CLINICAL AND PHARMACOLOGICAL CHARACTERISTICS OF MODERN CARPULAR ANESTHETICS OF THE AMIDE SERIES IN THE PRACTICE OF A DENTIST

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One of the criteria for successful dental treatment is the painlessness of the procedure and the psychophysiological comfort of the patient. Having once experienced a negative experience in the dentist's chair, the patient acquires fear and psychological trauma, which in the future may become an obstacle in the treatment process, since the central nervous system plays a leading role in the occurrence of pain and response to it. That is why modern dentistry should be a single system based on three main components: the use of new technologies in practice, the competence of a dentist and comfortable painless treatment. The latter is achieved through the use of modern highly effective local anesthetics. During most outpatient dental interventions, local anesthesia is the most optimal and safe method of pain sensitivity control.
The purpose of this work is to study the clinical and pharmacological properties of modern carpular anesthetics of the amide series. Sources and methods. The work was carried out on the basis of the analysis of literary sources: manuals, monographs and statistical data of Russian and foreign specialists in the field of anesthesiology, chemistry and dentistry. A mandatory criterion in the analysis of the conducted studies was the absence of severe somatic diseases in patients; all the studies considered included a sample of patients aged 18 to 65 years, which allowed us to determine the optimal anesthetic and dosage for each group of patients, taking into account age-related morphological changes in organs and body systems. Based on PubMed materials, a comparative characteristic was carried out among anesthetics of this group and the most optimal and effective drug for local anesthesia in outpatient dentistry was determined.
Results and their discussion. In the course of the work, studies devoted to the study of the effectiveness and biological safety of local anesthetics of the amide group were considered. As a result of the analysis of the conducted studies, which included the use of amide-type anesthetics, namely 4% articaine with adrenaline 1:100,000 and 2% lidocaine with adrenaline 1:100,000, in one hundred patients divided into 2 control groups of 50 people in need of removal of the third molars of the mandible, it was determined: the average start time of admission articaine and lidocaine are 3.16 ± 0.55 and 3.2 ± 0.48 min, respectively; the articaine group experienced a statistically longer period of anesthesia and duration of action of 289.04 ± 40 and 361.88 ± 40 minutes, respectively, compared with lidocaine, which is 144.2 ± 12 and 197.44 ± 25 minutes. [1, 2].These data allow us to conclude that Articaine 4% has a more powerful and long-lasting effect with better postoperative analgesia and can be considered as an alternative to lidocaine in clinical practice. [3, 4]. In addition, during the study of the pharmacochemical properties of amide-type anesthetics, it was found that Articaine 4% has low toxicity compared to lidocaine 2% and mepivacaine 3%, due to its low fat solubility, high percentage of binding to blood proteins and low half-life. [5]
Conclusions. The analysis of domestic and foreign studies, statistical data, as well as literary sources has shown that the most optimal and effective carpular anesthetic of the amide series in dental interventions is articaine, which is due to the high rate of onset and strength of anesthesia, sufficient duration, low toxicity and allergenic danger of this anesthetic.

About the authors

Alena Dmitrievna Nazarova

S. M. Kirov Military Medical Academy

Author for correspondence.
Email: belova-97a@inbox.ru
ORCID iD: 0000-0001-8784-1619

Clinical Resident

Russian Federation, 6 Academica Lebedeva str., St. Petersburg, 194044, Russia

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