Ultrakain: instructions for use. "Ultracain DS Forte": instructions for use, contraindications. Solution for injection for local anesthesia Ultracain ds forte instructions for use

From this article you will learn:

• reviews on Ultracain, release forms,
• the pros and cons of the drug,
• how much does anesthesia with Ultracaine cost.

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

The anesthetic Ultracaine is a drug in the form of an injection solution that has a very high analgesic effect when locally injected into tissues. The main active component of ultracaine is the substance "articaine hydrochloride" (Articaine), which makes it possible to attribute this drug to anesthetics of the articaine series.

The most commonly used ultracaine in dentistry, due to its high efficiency. There are several forms of release of this drug, which differ from each other in the concentration of the vasoconstrictor component, which is also part of the composition. The last one is epinephrine. This component is added to articaine to locally reduce blood supply in the area of ​​anesthesia, which will reduce the leaching of the anesthetic from the tissues (while increasing the duration and depth of anesthesia).

Anesthetic Ultracain: photo

For dentistry, the anesthetic is produced not in the form of conventional injection ampoules, but in the form of special cartridges, which are called carpules (Fig. 2). Such a carpule is inserted inside a special carpule syringe, which has a piston in the form of a handle, and a special double-edged carpule needle is inserted from the side of the syringe nose (Fig. 4). When pressing on the syringe plunger, the latter presses on the movable rubber insert inside the carpule, which leads to an increase in pressure inside the carpule and the withdrawal of the anesthetic solution through the needle.

Forms of release of Ultracaine -

• ultracaine DS forte (concentration of epinephrine 1:100.000),
• ultracaine DS (concentration of epinephrine 1:200.000),
• ultracaine D (without epinephrine).

The presence of three forms of drugs is explained by the possible side effects of epinephrine, which can increase the patient's blood pressure. For completely healthy people who do not have cardiovascular and other diseases, "Ultracain DS forte" is used. With moderately elevated pressure, "Ultracaine DS" with a reduced concentration of epinephrine can be used. Nevertheless, for ultracaine, the instructions for use indicate that any of the listed forms can be used as early as 4 years of age. More details about the indications for the use of each form - we will describe below.

How anesthesia is performed in dentistry: video

Ultracaine: the price of anesthesia

The cost of 1 cartridge of Ultracaine is from 90 rubles (it is at this price that dental clinics buy it). But in the dental clinic for Ultracain, the price for anesthesia will be about 400 to 500 rubles. Unfortunately, it will not work to buy an anesthetic cartridge in a pharmacy and bring it with you. This is strictly prohibited by law, because. the dentist in this case cannot guarantee that the anesthetic is not counterfeit or that it has been properly stored. As a result, the dentist will in any case be to blame for the complications, and will be responsible for this.

Forms of release of the anesthetic Ultracaine -

Ultracain: composition
regardless of the form of release, 1 anesthetic cartridge contains articaine 40 mg, and the volume of the anesthetic solution in the cartridge will be 1.7 ml. As for the content epinephrine, then, as we said above, each of the three forms will have its own concentration of this vasoconstrictor component (vasoconstrictor). It should also be noted that ultracaine anesthetic contains a preservative sodium disulfite, which is designed to stabilize the epinephrine in the composition of the drug. At the same time, since Ultracain D is produced without epinephrine, there will be no preservatives in it.

1. Ultracain DS forte (epinephrine 1:100.000) -

2. Ultracaine DS (epinephrine 1:200.000) -

3. Ultracaine D (without epinephrine) -

Ultracain: reviews of dentists

As a practicing physician, I try to use mainly this anesthetic, although its cost is 1.5-2 times more expensive than similar anesthetics based on articaine. Due to the optimal composition, a minimum of preservatives in the composition (and the complete absence of preservatives in the form of Ultracaine D) - this anesthetic can be used in all patients at risk (with cardiovascular, endocrine disorders, allergies, pregnancy and lactation).

Ultracaine dentist reviews are also as favorable as possible because this anesthetic will be a good choice if you have an allergic reaction to amide group anesthetics, for example, and others. But in addition to a high safety profile, this anesthetic is also much stronger than its predecessors (see below). In addition, this anesthetic acts in inflamed tissues, but Novocain practically does not anesthetize in the presence of purulent inflammation.

The duration of action and the depth of anesthesia will depend on the concentration of epinephrine in the composition of the product, for example, Ultracain DS forte 1: 100,000 is the most powerful drug in the line. When conduction anesthesia is performed on the lower jaw, the duration of action is on average 2 to 3 hours.

Ultracaine or lidocaine: which is better

• ultracaine is stronger than Novocain - 5-6 times,
• more effective than Lidocaine - 1.5-2 times.

Ultracaine during pregnancy and breastfeeding

The optimal form of this anesthetic during pregnancy is Ultracaine DS with an epinephrine concentration of 1:200.000. The use of anesthetics without epinephrine (or adrenaline) in pregnant and lactating women is generally not recommended. This is due to the fact that adrenaline, by narrowing the vessels at the injection site, leads to a slowdown in the absorption of the main component (articaine) into the blood, and accordingly this will reduce the peak concentrations of articaine in the blood, and hence its possible side effects on the fetus.

Ultracaine while breastfeeding -
after anesthesia with Ultracaine, the content of articaine in breast milk is possible, but the concentration is so small that it cannot cause any harm. Therefore, there is no need to stop breastfeeding. The content of epinephrine in Ultracaine DS is also very low and cannot negatively affect either the mother or the child.

Sources:

1. Higher prof. the author's education in surgical dentistry,
2. Based on personal experience as a dental surgeon,
3. National Library of Medicine (USA),
4. "Local anesthesia in dentistry" (Baart J.),
5. https://dental.sanofi.de/.

Solution - 1 ml:

• Active substances: articaine hydrochloride 40 mg, epinephrine hydrochloride 12 µg, equivalent to the content of epinephrine base 10 µg, which corresponds to the content of epinephrine in a solution of 1:100,000.
• Excipients: sodium disulfite (sodium metabisulphite), sodium chloride, water for injections.

1.7 ml - clear glass cartridges (10) - corrugated cardboard blocks (10) - cardboard packs.

