Available painkillers: esters and amides
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2 Certificate GMP-0036-000221/18
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11 On the Russian market there are so-called cosmetic products containing lidocaine and not registered as medicines
12 Cling film can be used as an occlusive dressing
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Indications for use
Local anesthetic preparations are widely used in dentistry for infiltration anesthesia - during tooth extraction (removal) and minor operations on the periodontium (gums).
In order to achieve superficial anesthesia, local anesthetics are used in ophthalmology - in the form of eye drops during operations on the conjunctiva (for laser vision correction, removal of foreign bodies from the eye) and the cornea.
In addition, local anesthetics for superficial anesthesia are used for wounds, minor surgical operations on the skin and mucous membranes, and for ulcers, including gastric ulcers - some local anesthetic preparations (for example, benzocaine) are part of combination drugs that reduce the acidity of gastric juice (antacids).
Certain drugs (lidocaine) are used in endoscopic diagnostics to facilitate the procedure - anesthesia of the pharynx before inserting a tube through the mouth or nose; placement of a urinary catheter.
To achieve conduction anesthesia, local anesthetics are used for pain relief during childbirth (epidural anesthesia), operations on the pelvic organs and lower extremities.
The local anesthetic lidocaine, in addition to its local anesthetic effect, has an antiarrhythmic effect, so it is also used for heart rhythm disturbances - arrhythmias.
Benefit
Local anesthesia provides pain relief for dental surgery and other outpatient procedures.
Local anesthesia is used when:
- the operation is minor and does not require general or regional anesthesia
- the procedure can be performed quickly and the patient does not have to stay overnight
- the operation does not require muscle relaxation or loss of consciousness of the patient
Examples include dental surgery, removal of warts, moles or cataracts, and biopsy.
Features of treatment with local anesthetics
For conduction and infiltration anesthesia, only sterile solutions of local anesthetics are used.
The effect of local anesthetics is weak or practically absent during inflammation - increased acidity (acidosis) is observed in inflamed tissues, which prevents the entry of local anesthetic drugs into the nerve cell, which is critical for the development of the drug’s effect.
Certain local anesthetics (articaine, lidocaine) can be combined with vasoconstrictor drugs, in particular with adrenaline (epinephrine). This helps the local anesthetic stay at the injection site longer without entering the systemic circulation. At the same time, the duration of the local anesthetic effect of the drug increases several times. In addition, adrenaline reduces the toxic effect of local anesthetics on the body.
Considering that local anesthetics (especially esters) often cause allergic reactions, before using these drugs it is advisable to determine individual sensitivity to them - inject the patient with a small amount of local anesthetic solution under the skin of the forearm and assess the reaction after five to ten minutes.
Basics of local anesthetic treatment
Preparations for conduction and infiltration anesthesia are produced exclusively in the form of solutions for injection; they are classified as prescription drugs. The administration of these drugs is carried out strictly by medical personnel in a clinical setting and under the mandatory supervision of a doctor.
From the moment of administration of the local anesthetic to the development of local anesthesia, it takes from several minutes to half an hour - it all depends on the specific drug. Therefore, you need to wait for the effect of the drug and not re-introduce it - this is dangerous due to the development of the toxic effect of the local anesthetic.
The duration of the effect of local anesthetics is different and depends on the chemical structure of the drug: esters of para-aminobenzoic acid are quickly destroyed by special esterase enzymes in human tissues, while substituted acetanilide amides are insensitive to the action of these enzymes, and therefore have a much longer local anesthetic effect.
