What You Need to Know about Local Anesthetics

Highlights

Dr. Aviv Ouanounou returns to speak to the Oasis Discussions audience. In this short video, Dr. Ouanounou provides an overview of local anesthetics which are commonplace in every dental office.

• Local anesthetics are hydrophilic with an amide (most common) or ester (less common) linkages.
• Topical anesthetics belong to the ester group.
• These drugs stop action potential propagation by blocking sodium channels.
• Onset and duration of anesthetic are affected by: pH and pka of the drug and tissues, concentration of the drug, area of administration, nerve morphology.
• Local anesthetic agents are generally very safe; however, they can induce psychogenic effects such as syncope.
• Allergic reactions are rare.
• 4% articaine with epinephrine should not be used for mandibular blocks.
• Clinicians should be aware of potential drug interactions with local anesthetics with epinephrine (e.g. beta-blockers, TCAs).
• Before administering local anesthetics to a child, the maximum dosage should be calculated after taking his/her weight and generally, a 4% solution should not be used.
• Elderly patients may have co-morbidities – epinephrine may be contraindicated and 2% solutions may be preferred.

Full Interview (14.50″)