Description of the dosage form

Solution for injection is clear, colorless.

pharmachologic effect

Combined local anesthetic drug, which includes articaine (local anesthetic agent of the amide type) and epinephrine (vasoconstrictor), which is added to the composition of the drug to prolong the duration of anesthesia.

The amide structure of articaine is similar to that of other local anesthetics, but its molecule contains one additional ester group, which is rapidly hydrolyzed by esterases in the human body. The rapid degradation of articaine to its inactive metabolite (articaic acid) is associated with a very low systemic toxicity of the drug, allowing repeated injections of the drug.

Local anesthetics cause a reversible loss of sensation due to the termination or decrease in the conductivity of sensory nerve impulses directly at the injection site and around it. They have a membrane-stabilizing effect by reducing the permeability of nerve cell membranes to sodium ions.

The drug has a fast (latent period - from 1 to 3 minutes) and a strong anesthetic effect and has good tissue tolerance. The duration of anesthesia is at least 45 minutes.

Due to the very low content of epinephrine in the preparation, the effect of the latter on the cardiovascular system is insignificant: there is almost no increase in blood pressure and an increase in heart rate.

Pharmacokinetics

Suction

After submucosal administration of 2 ml of the drug, Tmax of articaine in blood plasma is 10-15 minutes, and the average value in blood plasma Cmax of articaine is approximately 400 μg / l, Tmax of articaic acid is 45 minutes, and the average Cmax of articaic acid is 2000 μg / l . In children, comparable pharmacokinetic data were obtained. Differences between plasma concentrations of articaine and articaic acid reflect the rapid hydrolysis of articaine in tissues and blood, so that the administered articaine enters the systemic circulation mainly as an inactive metabolite.

Distribution

After submucosal administration, the concentration of articaine in the blood in the region of the dental alveoli is thousands of times higher than the concentration of articaine in the systemic circulation. An inverse relationship was found between the time after injection and the concentration of articaine in the alveolus of the tooth.

Plasma protein binding of articaine is 95%.

Metabolism

All local anesthetics of the amide type are metabolized in liver microsomes. In addition, articaine in tissues and blood is also inactivated by nonspecific plasma esterases by hydrolysis in the carboxyl group. Because hydrolysis occurs very quickly and begins immediately after administration, about 90% of articaine is inactivated by this method. The resulting major metabolite of articaine, articaic acid, has no local anesthetic activity and no systemic toxicity.

breeding

After submucosal administration, the elimination of articaine occurs exponentially with a T1 / 2 of approximately 25 minutes. Articaine is excreted mainly by the kidneys as articaic acid (64.2±14.4%), articaic acid glucuronide (13.4±5%) and unchanged articaine (1.45±0.77%).

After injection of the drug into the oral mucosa, the total clearance of articaine is 235±27 l/h.

Clinical pharmacology

Local anesthetic with a vasoconstrictor component for use in dentistry.

Indications for use Ultracain ds forte

Infiltration and conduction anesthesia during dental operations on the mucous membrane or bones, when it is necessary to create conditions for more pronounced ischemia:

• operations on the pulp of the tooth (amputation or extirpation);
• removal of a broken tooth (osteotomy);
• extraction of a tooth affected by apical periodontitis;
• prolonged surgical interventions (for example, Caldwell-Luc operation);
• percutaneous osteosynthesis;
• cyst excision;
• interventions on the mucous membrane of the gums;
• resection of the apex of the tooth root;
• preparation of cavities and grinding before prosthetics of highly sensitive teeth.

Contraindications to the use of Ultracain ds forte

• Hypersensitivity to articaine or other local anesthetics of the amide type, unless, in case of hypersensitivity to these agents, allergy to articaine has been excluded using appropriate studies carried out in compliance with all necessary rules and requirements;
• hypersensitivity to epinephrine;
• hypersensitivity to the auxiliary components of the drug, incl. to sulfites (including manifested in the form of bronchial asthma).

Contraindications related to articaine

• severe dysfunction of the sinus node or severe conduction disorders (such as severe bradycardia, AV block II and III degree);
• acute decompensated heart failure;
• pronounced arterial hypotension;
• anemia (including B12 deficiency anemia);
• methemoglobinemia;
• hypoxia;
• children's age up to 4 years (lack of clinical experience);

Contraindications related to epinephrine

• paroxysmal tachycardia, tachyarrhythmia;
• angle-closure glaucoma;
• taking non-cardioselective beta-blockers, for example, propranolol (risk of developing a hypertensive crisis and severe bradycardia);
• hyperthyroidism;
• pheochromocytoma;
• severe arterial hypertension.

The drug should be used with caution in patients with angina pectoris, atherosclerosis, postinfarction cardiosclerosis, cerebrovascular accidents, a history of stroke, chronic bronchitis, pulmonary emphysema, diabetes mellitus, cholinesterase deficiency (use is possible only if absolutely necessary, because prolonged and excessively strong effect of the drug), blood clotting disorders, severe impairment of liver and kidney function, severe agitation.

Ultracain ds forte Use during pregnancy and children

Articaine crosses the placental barrier.

Due to the lack of clinical data, a decision to prescribe a drug by a dentist can only be made if the potential benefit from its use justifies the potential risk to the fetus. If it is necessary to use articaine during pregnancy, it is preferable to use Ultracain® D-S with a lower concentration of epinephrine compared to Ultracain® D-S forte or a drug that does not contain it (Ultracain® D).

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

Use in children

Contraindicated in children under the age of 4 years (lack of clinical experience).

Ultracain ds forte side effects

From the side of the central nervous system: dose-dependent reactions - stupor, sometimes progressing to loss of consciousness, respiratory disorders, sometimes progressing to respiratory arrest, muscle tremor, muscle twitching, sometimes progressing to generalized convulsions; possible - dizziness, paresthesia, hypesthesia, transient visual disturbances (blurred vision, blindness, double vision) that occur during or shortly after the injection of a local anesthetic.

Sometimes, if the correct injection technique is violated when a local anesthetic is administered in dental practice, nerve damage is possible, in particular, in such cases, damage to the facial nerve is possible, which can lead to the development of facial paralysis.

Often - headache, mainly due to the presence of epinephrine in the preparation.

From the digestive system: nausea, vomiting.

