Going to the dentist is a responsible matter that requires strong nerves. Whether it's a bad tooth, inflamed jaw nerve or gum, all this is accompanied by severe pain, the inability to lead a normal life. Fear of intervention and fear of pain often leads the patient to postpone his visit to the doctor until the last.
Good painkillers used in dentistry help to solve this problem. One of them is "Ultracain D". It negates all the fears of patients, completely blocking the sensitivity at the site of manipulation.
Why is this drug preferred by most dentists?
Features
There are many different painkillers used in dentistry. The most famous of them are Novocaine and Lidocaine.
Dentists, knowing that the fear of their patients sometimes does not allow them to provide timely and proper medical care, prefer to use the most powerful painkillers in their practice. This is also related tothe fact that there are a large number of nerve fibers in the jaw area.
In terms of the strength of anesthesia, "Ultracain D" is 5 times more effective than "Novocaine" and "Lidocaine" - 2 times.
In addition, this variety of "Ultracaine" does not contain epinephrine, present in the other two forms of the drug. Epinephrine has a number of contraindications and is not allowed for use in patients with intolerance to this component.
The content of epinephrine in the composition of the anesthetic also provides for the presence of appropriate preservatives in it to preserve it, which may be allergenic for patients.
Thus, this form of the drug is optimal for use in people with a high likelihood of an allergic reaction, including those diagnosed with bronchial asthma.
Description
"Ultracain D" is available as a colorless transparent solution for injection.
1 ml contains: active ingredient - articaine hydrochloride (40 mg), additional ingredients - water for injection and sodium chloride.
The drug is classified as a local anesthetic of the articaine series.
Used as an injection in dental practice for conduction and infiltration anesthesia.
Freezing effect with loss of sensitivity of the area into which the injection was made occurs within 1-3 minutes. This effect lasts about 20 minutes.
Because articaine is rapidly degraded in the body to a non-toxic acid, repeated administration of the drug is allowed if necessary.
This anesthetic accumulatesin the liver, not excreted in breast milk, crosses the placenta, excreted by the kidneys.
Indications
"Ultracain D" (the composition excludes the presence of epinephrine) is permissible to apply to groups of patients with intolerance to sulfites.
Also, this anesthetic is allowed for conditions that are contraindications for other forms of "Ultracaine" containing epinephrine. These are diseases of the heart and blood vessels, tachyarrhythmia, tachycardia (paroxysmal), the use of non-cardioselective beta-blockers, pheochromocytoma, angle-closure glaucoma, hyperthyroidism, severe arterial hypertension.
Anesthetic "Ultracain D" instructions for use in dentistry recommends using for the following purposes:
- conduction and infiltration anesthesia of the oral cavity in patients with epinephrine intolerance;
- short-term dental operations (e.g. canines, incisors);
- cleaning carious areas of the tooth;
- grinding teeth for prosthetics;
- manipulations requiring a small amount of anesthetic.
Contraindications
Contraindications for the use of "Ultracain D" include such conditions as:
- intolerance to articaine and other amide-type anesthetics;
- serious cardiac conduction disorders;
- acute heart failure;
- severe hypotension;
- vitamin deficiency anemiaQ12;
- hypoxia;
- cholinesterase deficiency;
- CNS diseases;
- long-term or lengthy dental operations;
- patient age up to 4 years.
Use with care
We remind you that "Ultracain D" contains articaine, which crosses the placenta. In this regard, the decision to use this anesthetic in pregnant patients should be made by the doctor.
Articaine, unlike other local painkillers, crosses the placenta in very small amounts, but approval for its use can only be justified if the potential benefit outweighs the risk to the fetus and mother.
For lactating women, the drug is not contraindicated, since articaine is quickly excreted from the body and does not pass into breast milk.
How to use
"Ultracain D", the instruction warns, it is not recommended to inject into inflamed tissues.
Before administering the drug, it is necessary to conduct an aspiration test in order to avoid getting the solution into the blood vessel. To do this, after inserting the syringe needle into the area of the planned injection, it is necessary to slightly pull the syringe plunger in the opposite direction and make sure that no blood has appeared in the drug solution. The presence of blood in the syringe indicates that the needle has pierced a blood vessel, then the injection site or depth should be changed.
If the test result is negative, the drug can be injected into the selected area to numb it.
Dosage
Forinfiltration anesthesia requires 1.7 ml of the drug for one or two adjacent teeth.
For conduction anesthesia below the alveolar nerve, 1-1.7 ml of solution will be needed.
