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Ubistezin instructions for use in dentistry. Local anesthesia in dentistry: reviews

Ubistezin: instructions for use and reviews

Latin name: Ubistesine

ATX Code: N01BB58

Active substance: articaine + epinephrine (articaine + epinephrine)

Producer: 3M Deutschland GmbH (3M Deutschland GmbH) (Germany)

Description and photo update: 26.10.2018

Ubistezin is a combined drug 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 SO 2 - 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.

Application in childhood

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

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.

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

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

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

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

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

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

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

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

Composition and form of release of the drug

1.7 ml - cartridges (50) - tin cans.

pharmachologic effect

Combined drug, has a local anesthetic effect.

Artikain- a local anesthetic of the amide type of a number of thiafenes. The mechanism of action is due to the stabilization of neuronal membranes and the prevention of the occurrence and conduction of a nerve impulse.

epinephrine- adrenomimetic. Causes vasoconstriction at the injection site, which complicates the absorption of articaine and prolongs the action of local anesthetic action.

The onset of the effect is 0.5-3 minutes, the duration of action is 45 minutes.

Indications

Infiltration and conduction anesthesia (including in dentistry - tooth extirpation, cavity filling, tooth grinding for crowns).

Contraindications

B 12 - deficiency anemia; methemoglobinemia; paroxysmal ventricular tachycardia; atrial tachyarrhythmia; angle-closure glaucoma; hypoxia; intolerance to sulfo groups (especially with); hypersensitivity to the components of the combination.

Carefully: cholinesterase deficiency, renal failure, bronchial asthma, diabetes mellitus, hyperthyroidism, arterial hypertension, children's age (up to 4 years - efficacy and safety have not been determined).

At carrying out paracerebral blockade: preeclampsia, bleeding in the third trimester of pregnancy, amnionitis.

Dosage

Infiltration anesthesia: tonsillectomy (for each tonsil) - 5-10 ml; reduction of fractures - 5-20 ml; perineal suture - 5-15 ml.

Conduction anesthesia: anesthesia according to Oberst - 2-4 ml, retrobulbar - 1-2 ml, intercostal - 2-4 ml (for each segment), paravertebral - 5-10 ml, epidural (epidural) - 10-30 ml, sacral - 10- 30 ml, trigeminal nerve block - 1-5 ml, stellate ganglion block - 5-10 ml, brachial plexus block - 10-30 ml (supraclavicular or axillary access), external genital block - 7-10 ml (each side) , paracervical blockade - 6-10 ml (on each side).

With uncomplicated extraction of maxillary teeth in the non-inflammatory stage injected under the mucous membrane in the region of the transitional fold - vestibular depot 1.7 ml per tooth, if necessary - an additional 1-1.7 ml; palatal incision or suture - palatine depot 0.1 ml.

At removal of premolars lower jaw (5-5) in the uncomplicated stage, infiltration anesthesia gives the effect of conduction anesthesia.

At preparation of cavities and turning of teeth for crowns, with the exception of the molars of the lower jaw, - vestibular injection of 0.5-1.7 ml per tooth. The maximum dose is 7 mg/kg.

Side effects

From the CNS(depending on the size of the applied dose): impaired consciousness (up to loss of it); respiratory disorders (up to apnea); tremor, muscle twitching, convulsions.

From the digestive system: nausea, vomiting, diarrhea.

From the sense organs: rarely - transient visual impairment (up to blindness), diplopia.

From the side of the cardiovascular system: decrease in blood pressure, tachycardia, bradycardia, arrhythmia.

Allergic reactions: hyperemia and, conjunctivitis, rhinitis, angioedema of varying severity (including swelling of the upper and / or lower lip and / or cheeks, glottis with difficulty in swallowing, urticaria, difficulty breathing),.

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); nerve damage (up to the development of paralysis) - occurs only if the injection technique is violated.

drug interaction

Tricyclic antidepressants, MAO inhibitors enhance the hypertensive effect.