From the side of the cardiovascular system: lowering blood pressure, bradycardia, heart failure, shock. Very rarely, due to the content of epinephrine in the preparation, tachycardia, cardiac arrhythmias, and increased blood pressure may develop.

Allergic reactions: possible - hyperemia of the skin, conjunctivitis, rhinitis and angioedema. Angioedema can be manifested by swelling of the upper and / or lower lips, cheeks, swelling of the vocal cords with a feeling of "lump in the throat" and difficulty in swallowing, hives, difficulty breathing. Any of these manifestations can progress to anaphylactic shock.

Local reactions: swelling or inflammation of the mucous membrane at the injection site. In some cases, with accidental intravascular injection, ischemic zones may appear at the injection site, up to tissue necrosis.

drug interaction

Contraindicated combinations

The combination with cardiononselective beta-blockers, for example, propranolol, is contraindicated. there is a risk of developing a hypertensive crisis and severe bradycardia.

Interactions to Consider

It is possible to enhance the action of vasoconstrictors that increase blood pressure, such as epinephrine, while using tricyclic antidepressants or MAO inhibitors. Similar observations have been described for concentrations of norepinephrine 1:25,000 and epinephrine 1:80,000 when used as vasoconstrictors. The concentration of epinephrine in Ultracain® D-S is lower - 1:200,000. However, it is necessary to take into account the possibility of such an increase in action.

Local anesthetics enhance the effect of drugs that depress the central nervous system. Opioid analgesics enhance the effect of local anesthetics, but increase the risk of respiratory depression.

When injecting Ultracain® D-S to patients receiving heparin or acetylsalicylic acid, bleeding may develop at the injection site.

Ultracain® D-S increases the intensity and duration of action of muscle relaxants.

Ultracaine® D-S exhibits antagonism in relation to the effect on skeletal muscle with drugs for the treatment of myasthenia gravis, therefore, when it is used, especially at high doses, additional correction of the treatment of myasthenia gravis is required.

Ultracaine® D-S causes a slowdown in the metabolism of local anesthetic drugs.

With simultaneous use with cholinesterase inhibitors, the metabolism of local anesthetic drugs slows down.

Epinephrine is able to inhibit the release of insulin from pancreatic beta cells and reduce the effects of oral hypoglycemic agents.

Halothane may increase the sensitivity of the heart to catecholamines and therefore increase the risk of developing cardiac arrhythmias after injections of Ultracaine® D-S.

When treating the injection site of a local anesthetic with disinfectant solutions containing heavy metals, the risk of developing local reactions - swelling, soreness - increases.

Dosage of Ultracain ds forte

The drug is intended for use in the oral cavity and can only be administered to tissues where there is no inflammation. Do not inject into inflamed tissue.

The drug should not be administered intravenously.

For anesthesia with uncomplicated extraction of teeth of the upper jaw in the absence of inflammation, it is usually sufficient to create a depot of Ultracain® D-S (Ultracain® D-S forte) in the region of the transitional fold by introducing it into the submucosa from the vestibular side - 1.7 ml of the drug per tooth. In rare cases, an additional injection of 1 ml to 1.7 ml may be required to achieve complete anesthesia. In most cases, this avoids a painful palatal injection. When removing several adjacent teeth, the number of injections can usually be limited.

For anesthesia with incisions and suturing in the sky in order to create a palatine depot, about 0.1 ml of the drug is needed for each injection.

In the case of extraction of mandibular premolars in the absence of inflammation, mandibular anesthesia can be dispensed with, because. usually sufficient is infiltration anesthesia, provided by an injection of 1.7 ml of the drug per tooth. If in this way it was not possible to achieve the desired effect, an additional injection of 1-1.7 ml of the drug into the submucosa in the region of the transitional fold of the lower jaw from the vestibular side should be performed. If, in this case, it was not possible to achieve complete anesthesia, it is necessary to conduct a blockade of the mandibular nerve.

When treating cavities and grinding teeth for crowns, with the exception of the lower molars, depending on the volume and duration of treatment, the introduction of Ultracain® D-S with a lower epinephrine content into the region of the transitional fold from the vestibular side at a dose of 0.5-1.7 ml per tooth is indicated.

When performing one medical procedure, adults can enter articaine at a dose of up to 7 mg per 1 kg of body weight. It was noted that patients tolerated doses up to 500 mg (corresponding to 12.5 ml of injection solution) well.

In children older than 4 years, the dose of the drug is selected depending on the age and body weight of the child; the dose should not exceed 5 mg of articaine per 1 kg of body weight.

In elderly patients and patients with severe renal and hepatic insufficiency, it is possible to create elevated plasma concentrations of articaine. In these patients, the drug should be used at the minimum dose necessary to achieve a sufficient depth of anesthesia.

In order to avoid accidental intravascular administration of the drug, an aspiration test should always be performed before its administration.

The injection pressure should be appropriate to the sensitivity of the tissues.

Overdose

Symptoms: the first manifestations of toxic action - dizziness, motor agitation or stupor; possible bradycardia, a sharp decrease in blood pressure, respiratory failure, muscle twitching, generalized convulsions, severe circulatory disorders, shock.

Treatment: at the first manifestations of symptoms of toxic action during the administration of the drug, its administration should be stopped and the patient should be transferred to a horizontal position with raised lower limbs. It is necessary to ensure the patency of the respiratory tract and monitor hemodynamic parameters (heart rate and blood pressure). It is always recommended, even if the symptoms of intoxication seem mild, to put an IV catheter in order to be able to immediately carry out the IV administration of the necessary drugs, if necessary.

In case of respiratory disorders, depending on their severity, oxygen supply is recommended, and if there are indications for artificial respiration, endotracheal intubation and mechanical ventilation are recommended.

The introduction of centrally acting analeptics is contraindicated.

Muscle twitching and generalized convulsions can be stopped by intravenous administration of short-acting or ultra-short-acting barbiturates. It is recommended to administer these drugs slowly, under constant medical supervision (risk of hemodynamic disorders and respiratory depression) and with simultaneous oxygen supply and monitoring of hemodynamic parameters.

Often, bradycardia or a sharp drop in blood pressure can be eliminated by simply transferring the patient to a horizontal position with raised lower limbs.

