Safety Of Local Anesthesia Research Articles

Endodontic Treatment During Pregnancy: Knowledge of General Dental Practitioners and Interns in Zliten, Libya

This study was conducted to assess the knowledge of dental interns and general dentists about providing endodontic treatment to pregnant patients in Zliten-Libya. A descriptive, cross-sectional study was conducted using self-administered, closed ended questionnaire which was circulated among 127 dental interns and general dentists in Zliten-Libya. The questionnaire included demographical items and questions relative to the participant's knowledge regarding the endodontic treatment during pregnancy. The analysis of data was carried out using SPSS 26. 84% of survey participants indicated the second trimester as the safest period for endodontic treatment. 95% of respondents considered the need for a specific chair position among which 58% identified the correct one. 72% and 65% of respondents indicated the safety of local anaesthetics with vasoconstrictors and use of aspiration technique, respectively. 22% of respondents identified the toxicity of bupivacaine. 64% of respondents considered the safety of either root canal irrigants or intra-canal medicaments. The obturation materials were considered safe by 74% of respondents. 49% of respondents indicated the safety of radiographic examination among which 67% preferred RVG technique. 58% of respondents preferred acetaminophen for pain control. Dental interns and general dentists in Zliten exhibited a sufficient knowledge regarding the safety of endodontic treatment during pregnancy and required to improve their knowledge particularly regarding the safety of some local anaesthetics and radiographic examination during endodontic treatment.

Safety of Local Anesthesia in Coil Embolization of Aneurysms: A Systematic Review and Meta-analysis (P3-5.003)

Safety of Local Anesthesia in Coil Embolization of Aneurysms: A Systematic Review and Meta-analysis (P3-5.003)

Advancing ocular safety research: A comprehensive examination of benzocaine acute exposure without animal testing

Benzocaine is a widely employed local anaesthetic; however, there is a notable dearth of preclinical and clinical evidence regarding its safety in ophthalmological products. To address this, a comprehensive strategy incorporating in silico and in vitro methodologies was proposed for assessing benzocaine's ocular toxicity without animal testing. To collect the in silico evidence, the QSAR Toolbox (v4.5) was used. A single exposure to two benzocaine concentrations (2% and 20%) was evaluated by in vitro methods. Hen’s Egg Chorioallantoic Membrane Test (HET-CAM) was performed to evaluate the effects on the conjunctiva. To study corneal integrity, Short Time Exposure test (STE) and Bovine Corneal Opacity and Permeability (BCOP) assay, followed by histopathological analysis, were carried out. Results from both in silico and in vitro methodologies categorize benzocaine as non-irritating. The histopathological analysis further affirms the safety of using benzocaine in eye drops, as no alterations were observed in evaluated corneal strata. This research proposes a useful combined strategy to provide evidence on the safety of local anaesthetics and particularly show that 2% and 20% benzocaine solutions do not induce eye irritation or corneal damage, supporting the potential use of benzocaine in the development of ophthalmic anesthetic products.

