Anesthesia and analgesia wonder...still
Is there an increasing usage of potent sedatives and pain killers seeping into dental procedures these days? I have been seeing drugs such as Versed, Midazolam and even Fentanyl being commonly mentioned. Has dentistry changed that much where local anesthetics are not providing adequate anesthesia? Factor to ponder. However, on the other hand, patients are demanding a pain free experience when they visit with their dentist. It is also my observation that recently trained dentists are much more savvy about drugs in general, than were their colleagues say, ten years ago. Bupivacaine 0.5%, a tertiary amide compound commonly used to induce nerve block anesthesia in dental procedures, continues to mystify pharmacologist with its dual properties of producing analgesia after soft tissue anesthesia has worn off. Although structurally it resembles other amides such as lidocaine; however, in the hydrophilic section, it contains four extra carbons. We suspect this is responsible for its unique mode of action. This is a desirable feature, since it reduces the need to prescribe narcotic type pain killers. Its concentration of 0.5% of bupivacaine puts it in a class of low toxicity. Another useful tip on current issues. Comments are welcomed. Contact us at localanesthetics@yahoo.ca
About the Author
Haynes Darlington M.Sc. PhamD. is the author. He has been lecturing on the pharmacology of local anesthetics since 1983. He was intrumental in making submissions to FDA to have articaine Hcl accepted into North America.
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