In severe circulatory disorders and shock, regardless of their cause, the drug should be discontinued and the patient should be transferred to a horizontal position with raised lower limbs. It is necessary to provide oxygen supply, intravenous administration of electrolyte solutions, corticosteroids (250-1000 mg of methylprednisolone), if necessary, plasma substitutes, incl. albumin.

With the development of collapse and increased bradycardia, a slow intravenous administration of a solution of epinephrine (0.0025-0.1 mg) is shown under the control of heart rate and blood pressure. If necessary, administration in doses exceeding 0.1 mg, epinephrine should be administered by infusion, adjusting the rate of administration under the control of heart rate and blood pressure.

Severe tachycardia and tachyarrhythmia can be stopped by the introduction of antiarrhythmic drugs, with the exception of cardiononselective beta-blockers.

Increased blood pressure in patients with arterial hypertension, if necessary, should be reduced with the help of vasodilators.

Precautionary measures

The drug should not be administered intravenously. Do not inject into the inflamed area. An aspiration test should always be performed to avoid intravascular injection.

The injection pressure should be appropriate to the sensitivity of the tissue.

To prevent the introduction of infections (including viral hepatitis), it is necessary to ensure that new sterile syringes and needles are always used when taking the solution from the ampoules. Opened cartridges must not be reused for other patients.

Do not use a damaged cartridge for injections.

In patients with diseases of the cardiovascular system (chronic heart failure, pathology of the coronary vessels, angina pectoris, cardiac arrhythmias, a history of myocardial infarction, arterial hypertension), cerebrovascular disorders, a history of stroke, chronic bronchitis, emphysema, diabetes mellitus, hyperthyroidism, and also in the presence of severe anxiety, it is advisable to use the drug Ultracain® D, which does not contain epinephrine.

You can eat only after the termination of the action of local anesthesia (restoration of sensitivity).

Influence on the ability to drive vehicles and control mechanisms

Local anesthesia with Ultracain® D-S has not been shown in tests to cause any noticeable deviation from the normal ability to drive a car and participate in street traffic. However, the decision on when the patient after dental intervention can return to driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions should be made by the doctor.

Ultracaine is an anesthetic drug with a vasoconstrictive effect, intended for local anesthesia in dentistry. Ultracain is also used in gynecology for minor surgical interventions.

Release form

The dosage form of the drug is a solution for injection. This anesthetic is much stronger than Lidocaine, so there is no such form of release as Ultracaine spray, ointment or gel.

It is a colorless transparent liquid packaged in 2 ml glass ampoules or 1.7 ml glass cartridges.

Varieties and composition

The drug has two active ingredients - articaine hydrochloride and epinephrine hydrochloride (adrenaline). The type of medicine depends on the amount of the last substance in Ultracaine. There are three of them:

• Ultracaine DS Forte (amount of epinephrine 1:100,000). This anesthetic has a long duration of action. Perfectly is suitable for operative interventions and depulpation of teeth. However, anesthesia with this kind of Ultracaine is prohibited during pregnancy, breastfeeding, thyroid diseases and high blood pressure.

• Ultracaine DS (amount of epinephrine 1:200000). This variety should not be used for asthma and thyroid diseases. However, during pregnancy and lactation, anesthesia with this kind of Ultracaine is already allowed. In addition, it can be used for pain relief for people with compensated cardiovascular diseases.

• Ultracaine D without adrenaline (epinephrine) in dentistry is used for pain relief in patients with thyroid diseases, in those suffering from asthma and allergic reactions - due to the lack of adrenaline, the drug does not contain stabilizing preservatives. The drug is indicated for use in patients with hypertension and cardiovascular diseases. Of the minuses - a short time of action (about 25 minutes)

Most often, Ultracaine DS is used in dentistry, as the most versatile type of drug. We will analyze the instructions for using this particular variety of Ultracaine today.

So, what is included in 1 ml of solution:

• Articaine hydrochloride - 40mg
• Epinephrine hydrochloride - 0.006 mg
• Sodium chloride
• Sodium disulfite
• Water for injections

How much does Ultracain cost? The price varies depending on the number of ampoules in the package. A box in which 10 ampoules with a volume of 2 ml costs about 1000 rubles.

pharmachologic effect

Pharmacodynamics

1. The active active substance articaine blocks the sodium channels of the neuron membrane, and this leads to the fact that impulses along the nerve fiber go more weakly. This is how the analgesic effect is achieved.
2. Like other analgesics, it has a membrane-stabilizing effect, which is achieved by reducing the permeability of nerve cell membranes to sodium ions.
3. Acts directly at the injection site and around it
4. Acts quickly - the effect occurs in a minute or three
5. The duration of Ultracaine is about 45 minutes.

Pharmacokinetics

1. Plasma protein binding - 95%
2. After local anesthesia with Ultracaine, the half-life is 25-40 minutes
3. It practically does not penetrate the placental barrier and passes into breast milk to a minimal extent, which allows the use of Ultracaine during HB (breastfeeding) and during pregnancy
4. The metabolite obtained as a result of hydrolysis, articaic acid, has neither an anesthetic effect nor toxicity.
5. Excreted by the kidneys as articaic acid

Indications

Ultracaine is used as an anesthetic for dental treatment.
Conduction and infiltration anesthesia is carried out with it, which is necessary for dental operations:

• Uncomplicated extraction of one or more teeth
• Grinding teeth before prosthetics and, directly, fixing crowns
• Preventive measures and anesthesia of the carious oral cavity
• filling
• Removal of abscesses and treatment of wounds in the oral cavity

Contraindications

Narcosis (anesthesia) with Ultracaine is contraindicated in the following diseases and conditions:

• Artioventricular blockade 2 and 3 degrees
• Bradycardia
• All severe violations of the conduction and functions of the sinus node
• Acute decompensated heart failure
• tachyarrhythmia
• Paroxysmal tachycardia
• Chronically high or, conversely, low blood pressure
• Anemia
• hyperthyroidism
• The period of use of non-cardioselective beta-blockers
• hypoxia
• Methemoglobinemia
• Closed glaucoma
• Pheochromocytoma
• Children's age up to 4 years
• Hypersensitivity to the active ingredient of the drug and to any of its other components

Carefully:

• Blood clotting disorder
• Pronounced arousal of the patient
• Postinfarction cardiosclerosis
• angina pectoris
• Atherosclerosis
• History of stroke
• Severe liver or kidney dysfunction
• Violation of cerebral circulation
• Emphysema
• Chronical bronchitis
• Diabetes
• Cholinesterase deficiency

During pregnancy:

Often, expectant mothers are concerned about the question, is Ultracaine possible during early pregnancy? The period of bearing a child is not a contraindication to the use of the drug, the active active substance penetrates the placental barrier in small doses, but still penetrates. Therefore, during the first trimester it is better not to do dental operations, to postpone them to a later date, when the child's organs are already formed. However, it is Ultracaine that is most often used in dentistry during pregnancy, and if anesthesia cannot be avoided, this anesthetic is the most gentle.