РАЗРАБОТКА СОСТАВА, ТЕХНОЛОГИИ И ИСПЫТАНИЯ ПОЛИКОМПОНЕНТНЫХ СУППОЗИТОРИЕВ С ЭКСТРАКТОМ ПОСКОННИКА КОНОПЛЯНОГО

Hemorrhoids are one of the most common pathologies among rectal diseases, which most often affects residents of large cities around the world. This fact is explained primarily by the fact that the development of hemorrhoids is facilitated by a sedentary lifestyle of the urban population, bad habits, irregular and unbalanced nutrition, and abuse of fast-food products. The most effective way to treat hemorrhoids is surgery. However, drug therapy is no less important, both at the stage of conservative treatment and in the postoperative period. Most often, hormonal and antibacterial drugs are used to treat hemorrhoids. However, as medical practice shows, their use does not always provide a long-lasting and sustainable antihemorrhoidal effect, and is also characterized by a number of side effects associated with the possibility of systemic absorption of the active components of the drugs. In this regard, the search and development of new safe and effective drugs for the treatment and prevention of exacerbations of hemorrhoids is an urgent task of modern pharmaceutical science. When designing drugs for the treatment of hemorrhoids, it is necessary to take into account the combined clinical picture of this disease, including such manifestations as swelling, inflammation, pain, itching and burning in the rectal area. Thus, it seems appropriate to create a multifunctional antihemorrhoidal drug, which includes components of anti-inflammatory, antimicrobial and anesthetic action. It is possible to ensure such a rational combination by combining synthetic drugs and complexes of biologically active substances of plant origin One of the compositions suitable for the development of an antihemorrhoidal drug is, in our opinion, the combined presence of benzocaine and dry herb extract. Benzocaine is well known as an affordable, effective and safe local anesthetic used for local pain relief. Hemp sapling herb, in turn, is often used in folk medicine as a wound-healing, anti-inflammatory, antimicrobial, decongestant for the treatment of bruises, burns, infected wounds and ulcers of various etiologies. The most rational form for the combination of benzocaine and dry sapling herb extract proposed above seems to be suppositories. In this regard, the purpose of this study was to develop the composition, technology and testing of anti-hemorrhoidal suppositories from the sapling grass with dry extract and benzocaine. It has been established that the developed recipe for rectal suppositories on a hydrophilic basis containing polyethylene oxide 400 and 1500 is distinguished by the necessary technological properties, high bioavailability and meets the requirements of the State Pharmacopoeia of the Russian Federation XV edition.

Local anesthesia for Altis® single incision sling in women with stress urinary incontinence

Objective Local anesthesia for single incision slings has shown a good objective and subjective cure rate in women with stress urinary incontinence. The aim of the present study was to verify the efficacy and safety of local anesthesia during Altis® single incision placement. Material and methods One hundred sixty-six consecutive patients (83 patients for each group: local resp. spinal anesthesia) were selected from our database for this retrospective study among women who underwent an Altis® implantation for SUI from September 2016 to June 2021, after unsuccessful previous conservative treatment. Primary endpoints were objective and subjective cure rates; secondary endpoint was the evaluation of complications linked to this procedure. Results A total of 155 included patients completed our 12 months follow-up. Baseline characteristics were similar between the groups. Operative time (percentage difference of 50%; p < 0.05) and the Intraoperative Difficulty Scale resulted lower in spinal patients. No differences were found between populations in terms of objective (cough stress test and urodynamics) and subjective (PGI-I and FSDS questionnaires) cure rate and postoperative complications. Conclusion Local anesthesia for Altis® implantation could be considered a safe alternative to spinal anesthesia and an effective opportunity to avoid general anesthesia, increasing the possibility of outpatient implantation of this sling system.

Lidocaine-loaded dissolving microneedle for safe local anesthesia on oral mucosa for dental procedure

ABSTRACT Background Lidocaine has been widely used as a short-acting local anesthetic agent to reduce the pain caused by needle insertion. Dissolving microneedles (DMNs), which are minimally invasive, can effectively deliver drugs by overcoming the oral mucosal barrier and relieving patient discomfort. Methods Lidocaine solution prepared by mixing lidocaine-HCl and hyaluronic acid was used to fabricate oral lidocaine HCl-encapsulated DMNs (oral Li-DMNs) via centrifugal lithography. The dissolution, penetration ability, and local transmucosal drug delivery of oral Li-DMNs into the oral mucosa were evaluated in porcine jaws. Pharmacokinetic analysis and safety assessment were performed using rabbits. Results The insertion depth of the oral Li-DMNs satisfies the safety standard. The oral Li-DMNs were completely dissolved after 3 min of application. The local transmucosal drug delivery, pharmacokinetic, and safety evaluations showed that the oral Li-DMNs can obtain a local anesthesia effect at a relatively lower dose, and there was no oral mucosal irritation in rabbits. Conclusions A novel and safe oral Li-DMNs have potential applications in large animals and clinical trials and would possibly enter the anesthesia market.

