, the effect of other local anesthetics increases, this, in turn, can lead to depression of the nervous system.

The question is also often asked: what to choose – lidocaine or ultracaine? Both agents can be used equally for local anesthesia in dentistry. The only difference is the toxicity of the drug. Lidocaine is more toxic, while ultracaine has a stronger, sustained analgesic effect.

When using each new kit, only new sterile syringes should be used. This helps protect against infection. An open bottle should be stored strictly according to the instructions, taking into account the temperature conditions and the need for use over the next 48 hours.

The cost of ultracaine will depend on the form and type of preparation of the drug. The cost of one ampoule is approximately 60 rubles. Shelf life: 5 years.

Types of ultracaine

To date There are three types of this drug:

Indications for use

Anesthesia using ultracaine is widely used in dentistry as an anesthetic drug. Used for local anesthesia. It can also be used as a conductive pain reliever. Its effects and the absence of significant side effects make it possible to use ultracaine during pregnancy. Do not use the product when there is alcohol in the blood.

Used for local anesthesia during the following dental procedures:

• deletion;
• filling;
• preventive actions;
• fastening of crowns;
• removal of abscesses;
• treatment of wounds in the oral cavity.

Like every medical drug, ultracaine has some contraindications, which are divided into relative and absolute. The latter exclude the absolute possibility of using the drug, the former - use with caution under the strict supervision of a dentist over a person’s vital signs.

Absolute contraindications are:

• anemia, which appeared due to a lack of vitamin B12;
• increased sensitivity of a person to the components of the drug;
• glaucoma;
• hypoxia;
• intolerance to sulfo groups;
• cardiac tachycardia.

Relative contraindications are problems associated with diseases of the cardiovascular system, endocrinological diseases (diabetes), and bronchial asthma. It is possible to perform injections with ultracaine during arrhythmia, but under the strict supervision of a dentist. Ultracaine is approved for use during lactation.

Side effects

Side effects from the use of ultracaine can occur from various systems:

Also, when using ultracaine in dentistry, side effects at the injection site are likely, such as the appearance tumors and inflammation.

There are negative reviews about the drug when, after use, ischemic disorders appear in the tissues at the site of its administration. This appears after improper use of the product (entering a blood vessel). This side effect is not associated with the effects of ultracaine. The instructions for the drug indicate how to prevent these phenomena.

During an overdose of ultracaine, side effects increase significantly and may lead to convulsions, vomiting, stopping breathing and heartbeat, and a strong drop in blood pressure readings.

If side effects occur, especially during pregnancy, injections with the drug should be stopped immediately. The patient is placed in a horizontal position, clearing the airways, and blood pressure and pulse are monitored. Taking into account the subsequent condition of the patient, treatment is carried out, which consists of supplying oxygen using a mask. During swelling of the larynx, tracheal intubation is performed with constant monitoring of pulmonary ventilation. In case of severe disturbances in the functioning of the cardiovascular system, antiarrhythmic drugs are administered.

When seizures occur intravenous injection of barbiturates short or ultra-short exposure. If there is a suspicion of vascular collapse, then adrenaline is injected.

Ultracaine for children

The drug is used for the treatment, removal, and depulpation of teeth from 4 years of age. Before the injection, the dentist will certainly test for allergies and refuse to use it if the product is not suitable for the child.

Ultracaine has been used in dental practice for quite a long time, but even now this drug is considered one of the most effective anesthetics. Before the injection, the doctor treats the area with a freezing agent with a pleasant taste, which has a positive effect on a person’s perception of the entire procedure.

Today, local anesthesia is the main method of pain relief in dentistry, during which a person is conscious but does not feel any pain. The dentist has the opportunity to control his condition, calm him down, communicate, which has a beneficial effect on successful treatment.

The pharmaceutical industry produces three varieties of Ultracaine, which, due to changes in the concentration of active ingredients, differ slightly in their properties and possibilities for use in dentistry:

1. Ultracaine DSForte(adrenaline concentration 1:100,000). The drug is characterized by a pronounced duration of action. It is well suited for surgical interventions and pulp removal. Contraindications to its use are hypertension, thyroid disease, bronchial asthma, pregnancy and lactation.
2. (adrenaline in the amount of 1:200000). For bronchial asthma and thyroid diseases, the drug is contraindicated. But it can be used during breastfeeding and pregnancy, as well as with heart and vascular diseases under the supervision of a doctor.
3. (without adrenaline). This version of ultracaine is approved for use in people with bronchial asthma and thyroid disorders, since, along with adrenaline, it does not contain the preservatives necessary to stabilize it. The drug is used for high blood pressure, heart and vascular diseases. It has a relatively short period of action - about half an hour.