Side effects

The use of Ultracaine can provoke the following side effects:

central nervous system

• Headache
• Dizziness
• hypoesthesia
• paresthesia
• visual disturbances
• Blindness
• Paralysis of the facial nerve due to damage to it
• Stupor
• Loss of consciousness
• Inhibition of the respiratory center (up to respiratory arrest)
• Tremor and muscle twitching

The cardiovascular system

• Decrease or increase in blood pressure
• Heart rhythm disorder
• Tachycardia
• Bradycardia
• Heart failure

Digestive system

• Nausea
• Vomit

Allergic and local reactions

• Inflammation and swelling at the injection site
• When injected into a vessel - ischemia at the injection site
• tissue necrosis
• Hyperthermia of the skin
• allergic rhinitis
• Conjunctivitis
• swelling of the face
• Anaphylactic shock

Instructions for use

Instructions for the use of Ultracaine in dentistry implies the following methods of administration and dosage of the drug:

1. The anesthetic is injected into the tissues of the oral cavity. There should be no inflammation at the injection site.
2. The degree of pressure during the introduction should be determined based on the level of tissue sensitivity
3. Intravenous administration of the drug is contraindicated
4. Before the introduction, an aspiration test is carried out, due to this, accidental injection of the drug into the vessel is excluded.
5. Dosage for anesthesia with uncomplicated extraction of teeth is calculated based on the ratio: 1.7 ml of solution per tooth
6. Removal of premolars of the lower jaw involves the use of infiltration anesthesia (1.7 mg of solution per 1 tooth), and in case of incomplete anesthesia, mandibular anesthesia is additionally performed (conduction blockade of the mandibular nerve). The dosage of the anesthetic for her is 1-1.7 ml of solution
7. Anesthesia for incisions and suturing - 0.1 ml of solution

Overdose

Symptoms:

• Dizziness
• Psychomotor agitation or, conversely, stupor
• Bradycardia
• Lowering blood pressure
• Respiratory center depression
• Cramps and muscle twitches
• Severe circulatory disorder

Treatment:

• If the above symptoms appear during administration, the intake of the drug into the body should be immediately interrupted.
• The patient is laid horizontally, with the lower limbs raised
• Provides airway patency
• Hemodynamic parameters are monitored
• It is recommended that before the administration of the drug, a catheter be placed in the patient, through which the necessary intravenous drugs can be immediately administered.

Instructions for medical use

medicinal product

Ultracain ® DS forte

Tradename

Ultracaine ® DS forte

International non-proprietary name

Dosage form

Solution for injection 1:100000

Compound

1 ml of solution contains

active substances: articaine hydrochloride 40 mg

epinephrine hydrochloride 0.012 mg,

Excipients: sodium metabisulphite, sodium chloride, hydrochloric acid 10%, sodium hydroxide, water for injection.

Description

Clear colorless liquid

Pharmacotherapeutic group

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

ATX code N01BB58

Pharmacological properties

Pharmacokinetics

The binding of articaine to plasma proteins in the blood serum is 95%. The elimination half-life after submucosal administration into the oral cavity is 25.3 ± 3.3 minutes.

10% of articaine is metabolized in the liver, mainly by plasma and tissue esterases. Articaine is then excreted via the kidneys, mainly as articaic acid.

In children, the overall exposure after vestibular infiltration is similar to that in adults, but peak serum concentrations are reached more rapidly.

Pharmacodynamics

Ultracaine ® DS and Ultracain ® DS forte are local anesthetics of the amide acid type used for terminal and conduction anesthesia in dentistry. These are fast-acting drugs (latent period - 1-3 minutes) with a strong analgesic effect and good tissue tolerance. The duration of effective anesthesia is approximately 45 minutes for Ultracaine DS and about 75 minutes for Ultracaine DS forte.

The mechanism of action of articaine is presumably based on the inhibition of the conduction of nerve fibers due to the blockade of voltage-dependent Na + channels in the cell membrane.

Pediatric population

Clinical studies involving 210 patients aged 3.5 to 16 years showed that Ultracaine ® DS at a dosage of up to 5 mg / kg of articaine and Ultracaine ® DS at a dosage of up to 7 mg / kg provides sufficient local anesthesia for (mandibular) infiltration or (maxillary) conduction anesthesia. The duration of anesthesia was the same in all age groups and depended on the volume of the administered drug.

Indications for use

Ultracaine ® DC

Ordinary operations, for example, uncomplicated extraction of one or more teeth, preparation of carious cavities and teeth for a crown.

Ultracaine ® DS forte:

Operations on the mucous membrane or on the bones, requiring more intense ischemia

Operations on the dental pulp (amputation and extirpation)

Extraction of a broken tooth (osteotomy)

Long-term surgical interventions

Percutaneous osteosynthesis

Removal of cysts

Mucogingival operations

Resection of the apex of the tooth root

Dosage and administration

With uncomplicated extraction of the teeth of the upper jaw with forceps, if there is no inflammation, it is usually sufficient to create a depot from the vestibular side of 1.7 ml of the drug per tooth. In some cases, to achieve complete anesthesia, additional administration from the vestibular side from 1 ml to 1.7 ml may be required. Usually, a painful palatine injection is not required.

With incisions or suturing in the palate, about 0.1 ml of the drug per injection is enough to create a palatine depot.

When removing several adjacent teeth, in most cases the number of vestibular injections required can be limited.