The maximum allowed dose for adult patients is 4 mg per 1 kg of body weight.
Side effects
What undesirable consequences can cause "Ultrakain D"? Instructions for use in dentistry warns that after the introduction of an anesthetic, side effects such as dizziness, weakness, hearing loss, headache, drowsiness may occur.
If the dosage of the drug is exceeded, the patient may experience impaired consciousness or breathing, as well as convulsions.
Dyspeptic disorders - vomiting, nausea - can also be caused by the administration of the drug.
Disturbances in the system of the heart and blood vessels after the injection of "Ultracain D" may be as follows: lowering blood pressure, heart rhythm disturbance, heart failure, collapse, bradycardia, chest pain.
Before using the drug "Ultracain D" the instruction should be well studied. The anesthetic may be allergenic for patients, therefore it is recommended to conduct a preliminary test for sensitivity to this anesthetic.
The following symptoms indicate an allergy to the drug: redness of the skin, swelling at the injection site, urticaria, itching, rash, rhinitis, conjunctivitis, swelling of the face (swelling of the lips), swelling of the larynx, shortness of breath, anaphylactic shock.
If the tissue of nerve fibers is damaged, paresis of the facial nerve, paresthesia of the tongue can occurand lips, loss of sensation and taste perception.
Overdose care
Ultracain D is well tolerated by most patients. However, precautions should not be neglected when using it.
Symptoms of an overdose of the drug are: loss of consciousness, dizziness, bradycardia, excessive motor activity, decreased blood pressure.
Help: to give the patient's body a horizontal position with legs raised up. Provide fresh air and make sure airways are clear.
When using the anesthetic "Ultracain D", the instructions for use recommend monitoring blood pressure and heart rate.
If breathing is difficult, give the patient oxygen. When breathing stops, artificial ventilation of the lungs is indicated. With laryngeal edema - endotracheal intubation and mechanical ventilation.
For convulsions - administer intravenous barbiturates, give the patient oxygen, control hemodynamics.
For shock and severe circulatory problems, administer intravenous albumin, plasma substitutes, glucocorticoids, electrolytes.
Interaction
Since the anesthetic in question does not contain epinephrine (an analogue of adrenaline), which is a vasoconstrictor, it is obvious that "Ultracain D" without adrenaline, when used with anticoagulants, increases the risk of bleeding.
Like any local anesthetic, the drug enhances the effect of drugs that depress functionsCNS.
10 days before the use of anesthetic, it is necessary to stop the use of MAO inhibitors. This will reduce the risk of hypotension.
Vasoconstrictors and narcotic analgesics enhance and prolong the effect of the drug. The latter, at the same time, can cause depression or respiratory arrest.
Reviews
About the drug "Ultracain D" reviews boil down mainly to the fact that it has a good, but short-term analgesic effect.
Patients treated with this anesthetic during dental procedures note the following:
- the drug is sold in almost all pharmacies at an affordable price;
- this anesthetic relieves pain well, completely removing sensitivity and pain;
- the action of the drug is short-term, which allows you to quickly get rid of numbness, freely talk and eat;
- optimal anesthetic for those who do not like the long-term freezing effect of such drugs;
- good anesthetic option for people with asthma or thyroid disease;
- Unlike "Ultracaine" containing epinephrine, this drug does not cause heart problems such as palpitations, bradycardia, etc.
"Ultracain D", patient reviews confirm this, is very popular. The disadvantages, as well as the advantages, include only its short-term effect as an anesthetic.
Despite the fact that the drug can beindependently purchase at a pharmacy and take with you to an appointment with a dentist, you should consult a doctor before buying. Only a specialist can determine how long the procedure will take and may suggest using a longer acting drug.
Ultracain D forte
Trade name of the drug: "Ultracain D-S forte". Used in dental practice as a local anesthetic.
Produced as a clear, colorless solution for injection.
1 ml of anesthetic contains: articaine hydrochloride (40 mg) - active substance, epinephrine hydrochloride (0.012 mg) - active substance; sodium disulfite, water for injection, sodium chloride - excipients.
The ratio of epinephrine to articaine in this form of the drug is 1:100000, which is indicated on the packaging of the anesthetic.
Features
Epinephrine (analogous to adrenaline) as part of the anesthetic is a vasoconstrictor and allows you to prolong the analgesic effect of articaine.
The low toxicity of the drug allows its repeated administration if necessary.
This anesthetic temporarily desensitizes the nerve fibers at the injection site.
Tissue freezing effect occurs within 3 minutes after injection and lasts at least 75 minutes.
