RU2342125C1 - Method of anesthetic tissue injection - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: initially local anesthetic solution is injected with a vasoconstrictor. After that at once local anesthetic solution is injected without a vasoconstrictor.

EFFECT: increase in anesthesia efficiency due to pH augmentation of local anesthetic solution injection, faster block development of nerve impulse current.

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Description

The invention relates to medicine, namely to dentistry, and is intended for local injection pain relief.

It is known from the prior art that during the injection of local anesthetics into tissues during dental interventions, doctors select and use a single anesthetic solution, the effectiveness of which is suitable for the specific task of pain relief. Data on the duration of anesthesia for solutions of local anesthetics are known only without vasoconstrictors and with vasoconstrictors (Gritsuk S.F. Anesthesia in dentistry, Moscow, 1998, p. 34, table No. 2).

Local anesthetics without a vasoconstrictor are not effective enough and can be used for short-term dental interventions, and anesthetics with vasoconstrictors are used for long-term procedures, since a vasoconstrictor reduces the absorption rate of the drug and thereby increases the duration of its action (Gritsuk S.F. Anesthesia in dentistry, Moscow, 1998, p. 35.37).

But local anesthetics with a high content of vasoconstrictor cause complications mainly from the cardiovascular system in patients with risk factors (Borovsky E.V. Therapeutic dentistry, Moscow, 2005, p. 17-18; Krzhechkovskaya V.V., Vakhtangishvili R .Sh. Medicines in anesthesiology. Local anesthetics, Rostov-on-Don, Phoenix - 2006, p. 59).

In this regard, the solution of the problem of reducing the concentration of the vasoconstrictor in local anesthetic solutions and increasing their effectiveness is of great importance for practical medicine.

A known method for identifying the nature of the effect of a medicinal product, intended to select the optimal concentration of a vasoconstrictor in an anesthetic drug with local anesthesia (RU 2209034, 07.27.2003).

The disadvantages of this method are the lack of effectiveness and safety of local anesthesia.

The closest analogue to the proposed invention is a method of local injection pain relief. In this method, a capsule is used, consisting of a transparent cylindrical body, made two-chamber by means of an elastic partition with a thin middle part for piercing with the opposite end of a double-edged needle. The first chamber is filled with an anesthetic solution without a vasoconstrictor and has a volume sufficient to allow administration of 0.1 ml of solution, and the second chamber contains an anesthetic solution with a vasoconstrictor. Oral mucosal tissues are punctured, about 0.1 ml of anesthetic solution without a vasoconstrictor is injected from the chamber, after which the inner end of a double-edged needle punctures the thin middle part of the elastic septum, and the anesthetic solution with the vasoconstrictor from the chamber enters the anesthesia zone (RU 2180860, 27.03 .2002).

The disadvantage of this method is that there is no increase in the effectiveness and safety of local anesthesia, with a decrease in the amount of a vasoconstrictor during injection of anesthetic solutions, as well as a decrease in the concentration of a vasoconstrictor in local anesthetic solutions.

The problem to which the invention is directed is to create such a method of introducing an anesthetic into the tissue, which would eliminate the above disadvantages.

The technical result achieved by the implementation of this invention is to increase the safety of local anesthesia by reducing the concentration (amount) of the vasoconstrictor at the injection site of the solution into the tissue while increasing the effectiveness of anesthesia.

The specified technical result is achieved in the method of introducing an anesthetic into the tissue, in which phased administration of a solution of local anesthetic is carried out, first anesthetic with a vasoconstrictor is administered, then anesthetic without a vasoconstrictor is immediately administered.

The method of introducing anesthetic into the tissue is as follows.

In the treatment of, for example, caries (preparation of hard tissues of the tooth), local anesthesia is performed. Local anesthesia is carried out in two stages. Initially, a solution of local anesthetic with a vasoconstrictor is injected into the tissue from the carpula using a single-use syringe. Then (second stage), a solution of local anesthetic without a vasoconstrictor is immediately injected with a syringe.