In the case of uncomplicated mandibular premolar extractions in the absence of inflammation, mandibular anesthesia is not required, since anesthesia by injection of 1.7 ml per tooth is usually sufficient. However, in case of incomplete anesthesia, an additional vestibular injection of 1-1.7 ml is recommended. Conventional anesthesia using the mandibular blockade is indicated only if the above methods failed to achieve complete anesthesia.

When treating cavities and grinding teeth for crowns, with the exception of the lower molars, the vestibular administration of Ultracaine DS at a dose of 0.5-1.7 ml per tooth is indicated, the individual dose depends on the volume and duration of treatment.

During the course of treatment, adults can be administered Ultracaine ® (articaine) at a dose of up to 7 mg per 1 kg of body weight. Doses up to 500 mg (equivalent to 12.5 ml of injectable solution) are well tolerated when using aspiration technique.

Elderly patients and patients with severe hepatic and renal impairment

In elderly patients and patients with severe renal and hepatic impairment, an increase in plasma articaine concentrations is possible. In such patients, the drug should be used with extreme caution in the minimum doses necessary to achieve a sufficient depth of anesthesia.

Pediatric population

For children, Ultracain ® DS or Ultracain ® DS forte should be used in the minimum amount necessary to achieve appropriate anesthesia; the volume of the injection is selected individually, depending on the age and body weight of the child, but not more than 7 mg of articaine per 1 kg of body weight. The efficacy and safety of the drug has not been established in children under 3.5 years of age. Therefore, the drug is not recommended for children under the age of 3.5 years.

Mode of application

Ultracain ® DS and Ultracain ® DS forte are intended for administration through the oral mucosa.

Aspiration is always recommended prior to injection to avoid intravascular injection. Aspiration is performed in two stages, i.e. by rotating the needle 90° or even better 180°. If cartridges are used, Uniject ® K or Uniject ® K vario injection syringes are particularly suitable for this purpose. Major systemic reactions resulting from accidental intravascular injection can be avoided in most cases with the injection technique - after aspiration, slowly injecting 0.1-0.2 ml and slowly injecting the remaining amount - no earlier than 20-30 seconds. The injection pressure should correspond to the sensitivity of the tissues at the injection site.

The use of suitable syringes (Uniject ® K or Uniject ® K vario for infiltration anesthesia and Ultraject ® for intraligamentous anesthesia) ensures maximum protection against glass breakage and uniformity of administration. Do not use damaged cartridges for injection.

To avoid the risk of infection (eg transmission of hepatitis), syringes and needles used to draw the solution must always be new and sterile. This medicine should not be used if it is cloudy or has changed color. The solution should be clear and colorless.

It is recommended that partially used multi-dose vials be stored as directed and that contents be used up within 2 days of first use. The date of first use of the contents of the ampoule should be noted on the label.

Side effects

Frequency unknown

Hypersensitivity reactions (allergic or pseudo-allergic nature) in the form of swelling and / or inflammatory reaction at the injection site, erythema of the skin, pruritus, conjunctivitis, rhinitis, swelling of the face (Quincke's edema) with swelling of the upper and / or lower lip and / or cheeks, edema vocal cords with a feeling of "lump in the throat" and difficulty in swallowing, urticaria and difficulty in breathing, which can progress with the development of anaphylactic shock.

Dose-dependent reactions (especially with an excessively high dose or unintentional intravascular injection) from the central nervous system: agitation, nervousness, stupor (sometimes progressing to loss of consciousness), coma, respiratory distress, sometimes progressing to respiratory arrest, muscle tremor and muscle twitching, sometimes progressing to generalized seizures

Facial palsy, reduced taste sensitivity due to anatomical conditions at the injection site or improper injection technique

Transient visual disturbances (blurred vision, double vision, dilated pupils, blindness)

Cardiac arrhythmia, increased blood pressure, hypotension, bradycardia, heart failure, and shock (possibly life-threatening)

In case of accidental intravascular injection, ischemic zones may appear at the injection site, sometimes progressing to tissue necrosis (see "Method of administration and doses").

Often (≥ 1/100< 1/10)

Paresthesia, hypoesthesia, headache (presumably due to the presence of adrenaline in the preparation)

Nausea, vomiting

Infrequently(≥ 1/1000 < 1/100)

Dizziness

Tachycardia

Very rarely

Vomiting, diarrhea, wheezing, acute asthma attacks, confusion or shock (allergic reaction to sodium metabisulphite)

Contraindications

Hypersensitivity to the components of the drug

Since Ultracaine ® DS and Ultracain ® DS forte contains articaine, drugs should not be used in cases of:

• hypersensitivity to other local anesthetics of the amide type
• severe disturbances in the formation of the cardiac impulse and conduction (for example, atrioventricular blockade of the 2nd or 3rd degree, severe bradycardia)
• acute decompensated heart failure (acute congestive heart failure)
• severe hypotension

• in patients with angle-closure glaucoma
• in patients with hyperthyroidism
• in patients with paroxysmal tachycardia or absolute arrhythmias with palpitations

In patients with recent (3 to 6 months) myocardial infarction

In patients who recently (3 months ago) underwent coronary bypass surgery

• in patients taking non-cardioselective beta-blockers, such as propranolol (risk of developing a hypertensive crisis or severe bradycardia)
• in patients with pheochromocytoma
• in patients with severe hypertension
• with simultaneous treatment with tricyclic antidepressants or MAO (monoamine oxidase) inhibitors, since these active substances can increase the effect of epinephrine on the cardiovascular system. This can occur up to 14 days after the end of therapy with MAO inhibitors.

- intravenous administration is contraindicated

Drug Interactions

The combination of different anesthetics causes an additive effect on the cardiovascular system and CNS (central nervous system).

The action of vasoconstrictor drugs that increase blood pressure, such as sympathomimetics (such as epinephrine), may be enhanced by tricyclic antidepressants or MAO inhibitors, so their use is contraindicated.

Ultracain ® DS and Ultracain ® DS forte should not be used in patients taking non-cardioselective beta-blockers (eg propranolol). Epinephrine can inhibit the secretion of insulin from the pancreas, thereby reducing the effectiveness of oral antidiabetic drugs.