COMPARISON OF 0.5% LEVOBUPIVACAINE- FENTANYLAND 0.5% ROPIVACAINE-FENTANYL IN INFRAUMBILICAL SURGERIES

Spinal anaesthesia is a commonly performed procedure when the surgical site is located on the lower abdomen, perineum or lower extremities. The advantages are an awake and spontaneously breathing patient, minimal drug costs, reduction of poly-pharmacy and rapid patient turnover. Regional anesthesia techniques have seen numerous modifications over the last two decades with the advent of many new and safer local anesthetics. Presently, hyperbaric bupivacaine is the most commonly used drug for administration of spinal anaesthesia. Levobupivacaine and ropivacaine have recently become available in India for clinical use. Very few studies have been done comparing these two drugs in India. Hence, present study was undertaken to compare 0.5% Levobupivacaine (isobaric)-fentanyl(25µg) and 0.5% Ropivacaine (isobaric)-fentanyl(25µg)with regards to onset and duration of blockade infra umbilical surgeries in spinal anaesthesia. Methods and materials- this is a hospital based randomized double blinded comparative clinical study. Adult patients scheduled for elective infra umbilical surgeries under spinal anaesthesia. Eighty patients were randomized to two groups: group LF and RF (n=40 for each group). All patients received drug volume of 3.5ml containing 3 ml isobaric levobupivacaine (15 mg) + 0.5 ml (25 mcg) fentanyl in group LF, and 3ml isobaric ropivacaine (15mg) + 0.5 ml (25 smcg) fentanyl in group RF. The time for completion of intrathecal administration of study drugs injection is considered as TIME 0. The following parameters were observed – time of onset and duration of sensory block, motor block. Results: In the present study, mean onset of sensory block was faster in Group LF (5.25±0.74 min) than in Group RF (6.53 ± 0.51 min) and was statistically significant (p value &lt; 0.001). In the present study, mean onset of motor block was faster in Group LF (7.25±0.98 min) than in Group LF (11.2 ± 0.61 min) and was statistically significant (p value &lt;0.001). Conclusion: LF group provided better sensory and motor blockade with higher dermatome coverage than RF group.

Comparison of Safety and Effectiveness of Local or General Anesthesia after Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis.

It remains controversial to choose anesthesia for transcatheter aortic valve implantation (TAVI). A meta-analysis of cohort studies was conducted to assess the efficacy and safety of local anesthesia (LA) compared to general anesthesia (GA) in TAVI. All relevant studies published from 1 January 2002, to 31 June 2022, were searched in Ovid, PubMed, Embase, Web of Science, and Cochrane Library. A total of 34 studies involving 23,480 patients were included in the meta-analysis. TAVI with LA was associated with a significant reduction in hospital stay [WMD = −2.48, 95% CI (−2.80, −2.16), p < 0.00001], operative [WMD = −12.25, 95% CI (−13.73, −10.78), p < 0.00001] and fluoroscopy time [WMD = −3.30, 95% CI (−5.40, −1.19), p = 0.002], and an increased risk of acute kidney injury [OR = 1.31, 95% CI (1.01, 1.69), p = 0.04] and a reduced incidence of major bleeding [OR = 0.59, 95% CI (0.46, 0.75), p < 0.0001] and the use of cardiovascular drugs [OR = 0.17, 95% CI (0.05, 0.57), p = 0.004]. No differences were found between LA and GA for 30-day mortality, procedural success rate, myocardial infarction, permanent pacemaker implantation, paravalvular leak, shock, and cerebrovascular events. Overall, 4.4% of LA converted to GA. Based on current evidence, our results suggested that LA strategies reduced hospital stay, operative time, fluoroscopy time, cardiovascular drug consumption, and major bleeding rates in patients undergoing TAVI but led to increased acute kidney injury rates. Further studies and randomized trials are required to verify the presented findings and to identify patients who might benefit from LA.

