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International Nonproprietary Name - articaine, epinephrine Clinical-pharmacological group: Anesthesiology, resuscitation, transfusionology → Local anesthetics → Preparations for anesthesia in dentistry Indications - Operations on mucous membranes or bones requiring more intense ischemia; - Operation on the tooth pulp (amputation and extraction); - Extraction of a fractured tooth (osteotomy) or extraction of a tooth damaged by apical periodontitis, long surgical operations (e.g., Caldwell-Luc operation), transcutaneous osteosynthesis, cyst removal, muco-gingival operations, root tip resection, preparation of the oral cavity and tooth for crown placement on hypersensitive teeth. Dosage regimen For uncomplicated extraction of upper teeth with forceps, in the absence of inflammation, a vestibular injection of 1.7 ml per tooth is usually sufficient. In individual cases, an additional vestibular injection of 1 to 1.7 ml may be required for complete anesthesia. In most cases, it is not necessary to perform an injection with a painful palatal approach. If it is necessary to incise or suture the palate, a depot injection into the palate with a dose of approximately 0.1 ml per puncture is sufficient. When extracting multiple adjacent teeth, the amount of vestibular injection can usually be limited. For uncomplicated extraction of lower premolars with forceps, in the absence of inflammation, anesthesia of the lower jaw may not be necessary, as infiltrative anesthesia, provided by an injection of 1.7 ml per tooth, is sufficient. If the desired result cannot be achieved this way, an additional vestibular injection of 1 to 1.7 ml should be performed. Only when complete anesthesia cannot be achieved, conventional anesthesia by the method of mandibular block is necessary. For preparation of the oral cavity or preparation for placing a crown on any tooth, excluding lower molars, Ultracain vestibular injection in a dose of 0.5-1.7 ml per tooth is indicated. The exact amount depends on the desired depth and duration of anesthesia. For surgical operations, Normocaine is indicated in individual doses, taking into account the severity and duration of the operation. For one treatment procedure, adults can be administered up to 7 mg of Normocaine (articaine) per 1 kg of body weight. A dosage of up to 500 mg (i.e., 12.5 ml of injectable solution) is well tolerated if the aspiration control method is used. A test aspiration should always be performed before injection to rule out intravascular injection. Aspiration is particularly facilitated by using the Unijekt K syringe with cartridges. Injection pressure should correspond to tissue sensitivity. Eating is permitted only after sensation is restored. Side effects As with all local anesthetics, changes in the central nervous system (from stupor to loss of consciousness) may occur due to dosage errors, respiratory disturbances up to respiratory arrest, muscle tremors, involuntary muscle contractions up to generalized convulsions, as well as nausea, up to vomiting. During or immediately after injection of a local anesthetic into the head area, temporary visual disturbances (blurring, blindness, double vision) may develop. Such events are very rare.