Some inhalational anesthetics, such as halothane, can increase myocardial sensitivity to catecholamines and thus cause arrhythmia after administration. Ultracaina DS and Ultracaina DS forte.

It should be remembered that in patients taking antithrombotic agents (for example, heparin or acetylsalicylic acid), an accidental puncture of the vessel during local anesthesia can cause serious bleeding (in such patients, as a rule, there is an increased tendency to bleed).

special instructions

In patients with cholinesterase deficiency, Ultracaine ® DS and Ultracain ® DS forte should be used only for special indications, since there is a possibility of prolongation and, sometimes, excessive enhancement of the drug's effect.

Ultracain ® DS and Ultracain ® DS forte should be used with extreme caution in cases of:

Blood clotting disorders

Severe impairment of liver and kidney function

Concomitant treatment with halogenated inhalation anesthetics (see "Drug Interactions")

Epilepsy history (see "Side effects")

In addition, the use of Ultracain DS and Ultracain DS forte should be prescribed with caution, taking into account the minimum content of epinephrine for patients with:

Cardiovascular disease (eg, heart failure, coronary artery disease, angina pectoris, history of myocardial infarction, cardiac arrhythmias, hypertension)

atherosclerosis

Impaired cerebral circulation, history of stroke

Chronic bronchitis, emphysema

diabetes mellitus

Strong feelings of anxiety

Injections into inflamed (infected) areas are not recommended (there is an increased absorption of Ultracaine DS and Ultracaine ® DS forte with reduced efficiency).

Before using this drug, ask the patient questions about the history of the disease, concomitant treatment, maintain a dialogue with the patient and test the drug in an amount corresponding to 5 or 10% of the dose in case of a risk of developing allergies.

To avoid side effects, the following rules must be followed:

• choosing the lowest effective dose
• two-stage aspiration before injection (to prevent accidental intravascular injection)

Nerve damage is theoretically possible in any dental procedure due to anatomical conditions at the injection site or improper injection technique. In such cases, the facial nerve may be damaged and its paresis may occur. This can lead to decreased taste sensitivity.

Transient visual disturbances (blurred vision, double vision, dilated pupils, blindness) occurring during or shortly after injection of a local anesthetic into the head.

Methyl 4-hydroxybenzoate (E.F.) may cause allergic reactions (possibly delayed) and, in exceptional cases, bronchospasm.

Intravenous administration is contraindicated

Since Ultracain ® DS and Ultracain ® DS forte contain epinephrine, drugs are not prescribed for anesthesia of extremities (eg fingers) due to the risk of ischemia. Ultracain ® DS and Ultracain ® DS forte should not be used in patients with bronchial asthma with hypersensitivity to sulfites. In such individuals, Ultracaine ® DS and Ultracaine ® DS forte may cause acute allergic reactions with anaphylactic symptoms such as bronchospasm.

Pediatric population

In published studies, the safety profile was similar in children and adolescents aged 4 to 18 years compared with adults. However, accidental soft tissue injuries are more common (up to 16% of children), especially in 3-7 year olds, due to prolonged soft tissue anesthesia. In a retrospective study of 211 children aged 1 to 4 years, dental treatment was performed using a dose of Ultracaine DS or Ultracaine DS forte up to 4.2 ml, without side effects.

Educators of young children should be warned about the risk of accidental soft tissue injury associated with self-biting due to prolonged soft tissue numbness.

The efficacy and safety of the drug has not been established in children under 3.5 years of age. Therefore, the drug is not recommended for children under the age of 3.5 years. Ultracain ® DS and Ultracain ® DS forte contain sodium, but less than 1 mmol (23 mg) of sodium per 1 ml.

Pregnancy

There is no experience with the use of articaine in pregnant women, except for use during childbirth. Preclinical studies have not revealed direct or indirect adverse effects of articaine on pregnancy, embryonic/fetal development, childbirth or postnatal development of the child; but showed that epinephrine has a toxic effect on the reproductive system in doses exceeding the maximum recommended. Epinephrine and articaine cross the placental barrier, although articaine penetrates to a lesser extent than other local anesthetics. Serum concentrations of articaine measured in neonates were approximately 30% of maternal levels. In case of accidental intravascular administration of epinephrine to the mother, it can reduce uterine perfusion. During pregnancy Ultracaine ® DS and Ultracain ® DS forte should only be used after a thorough benefit/risk analysis.

It is preferable to use Ultracaine ® DC (1:200,000) due to the lower content of epinephrine.

Lactation

Due to the rapid decline in serum levels and rapid elimination, clinically significant amounts of articaine are not found in breast milk. Epinephrine passes into breast milk, but also has a short half-life. There is usually no need to interrupt breastfeeding for short-term use.

Fertility

Preclinical studies with 40mg/ml articaine + 0.01mg/ml epinephrine showed no effect on fertility. At therapeutic doses, adverse effects on human reproductive function are not expected.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

After using Ultracain DS or Ultracain DS forte, the dentist must decide when the patient will be able to drive or use machines again. Patient anxiety and stress associated with surgery may affect the ability to perform these activities; although, in relevant studies, local anesthesia with articaine did not lead to a noticeable impairment in driving ability.

Overdose

Symptoms

CNS stimulation: agitation, anxiety, confusion, hyperpnea, tachycardia, increased blood pressure with facial flushing, nausea, vomiting, tremors, muscle twitches, tonic-clonic epileptic seizures.

CNS suppression: dizziness, hearing impairment, loss of speech, stupor, loss of consciousness, muscle atony, vasomotor paralysis (weakness, pallor), dyspnea, death from respiratory paralysis.

Cardiovascular suppression: bradycardia, arrhythmia, ventricular fibrillation, hypotension, cyanosis, cardiac arrest.

Treatment: at the first manifestations of side effects or intoxication, such as dizziness, motor agitation or stupor, the injection should be stopped and the patient should be transferred to a horizontal position. The patient's airway should be secured and the pulse and blood pressure should be monitored.

Even if the symptoms of intoxication do not seem severe, it is recommended to place an intravenous catheter for immediate intravenous injection if necessary.

In case of respiratory disorders, depending on their severity, oxygen supply is recommended, and if necessary, artificial respiration, as well as, if necessary, endotracheal intubation and controlled ventilation of the lungs.