Lidocaine reinforces the anti-inflammatory action of dexamethasone on myeloid and epithelial cells activated by inflammatory cytokines or SARS-CoV-2 infection

BackgroundSevere cases of Coronavirus Disease 2019 (COVID-19) that require admission to the Intensive Care Unit (ICU) and mechanical ventilation assistance show a high mortality rate with currently few therapeutic options available. Severe COVID-19 is characterized by a systemic inflammatory condition, also called “cytokine storm”, which can lead to various multi-organ complications and ultimately death. Lidocaine, a safe local anesthetic that given intravenously is used to treat arrhythmias, has long been reported to have an anti-inflammatory and pro-homeostatic activity. MethodsWe studied the capacity of lidocaine to modulate cytokine secretion of mouse and human myeloid cell lines activated by different cytokines or Toll Like Receptor (TLR) ligands (flagellin (FliC), Lipopolysaccharide (LPS), Polyinosinic:polycytidylic acid (Poly I:C) and N-Palmitoyl-S- [2,3-bis(palmitoyloxy)-(2RS)-propyl]-(R)-cysteinyl-(S)-seryl-(S)-lysyl-(S)-lysyl-(S)-lysyl-(S)-lysine x 3HCl (Pam3Cys-SKKKK)) or by Severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) infection to epithelial cells. Reporter cell lines were used to study modulation of lidocaine of specific signaling pathways. ResultsLidocaine used in combination with dexamethasone, had an additive effect in the modulation of cellular inflammatory response triggered by Tumoral Necrosis Factor alpha (TNFα), Interleukin 1 beta (IL-1β) as well as different TLR ligands. We also found that lidocaine in combination with dexamethasone modulates the Nuclear factor kappa B (NF-κB) pathway, inflammasome activation as well as interferon gamma receptor (IFNγR) signaling without affecting the type I interferons (Type I IFNs) pathway. Furthermore, we showed that lidocaine and dexamethasone treatment of epithelial cells infected with SARS-CoV-2 modulated the expression of chemokines that contribute to pro-inflammatory effects in severe COVID. ConclusionsWe reported for the first time in vitro anti-inflammatory capacity of lidocaine on SARS-CoV-2 triggered immune pathways. These results indicated the potential of lidocaine to treat COVID-19 patients and add tools to the therapeutic options available for these concerning cases.

Local Anesthesia in Interventional Radiology.

Interventional radiology is an evolving field that treats a variety of diseases. Local anesthetics is an important component of pain management during interventional radiologic procedures. It is highly effective and generally safe for routine procedures. However, local anesthetics can be associated with painful initial injection, allergic reactions, and rare but potentially devastating systemic toxicities. Recent evidence has shown that buffered solution and warm local anesthetics may reduce injection discomfort and improve clinical efficacy. Sensible safety practices and prompt recognition/treatment of the systemic toxicity are of paramount importance to provide safe local anesthesia. Interventional radiologists should be familiar with the basic pharmacology, common local anesthetics, optimizing strategies, complications, and management to provide safe and effective local anesthesia for patients.

Comparing the Effectiveness and Safety Between Local Anesthesia versus Epidural Anesthesia for Percutaneous Transforaminal Endoscopic Discectomy: A Systematic Review and Meta-Analysis

The objective of this study was to compare the effectiveness and safety of local anesthesia (LA) and epidural anesthesia (EA) for percutaneous transforaminal endoscopic discectomy (PTED) and provide reference data for clinical decision-making. We searched PubMed, EMBASE, the Cochrane library, Web of Science, Medline, Science Direct, and China National Knowledge Infrastructure from inception to March 2022 to identify randomized and nonrandomized controlled trials comparing LA and EA for PTED. Studies that assessed at least 2 of the following indicators were considered eligible: surgical duration, X-ray exposure time, satisfaction rate, visual analog scale scores for pain, Oswestry Disability Index, and complications. Meta-analysis was conducted using Review Manager 5.3.3 software. Five randomized controlled trials and 5 retrospective cohort studies involving a total of 1660 patients were included. The LA and EA groups included 803 and 857 patients, respectively. Meta-analysis revealed significant intergroup differences in the intraoperative lumbar visual analog scale scores (P < 0.00001) and anesthesia satisfaction rate (P < 0.00001). There were no significant intergroup differences in the surgical duration, X-ray exposure time, postoperative Oswestry Disability Index, and complication rate. EA is as safe as LA and produces better anesthetic effects than LA in patients undergoing PTED. Therefore, EA should be promoted as a reliable anesthetic technique for PTED.