Indications
The drug is used in dental practice for infiltration and conduction anesthesia, which is required for operations on the oral mucosa or ontooth pulp, to remove a broken tooth, with long-term surgical interventions.
Contraindications
This anesthetic is contraindicated in almost the same cases as "Ultracain D" described above. This is due to the common active ingredient in both drugs - articaine. Only long-term oral surgery is not a contraindication for this anesthetic, as epinephrine prolongs its action.
However, epinephrine itself has a number of contraindications that apply to this form of release of "Ultracaine".
These include:
- intolerance to sulfites and other substances in the composition of the anesthetic;
- bronchial asthma;
- tachyarrhythmia;
- paroxysmal tachycardia;
- thyroid disease;
- severe arterial hypertension;
- use of non-cardioselective beta-blockers;
- glaucoma (angle-closure).
Use with caution if the patient has angina pectoris, cardiosclerosis, cerebrovascular accident, atherosclerosis, stroke, pulmonary emphysema, diabetes mellitus, chronic bronchitis, severe kidney or liver dysfunction, cholinesterase deficiency, blood clotting disorders, in an overly excited state.
Use during pregnancy
"Ultracain D" is undesirable during pregnancy, because articaine crosses the placenta. But if the need for an anesthetic is great, it is better to choose a form"Ultracaine", which does not contain epinephrine or contains it in a lower dosage than "Ultracaine D-S forte"
For lactating women, the drug is not contraindicated, since its amount in breast milk is very small.
Dosage and method of administration
It is recommended to inject the drug only in those areas where there is no inflammation.
This anesthetic must not be allowed to enter the bloodstream!
To perform one treatment procedure for an adult patient, a dose of anesthetic is sufficient at the rate of: per 1 kg of weight - no more than 7 mg of the drug.
For children over 4 years old, the maximum dose of painkillers should not be more than 5 mg of solution per 1 kg of body weight.
Elderly patients and those with severe hepatic or renal insufficiency should not administer more than the minimum dose required to achieve pain relief.
Adverse reactions of the body to the drug
The side effects of this form of release of "Ultracaine" are the same as those of "Ultracaine D". However, the presence of epinephrine in solution can cause additional negative reactions from the body. True, such complications occur extremely rarely, they include tachycardia, heart rhythm disturbance, increased blood pressure.
If the drug enters a blood vessel, areas of necrosis may occur at the injection site.
Ultracain D-S
The only form of release of "Ultracaine" that does not contain epinephrine is "Ultracaine D". "Ultracain D-S", inin turn, includes epinephrine, but at a lower dosage than Ultracain D-S forte.
Composition
1 ml of anesthetic contains 40 mg of articaine and 0.006 mg of epinephrine. The ratio of epinephrine to articaine in this form of the drug is 1:200,000. Additional substances are also included in the solution: water for injection, sodium disulfite, sodium chloride.
Features
When this anesthetic is injected, its effect occurs after 3 minutes and lasts at least 45 minutes.
Due to the small dose of epinephrine, the drug does not have a significant effect on the heart, which allows it to be safely used for longer medical procedures.
Indications
Conduction and infiltration anesthesia for dental operations such as:
- tooth extraction;
- grinding teeth for prosthetics;
- treatment of carious teeth.
Contraindications
Since the ratio of epinephrine to articaine in the composition of the drug "Ultracaine D-S" is 1:200,000, contraindications to the use of this anesthetic are mainly associated with sensitivity in patients to articaine.
The drug is contraindicated in bronchial asthma and hyperthyroidism due to epinephrine, which, although in a small dose, is present in the composition of the anesthetic.
Yet this form of "Ultracaine" is relatively safe for use in pregnant and lactating patients, people with compensated diseases of the heart and blood vessels.
Attention! The drug must not enter the blood vessels andinflamed tissue!
All other recommendations for the use of this anesthetic: interaction with other drugs, side effects, contraindications, indications, consequences of an overdose, are the same as the instructions prescribed for "Ultracain D-S forte".
Issue form
All 3 types of "Ultracain D" are available as a solution in ampoules of 2 ml (10 pcs in a package) or in cartridges with a capacity ("Ultracain D") 1, 7; 100 per box.
Before using the anesthetic, you must carefully read the instructions, check the expiration date of the solution, make sure the upcoming procedure is sterile, conduct a drug sensitivity test and an aspiration test.
After the injection, it is recommended to carefully monitor the patient's condition and, if necessary, take the necessary first aid measures.