Thus, the concentration of the vasoconstrictor decreased, and the effectiveness of anesthesia increased. This was due to the high concentration of the vasoconstrictor in the first portion of the anesthetic, which reduced blood circulation in the anesthesia zone, and the anesthetic without a vasoconstrictor raised the pH and increased the blockade of the nerve impulse in the nerve fiber. It also increases safety by reducing complications with a decrease in the concentration (quantity) of the vasoconstrictor directly in the tissues, rather than the dose of the solution in the carpule, as standard anabolics with a ready-made solution of anesthetic with clear doses of the vasoconstrictor are used for anesthesia, the dosage of which does not change.

The concentration (amount) of the vasoconstrictor decreases in the tissues during administration. Since half of the solution is injected with standard doses of a vasoconstrictor, which in turn reduces the amount of the vasoconstrictor by half, the next solution of the vasoconstrictor does not contain, but only affects the increase in pH and the increase in pain relief, which is also prolonged due to tissue ischemia, which occurs with the introduction of the first anesthetic solution with a vasoconstrictor.

Examples. Patient: R.I. Yarema, 23 years old.

1. With the introduction of 4% Articaine with a vasoconstrictor 1: 100000 (1.7 ml) for 60 s, the preparation of the tooth was painless for 51 min after administration.

2. With the introduction of 4% Articaine with a vasoconstrictor 1: 200000 (1.7 ml) for 60 s, the preparation of the tooth was painless for 28 minutes after administration.

3. With the introduction of 4% Artikain without a vasoconstrictor (1.7 ml) for 60 s, the preparation of the tooth was painless for 6 minutes after administration.

4. With the introduction of 4% Articaine without a vasoconstrictor (0.8 ml) for 30 seconds, analgesia was not effective.

5. With the introduction of 4% Articaine with a vasoconstrictor 1: 100000 (0.8 ml) for 30 s, the preparation of the tooth was painless for 25 minutes after administration.

6. Combined (phased) anesthesia.

First, 4% Articain was administered with a vasoconstrictor 1: 100000 (0.8 ml) for 30 s. Then immediately introduced into the same zone 4% Artikain without a vasoconstrictor (0.8 ml) for 30 s.

The preparation of the tooth was painless for 48 minutes after administration.

Thus, with the introduction of 0.8 ml of a solution of 4% Articaine in an adrenaline concentration of 1: 100000, the amount of a vasoconstrictor decreased by half, which corresponds to the amount of a vasoconstrictor with the introduction of 1.7 ml of a solution of 4% Articaine in an adrenaline concentration of 1: 200000.

With phased anesthesia, the concentration of the vasoconstrictor decreased to 1: 200000, and the effectiveness increased to a solution of 1: 100000. This was due to the high concentration of the vasoconstrictor in the first portion of the anesthetic, which reduced blood circulation in the anesthesia zone, and the anesthetic without a vasoconstrictor raised the pH and increased the blockade of the nerve impulse in the nerve fiber. And also due to a shift in the acidity of tissues to the alkaline side with the combined introduction of local anesthetics with vasoconstrictors and without vasoconstrictors in the tissue, since the anesthetic solution with a vasoconstrictor has a pH of 3-3.5, and the anesthetic solution without a vasoconstrictor has a pH of 6. General increase in the pH of the solution in tissues increases, which leads to a more rapid development of blockade of the nerve impulse and increased severity of anesthesia.

And, on the contrary, with tissue inflammation (gingivitis, periodontitis, periodontitis), the acidity of the tissues shifts to the acid side, and the effectiveness of anesthesia decreases sharply.

Thus, there is an increase in the effectiveness of local anesthesia with a decrease in the amount of vasoconstrictor during injection of anesthetic solutions, which leads to an increase in the safety of local anesthesia for patients with diseases of the cardiovascular system of CVS (hypertension, angina pectoris, etc.), since it does not cause an increase HELL and tachycardia.

Claims (1)

The method of introducing an anesthetic into tissues, characterized in that a phased administration of a local anesthetic solution is carried out, at the beginning an anesthetic with a vasoconstrictor is administered, then an anesthetic without a vasoconstrictor is immediately administered.