Postoperative outcomes of mepivacaine vs. bupivacaine in patients undergoing total joint arthroplasty with spinal anesthesia

BackgroundSpinal anesthesia (SA) has been previously associated with improved outcomes after total joint arthroplasty (TJA). The purpose of this study was to compare outcomes between various local anesthetics.MethodsThis was a retrospective study of 1,328 patients undergoing primary TJA with SA from September 2020–2021 at a single institution. Patients were grouped based on TKA or THA and further separated and analyzed in terms of anesthetic agents—mepivacaine (M), hyperbaric bupivacaine (HB), or isobaric bupivacaine (IB). Subgroup analysis of same-day-discharge (SDD) patients and low- (<11 mg) and high-dose bupivacaine was performed. Statistical significance was assessed at P<0.05.ResultsMepivacaine use was associated with younger age, lower ASAs, and lower Charlson Comorbidity Index (CCI) scores in both THAs and TKAs. Postoperatively, significant differences were found between HB, IB, and M in LOS, the first PT ambulation distance and rates of SDD, and home discharge in both THAs and TKAs. No significant differences in outcomes were observed between high- and low-dose bupivacaine in THAs or TKAs. In SDD patients, a significant difference was found only in the first 6-clicks mobility scores. After controlling for age, BMI, sex, ASA, and procedure type, mepivacaine was found to be associated with shorter LOS, increased likelihood of SDD, home discharge, POD-0 ambulation, and, further, the first ambulation distance. No significant differences were observed in 6-clicks mobility scores, urinary retention, 30-day ED returns or 30-day readmissions.ConclusionsBoth bupivacaine and mepivacaine are safe and effective local anesthetics for patients undergoing TJA as evidenced by low, similar rates of urinary retention and 30-day ED returns and readmissions. Mepivacaine does appeared to facilitate early ambulation, shorter LOS and home discharge and should be considered as the local anesthetic of choice for patients undergoing rapid recovery TJA.

PLACE OF MODERN REGIONAL ANESTHESIA TECHNIQUES IN THE PERIOPERATIVE PERIOD. ADVANTAGES OF LONG-TERM EPIDURAL ANALGESIA WITH ROPIVACAINE

The article deals with the use of modern regional analgesia techniques in the perioperative period. A review of the literature was also conducted, which includes issues of pain control in patients in the perioperative period, characteristics of pain in surgical patients, features of pain relief methods, and certain aspects of the characteristics of local anesthetics. Based on the review of the literature, it can be concluded that neuraxial anesthesia, as well as blockade of peripheral nerves and plexuses have become an integral part of the modern clinical practice of an anesthesiologist. Due to a number of advantages, various methods of local and regional anesthesia are gaining acceptance, and the use of extended catheter techniques for central and peripheral blockades is now recognized as a standard technique in the perioperative management of surgical patients. In modern regional anesthesia and analgesia, both in outpatient settings and in surgical hospitals, the effectiveness and safety of local anesthetics are of fundamental importance

Comparative benefits of local anesthesia and spinal anesthesia in adult open inguinal hernia: a meta-analysis of clinical randomized controlled trials.

The aim of this meta-analysis is to systematically evaluate the clinical effects of local anesthesia and spinal anesthesia in the treatment of open inguinal hernia in adults, and provide theoretical evidence for clinical choice. We searched the PubMed, Embase and The Cochrane Library, and collected published clinical randomized controlled trials (RCTs) on the efficacy and safety of local anesthesia and spinal anesthesia for open inguinal hernia surgery in adults. According to the inclusion and exclusion criteria, the literature was screened and the data was analyzed by using Review Manager. A total of 11 RCT studies were included in the meta-analysis, with 591 cases in the local anesthesia group and 584 cases in the spinal anesthesia group. Our results showed that compared with the spinal hernia repair group, the hernia repair group under local anesthesia had a lower incidence of headache (RR=0.11, 95% CI: 0.03, 0.46), urinary retention (RR=0.13, 95% CI: 0.05, 0.32) and postoperative pain score at 12 hours (SMD=-1.09, 95% CI: -1.41, -0.76), and a higher anesthesia efficiency (RR=1.09, 95% CI: 1.03, 1.16) and satisfaction rate (RR=1.12, 95% CI: 1.01, 1.24). There was no statistically significant difference between the two groups in operation time, the incidence of intraoperative pain, hematoma, infection, postoperative chronic pain in the groin area, and testicular pain/swelling. In open inguinal hernia surgery for adults, local anesthesia is better than spinal anesthesia with lower incidence of adverse events, higher efficacy and satisfaction.

