Local Anesthetic

Anesthesia for infiltration and nerve block anesthesia in clinical dentistry

Known hypersensitivity to any of its components and/or local anesthetics of the amide group; in the presence of inflammation and/or sepsis near the injection site; in patients with severe shock, any degree of heart block, paroxysmal tachycardia, known arrhythmia with rapid heart rate, narrow-angle glaucoma, cholinesterase deficiency, existing neurologic disease, severe hypertension; when articaine with epinephrine is used, the caution required of any vasopressor drug should be followed

Articaine should be used cautiously in persons with known drug allergies or sensitivities, or suspected sensitivity to the amide-type local anesthetics. Avoid excessive premedications with sedatives, tranquilizers, and antiemetic agents. Inject slowly with frequent aspirations and if blood is aspirated, relocate needle. Articaine should be used with extreme caution in patients having a history of thyrotoxicosis or diabetes. Due to the sulfite component of the articaine preparation, hypersensitivity reactions may occur occasionally in patients with bronchial asthma.

Cardiovascular: Myocardial depression, arrhythmias, tachycardia, bradycardia, blood pressure changes, edema

Central nervous system: Excitation, depression, nervousness, dizziness, headache, somnolence, unconsciousness, convulsions, chills

Dermal: Allergic reactions include cutaneous lesions, urticaria, itching, reddening of skin

Gastrointestinal: Vomiting, allergic reactions include nausea and diarrhea

Local: Reactions at the site of injection, swelling, burning, ischemia, tissue necrosis

Neuromuscular & skeletal: Tremors

Ocular: Visual disturbances, blurred vision, blindness, diplopia, pupillary constriction

Otic: Tinnitus

Respiratory: Allergic reactions include wheezing, acute asthmatic attacks

Solutions containing epinephrine should be used with caution, if at all, in patients taking MAO inhibitors or tricyclic antidepressants because severe prolonged hypertension may result

Blocks nerve conduction by interfering with the permeability of the nerve axonal membrane to sodium ions; this results in the loss of the generation of the nerve axon potential

Adults:

Infiltration:

Volume: 0.5-2.5 mL

Total dose: 20-100 mg

Nerve block:

Volume: 0.5-3.4 mL

Total dose: 20-136 mg

Oral surgery:

Volume: 1-5.1 mL

Total dose: 40-204 mg

Ultracaine DS®:

Infiltration:

Volume: 0.5-2.5 mL

Total dose: 20-100 mg

Nerve block:

Volume: 0.5-3.4 mL

Total dose: 20-136 mg

Oral surgery:

Volume: 1-5.1 mL

Total dose: 40-204 mg

Maximum dose: 7 mg/kg

To date, Ultracaine® has not been administered to children <4 years of age, nor in doses >5 mg/kg in children between the ages of 4 and 12

No information available to require special precautions

No effects or complications reported

Injection:

Ultracaine DS Forte®: Articaine hydrochloride 4% with epinephrine [1:100,000] and sodium metabisulfite [0.5 mg/mL] and an antioxidant and water for injection (1.7 mL) [50s]