Muscle twitching or generalized convulsions may be treated with intravenous administration of short-acting antispasmodics (eg, suxamethonium chloride, diazepam). In addition, artificial lung ventilation (oxygen) is recommended.

Decreased blood pressure, tachycardia, or bradycardia can be corrected by simply placing the patient in a supine or slightly head down position.

In severe circulatory disorders and shock, regardless of their cause, it is necessary to stop the administration of the drug and immediately take the following urgent measures:

Place the patient in a supine or head-down position and secure an airway (oxygen supply)

Provide intravenous infusion (balanced electrolyte solution),

Intravenous glucocorticoids (for example, 250-1000 mg of prednisolone or an equivalent volume of a derivative, for example, methylprednisolone),

Replenishment of the volume of circulating blood (additionally, if necessary, plasma substitutes, human albumin).

In the event of vascular collapse and increasing bradycardia, immediate intravenous administration of a solution of epinephrine (adrenaline) is indicated. Dilute 1 ml of 1:1000 epinephrine standard solution to 10 ml (1:10,000 epinephrine solution can be used instead) and slowly inject 0.25-1 ml of this solution (0.025-0.1 mg epinephrine) intravenously while monitoring pulse and blood pressure (may develop cardiac arrhythmia). Do not inject more than 1 ml (0.1 mg epinephrine) per intravenous injection. If additional doses are necessary, it is recommended to administer them together with the infusion solution (the infusion rate is adjusted taking into account heart rate and blood pressure).

Severe forms of tachycardia and tachyarrhythmia can be eliminated by the use of antiarrhythmic drugs, but non-cardioselective beta-blockers such as propranolol should not be used (see "Contraindications"). In these cases, it is necessary to use oxygen and control hemodynamic parameters.

With an increase in blood pressure in patients suffering from hypertension, peripheral vasodilators should be used, if necessary.

Very often, people do not have enough time to visit the dentist. To maintain healthy teeth, you need to have an oral examination at least twice a year. This allows you to timely eliminate emerging problems on the teeth. But there are frequent cases when a person treats with strong sensations of pain. During the examination, an advanced stage of pulpitis or caries is detected. In this case, treatment without anesthesia is almost impossible, as the dentist is faced with exposed nerves of an already diseased tooth.

More recently, this issue was resolved with the help of arsenic. It was placed in the cleaned cavity of the tooth and covered with a temporary filling for several days. Exposure to arsenic has a detrimental effect on the nerves, which subsequently allows the doctor to clean the tooth and carry out a filling.

To date, anesthesia in dentistry is different. Ultracaine completely changed the idea of ​​local anesthesia in dentistry. 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 complex for conduction anesthesia. Good for reducing patient pain. The pharmacological effect of this remedy is explained by its vasoconstrictive ability and analgesia. Ultracaine is used during tooth extraction, as well as during 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 withdrawal time of the drug is 6-11 hours. During this time, the body is cleansed, and the remains are excreted through the bladder and kidneys.

Side effects during the use of ultracaine are minimal, because 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 the reaction is noted, therefore, after using it, it is not recommended to drive a car or work that is associated with a quick reaction.

During pregnancy, dental treatment is allowed to use this tool, because it contains a minimum amount of epinephrine. Ultracaine does not have the ability to pass through the placental shield, that is, in no way can 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 drug is not administered intravenously, and it does not inject into the inflamed area. An injection is made in a neighboring honor.

Eating is possible only after the ultracaine finishes its effect, this is indicated return of sensitivity.

Instructions for using ultracaine also define age restrictions. The beginning of the use of the drug is possible from the age of 4 years. After 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;
• Sealing and removal with complications - 1.5 ml.

If the drug is used in the complex of conduction anesthesia, then the drug is administered in a volume of not 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 agent correspond to the sensitivity of the tissues. The highest allowable dosage for performing local anesthesia in one session:

• Children - 5 ml;
• Adults - 7 ml.

Sharing of medicine with anticoagulants and inhibitors is inadmissible. During their simultaneous use, an increased hypertensive effect of ultracaine is noted.

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

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

During the use of each new set, only new sterile syringes should be used. This keeps you safe from infection. An open vial should be stored clearly according to the instructions, taking into account the temperature regime and the need to use it within 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 for 5 years.

Types of ultracaine

To date There are three types of this drug:

Indications for use

Anesthesia with ultracaine is widely used in dentistry. as an anesthetic drug. Used for local anesthesia. It can also be used as a conductive anesthetic drug. Its effect and the absence of significant side effects makes it possible to use ultracaine during pregnancy. It is forbidden to use the drug when there is alcohol in the blood.

Used for local anesthesia during the following dental procedures:

• removal;
• filling;
• preventive actions;
• fastening 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 - to use with caution under the strict control of the dentist over the vital signs of a person.

Absolute contraindications are:

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

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

Side effects

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

Also, during the use of ultracaine in dentistry, such side effects at the injection site as the appearance of tumors and inflammation.

There are negative reviews about the drug when, after use, an ischemic disorder appeared in the tissues at the site of its administration. This appears after improper use of the agent (getting into the blood vessel). This side effect is not associated with exposure to ultracaine. Instructions for the drug indicate how to prevent these phenomena.

During an overdose of ultracaine, side effects are significantly increased and may lead to convulsions, vomiting, stop breathing and heartbeat, 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, freeing the airways, pressure and pulse are monitored. Taking into account the subsequent condition of the patient, treatment is performed, which consists in supplying oxygen with a mask. During swelling of the larynx, tracheal intubation is performed with constant control of lung ventilation. With severe disorders of the cardiovascular system, antiarrhythmic drugs are administered.

When convulsions occur, intravenous barbiturate injection 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, depulpation of teeth from 4 years. Before the injection, the dentist will certainly test for allergies, refuse to use when the remedy 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 preparation with a pleasant taste, which has a positive effect on the perception of the whole procedure by a person.

To date, the implementation of local anesthesia is the main method of anesthesia in dentistry, during which the person is conscious, but does not feel any pain. The dentist, on the other hand, has the ability to control his condition, calm him down, communicate, which favorably affects the successful treatment.