Dental Practitioners’ Knowledge, Behavior, and Attitude toward Safe Local Anesthesia Practice in Jeddah

Objectives: This study aims to assess the knowledge level, behavior, and attitude of dental practitioners regarding the absolute maximum dose of local anesthetics, their MRD, and systemic complications. Materials &amp; Method: An electronic survey was distributed through social media platforms to dental practitioners in Jeddah. The survey consisted of 4 sections: demographic information, knowledge, behavior, and attitude. Cronbach’s alpha was used to test for the validity 0.86. Results: A total of 403 participants completed the questionnaire, with a response rate of 60%. Of all, 55.8% were females. The majority were undergraduate students 42.4%, and below the age of 25 44.9%. For the question “what is the MRD/ kg for 2% lidocaine with Epinephrine?” we found a statistically significant difference between the professional rankings p=0.001. Although the undergraduate dentists were the least group to answer the questions “What does a 2% local anesthetic solution mean?”, there was no statistically significant difference between those who answered correctly. Conclusion: We found many of our participants to have false knowledge regarding the topics of LA, MRD/kg, and LAST. We believe that the current levels are not acceptable, and that more efforts must be made to raise the knowledge pertaining to this topic

The study and analysis of the prognosis criteria for a safe local anesthesia in patients with arterial hypertension

Relevance. To develop the algorithm for a safe and effective local anesthesia in dental outpatients with arterial hypertension.Materials and methods. The study was conducted in the laboratory of functional and clinical studies of Moscow State University of Medicine and Dentistry. Electric pulp testing (µA) was performed and pulp microcirculation (PU) was assessed in the intact teeth of patients with hypertension before and 5, 10, 15, 30 and 60 minutes after the administration of local anesthesia. We used 4% articaine solutions without a vasoconstrictor and with its minimal concentration 1:200 000 and 1:400 000, and 3% mepivacaine solution. The safety of the administered local anesthetic was assessed by the continuous hemodynamic monitoring.Results. 4% articaine solution without epinephrine had a shallow anesthetic effect in the maxilla and anterior mandible. 1:400 000 and 1:200 000 vasoconstrictor concentrations in 4% articaine solution increase the depth and duration of the anesthesia from 20 to 30 minutes respectively. Changes in the pulp sensibility but not in blood microcirculation were demonstrated by the functional parameters of the intact dental pulp in patients with hypertension after the administration of 3% mepivacaine solution at the mandibular foramen. The continuous hemodynamic monitoring data showed no changes in arterial blood pressure, heart rate, oxygen saturation on administration of either of the studied local anesthetic solutions or techniques.Conclusion. The analysis of the prognosis criteria for a safe local anesthesia allowed us to ground the choice of anesthetic in dental outpatients with arterial hypertension.

Surgery of chronic subdural hematoma under local anesthesia and its association with recurrence: A single tertiary care center experience