In addition to different options for the composition of the drug, there are also two types of dosage forms of Ultracaine:

1. ampoules of 2 ml (pack of 100 ampoules);
2. capsules (cartridges, carpules) 1.7 ml (pack of 100 ampoules).

As a means for local anesthesia, the drug is used for such types as conduction and infiltration. A minimal dose of medication can provide good anesthesia.

Application and action

The use of Ultracaine with caution is possible in the case of the following relative contraindications:

• Lack of cholinesterase enzyme;
• Kidney failure;
• Enlarged thyroid gland;
• Anemia;
• Hypertonic disease.
• Bronchial asthma;

The drug is used with caution for treatment in children (there is no data on its use in children under 4 years of age).

Ultracaine is usually well tolerated by adults. However, in a number of cases Work-related side effects may occur:

1. Of cardio-vascular system. Since adrenaline, which is part of the anesthetic, constricts blood vessels, this action can cause heart rhythm disturbances (rapid heartbeat - tachycardia). This usually happens when the dose of ultracaine is chosen incorrectly. There may also be a slight increase in blood pressure and complaints of a racing heart, shortness of breath and pain in the head.
2. Nervous system. In rare cases, the drug may impair or stop breathing and muscle contraction, causing fainting.
3. Gastrointestinal tract. Complaints of pain in the stomach, nausea and vomiting are possible.
4. Organs of vision. Possible double vision of objects in the eyes, their blurriness, problems with focusing.
5. Allergic reactions. They manifest themselves in the form of swelling, redness of the mucous membranes, and various rashes on the skin. Such reactions are not typical due to the presence of adrenaline in the drug and may indicate disturbances in the functioning of the immune system. Therefore, before the first administration of Ultracaine, it is necessary to test for sensitivity to the drug.

Dosage

The dosage of Ultracaine depends on the purpose and method of use of the drug:

• When removing teeth or installing a filling, 1.5 ml of the drug is injected into the palatal suture.
• for infiltration anesthesia, the following doses are used: when removing tonsils, 5-10 ml of Ultracaine is used for each of them; to reduce fractures you will need from 5 to 20 ml of anesthetic; for suturing in the perineum from 5 to 15 ml.
• for conduction anesthesia, depending on the specific type of surgery, from 1 to 30 ml of the drug is administered.

Before administering Ultracaine, the doctor performs diagnostic procedures and a sensitivity test to the drug.

After the manipulation has been carried out, monitoring of blood pressure and the state of the nervous and respiratory systems continues.

The maximum dose for an adult does not exceed 7 mg; for children after four years of age, a single dose is possible in a dose not exceeding 5 mg.

The sensitivity of the oral cavity after the administration of Ultracaine is restored slowly and gradually, since the medicine has a long period of action. It is recommended to take food only 2 – 3 hours after pain relief using Ultracaine.

Symptoms of using a large dose of anesthetic:

• disturbances of consciousness, fainting,
• breathing problems or stopping,
• muscle tremors, cramps,
• a sharp decrease in blood pressure,
• state of shock
• cardiac arrest.
• nausea, vomiting,

If these side effects and symptoms occur, stop the injection immediately, lay the patient horizontally and ensure airway patency. Monitor pulse and blood pressure.

Information on drug interactions with Ultracaine

• When used with tricyclic antidepressants, the hypertensive effect of the drug may be increased.
• When taking vasoconstrictor drugs simultaneously, the analgesic effect of Ultracaine increases.
• When treated with non-selective beta-blockers, a decrease in heart rate and a hypertensive crisis is possible.
• When other local anesthetics are co-administered with Ultracaine, depression of the functions of the nervous system occurs.
• Combination with alcohol, even in small doses, is extremely undesirable.

The local anesthetic Ultracaine is a prescription drug and can only be purchased at a pharmacy if prescribed by a doctor.

The medicine is stored in a place protected from children at a temperature not exceeding 25 °C.

Ultracaine cost

The cost may vary depending on the form of the drug and its type. The average price for Ultracain DS (quantity - 10 ampoules) is 550 rubles. You can buy 1 ampoule of ultracaine DS Forte for an average of 50 rubles. It is better to check with a specific pharmacy how much ultracaine costs.

Ultracaine is a high-quality, effective and safe modern local anesthetic drug. But, like all medications in this group, you should not use it as part of self-medication, without consulting a dentist. Before using it for the first time, be sure to tell your doctor about your state of health, the possibility of allergic reactions and other medications you are using.

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