The local anesthetic effect of articaine is enhanced and lengthened vasoconstrictors.

Non-selective increase the risk of developing a hypertensive crisis and severe bradycardia.

special instructions

Do not enter in / in! An aspiration test should be performed to avoid intravascular injection. The injection pressure should be appropriate to the sensitivity of the tissue.

Do not inject into the inflamed area.

Eating is possible only after the restoration of sensitivity.

Influence on the ability to drive vehicles and mechanisms

The possibility of allowing the patient to drive vehicles or to engage in activities that require a high mental and motor reaction is determined by the doctor.

Pregnancy and lactation

It does not have a harmful effect on the fetus (with the exception of possible bradycardia) with any application technique and dosage.

During lactation, there is no need to interrupt breastfeeding, because. no clinically significant concentrations of articaine are found in breast milk.

Application in childhood

WITH caution: children's age (up to 4 years - efficacy and safety have not been determined).

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, vulva).

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. Recommended for use in apparently 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

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 medicine use Ubistezin surely consult with the attending physician.

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

Ultracain
Ubistezin
Primakain
Septanest
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 and 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. During general anesthesia, the patient's consciousness is turned off.

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. This active substance is used in such anesthetics as Ultracain, 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 are a healthy person -
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.

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

Indications for use

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

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.

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.

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

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 in the early stages, but sometimes there are situations when complex treatment with anesthesia is necessary.

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 lowering 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:

Ultracaine- practically harmless, used during pregnancy, not burdened by pathological processes. In case of an overdose, headaches, arrhythmia, and palpitations may occur. Available in three forms with different concentrations of adrenaline.
Ubistezin- an analogue of ultracaine with high efficiency. Differs in low toxicity and speed.
Primakain- does not have a harmful effect on the fetus if the dosage is observed. Not recommended for use in the last trimester.
Septanest- rarely used for anesthesia during pregnancy due to the high amount of preservatives.
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, it is required to check blood pressure, the state of the respiratory system, and the central nervous system.

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 the bearing of the baby, 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. There are general dosage recommendations:

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 the respiratory function is impaired, it is necessary to connect the 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.
In anaphylactic shock, drugs based on plasma substitutes, albumin and glucocorticosteroids should be introduced into the body; 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), the digestive system (vomiting, nausea), the cardiac system (drop in blood pressure, tachycardia and some other violations).
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 pharmaceutical market, 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 of the drug are used in such cases - extraction of teeth, installation of a crown, 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. Further.

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 it possible to use the drug during pregnancy.

For long-term anesthesia, for example, during operations on bone structures, the drug Ultracain D-S forte is used, which provides a slow release of active ingredients 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: changes in 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. At the site of 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 the 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.

The third trimester is also a 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 anesthetics indicated during pregnancy. If you are looking for reliable dentistry, we suggest using the convenient search engine of our website.

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

Release form

Solution in carpules in a metal container.

pharmachologic effect

Local anesthetic.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

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

Pharmacokinetics

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

Indications for use

Anesthesia for minor dental interventions:

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

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

Contraindications

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

Be careful with the following diseases and conditions:

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

Side effects

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

Instructions for Ubistezin (Method and dosage)

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

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

Instructions for Ubistezin forte

Ubistezin forte contains articaine 40 mg as well doseepinephrine 2 times more -10 mcg / ml. It is an anesthetic with an average content of vasoconstrictor, is the most effective of the painkillers. Ubistezin forte is used for long and complex extractions, with a large group of teeth. Recommended for use in apparently 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 ; at shocked- infusion electrolytes , glucocorticosteroids ; at vascular collapse- intravenously 0.1 mg; at tachycardia- intravenously selective beta blockers ; at increase in pressure- peripheral vasodilators .

Interaction

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

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

Hypertensive effect epinephrine intensifies tricyclic antidepressants .

Terms of sale

Released by prescription.

Storage conditions

At temperatures up to 250 C.

Best before date

Analogues

Coincidence in the ATX code of the 4th level:

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

Ubistezin during pregnancy

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