ObjectiveChronic subdural hematoma (CSDH) surgery is like other neurosurgical procedures in terms of its potential for major morbidities, especially recurrence, which may mandate further surgeries. An extremely limited number of studies have looked at the type of anesthesia and its association with recurrence. In fact, most of the studies that exist are focused on the safety of local anesthesia in minimizing potential cardiac and respiratory complications, rather than looking at recurrence as an outcome. This study aimed to evaluate the association between the type of anesthesia and the recurrence of CSDH. MethodsA hospital-based case series study of combined prospective and retrospective nature was conducted on 88 patients who had undergone surgical care for CSDH during the period from January 2016 through December 2018 in the neurosurgery department of Aseer Central Hospital, Abha, Saudi Arabia. ResultsA total of 88 patients were included in the study. The median age was 70 years, and most patients (62%) had one or more comorbid disease(s), 47 (53.4%) underwent general anesthesia for CSDH surgery, whereas 41 (46.6%) underwent local anesthesia (LA). Recurrence within 3 months was seen in 12 patients (13.6%). Univariable regression analysis revealed that the risk of recurrence was four times more when surgery was performed under LA. ConclusionsThe study is the first in the English literature to conclude that drainage of CSDH under LA is associated with a higher recurrence rate; however, the authors remain neutral and recommend individualization of treatment options based on the patient’s status. Local anesthesia may be safer in terms of postoperative anesthetic complications, but it carries a higher rate of recurrence. Further well-designed randomized studies are required.

Safety of local anesthesia and prevalence of hypersensitivity reactions in adult patients with clonal mast cell diseases: A retrospective single-center study

Local anesthetics (LAs) cause hypersensitivity reactions, including toxicity, vasovagal reactions, and side effects of concomitant epinephrine administration and allergic reactions, in 2.5% to 10% of cases.1,2 The introduction of the amide LA group reduced the number of reactions, but related allergy incidence is unclear, as it ranges from 0% to 5% among different studies.1,2

Influence of anxiety and anesthetic vasoconstrictors upon hemodynamic parameters during dental procedures in controlled hypertensive and non-hypertensive patients.

BackgroundTo determine the influence of dental anxiety and the vasoconstrictor used in local anesthesia upon different hemodynamic parameters - systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and peripheral oxygen saturation (SatO2) - during dental extraction and oral hygiene. The safety of local anesthesia with vasoconstrictor in patients with medically controlled hypertension was also assessed. Material and MethodsA total of 159 patients were divided into two groups according to the dental treatment received: tooth extraction (n = 106) and oral hygiene (n = 53). The hemodynamic parameters (SBP, DBP, HR and SatO2) were recorded throughout dental treatment. Patient anxiety was assessed using the Beck Anxiety Inventory (BAI), the Modified Corah’s Dental Anxiety Scale (MDAS) and the Hamilton test. ResultsThe HR increased after anesthetic infiltration with vasoconstrictor and decreased after the tooth extraction. However, HR remained stable in the oral hygiene group, in both hypertensive and non-hypertensive patients. The SatO2 values decreased after anesthetic infiltration with vasoconstrictor. These slight changes associated with the vasoconstrictor agent were observed in patients without anxiety, but not in patients with mild or moderate anxiety. Both SBP and DBP remained constant after local anesthetic infiltration with vasoconstrictor, regardless of whether the patients presented hypertension or moderate anxiety. ConclusionsThe vasoconstrictor used in local anesthesia may induce a very subtle increase in HR, with no significant increase in patients who experience anxiety. Key words:Tooth extraction, dental anesthesia, vasoconstrictor agents, dental anxiety, hypertension.

Characteristic of hemodynamic changes when carrying out of anesthesia using “Anthogyr Miniject” device in therapeutic dentistry

Aim of this work—the determination of the main hemodynamic parameters to assess the effectiveness and safety of local anesthesia in dental treatment using a specialized Goldway G30 cardiomonitor. Materials and methods. In the period from 2016 to 2019, 95 patients with caries and its complications were examined and treated at the clinical base of the Department of General Dentistry of the Belgorod State National Research University. Blood circulation was assessed using a specialized Goldway G30 cardiomonitor at the main stages of local anesthesia (guided by P.M. Egorov and intraligamentary using the Anthogyr Miniject device) with traditional dental therapeutic interventions on the chewing group of teeth of the lower jaw. Conclusion. A comprehensive clinical and laboratory study allows us to evaluate the method of intraligamentary anesthesia using the «Anthogyr Miniject» system as the most effective, safe, especially for people with background diseases, and the most suitable for performing therapeutic dental interventions on the chewing group of teeth of the lower jaw.