Re: Injection dosing
- From: Joel M. Eichen <joeleichen@xxxxxxxxx>
- Date: Fri, 28 Oct 2005 07:27:02 -0400
On Fri, 28 Oct 2005 01:43:41 GMT, Steven Bornfeld
<dentaltwinnospam@xxxxxxxxxxxxx> wrote:
>
>
>JohnCM wrote:
>> Just curious as to the amount of local anesthetic used in various
>> dental procedures. I notice that when I got my cleaning (they did it in
>> two visits, each side at a time) that it took longer for the anesthetic
>> to wear off (a bit over 2 hours) versus when I had my wisdom teeth
>> extracted (around 90 minutes).
>> Do they use more for cavities? Root canals?
>> I still think I get a brief pulse rate increase right after the epi
>> injection. Seemed to be more pronounced when I had the extractions
>> versus the cleanings. Thing is when I was younger I don't think they
>> used epi, because I didn't get an increaseed pulse rate and the
>> anethetic wore off quickly and they had to re-inject. So I'd rather
>> deal with the minute or so of fast heart rate, than pain or extra
>> injections. Also I do take vitamin C alot. I heard it should be avoided
>> before dental work so the anesthetic works better.
>> What they use though works pretty well. I hardly feel any pain and
>> don't even know where the instruments are, which is the way I like it.
>> The most painful part of dental work is the injection. Once its numb I
>> really don't feel much pain at all, maybe pressure during extraction
>> but that's just about it.
>
> This is actually not one question, but a bunch. Generally, the average
>procedure can be done with one cartridge of anesthetic. There are about
>1.8 cc. of anesthetic solution in the cartridge, and anesthetic
>solutions tend to be between 2% and 4% anesthetic by weight. A quick
>calculation (correct me if I'm wrong guyz) is about 36 mg of anesthetic
>for a 2% anesthetic cartridge.
OK, quite good, now let's calculate molarity!
Joel
> Older anesthetic solutions such as procaine (Novocain) wore off very
>quickly, and epinephrine was added to increase potency and duration of
>anesthetic. Still, procaine caused vasodilatation, so the epinephrine
>was partly to counteract this effect. Lidocaine also causes
>vasodilatation (though not so much as procaine), but some anesthetics
>such as mepivacaine and prilocaine cause little or no vasodilatation.
>So these anesthetics are available without vasoconstrictors added. They
>are still not as potent as the anesthetics with vasoconstrictors, but
>they generally are adequate--and are preferred either with patients with
>cardiac history, hypertension, or where shorter duration of anesthesia
>is desired.
> Just how much anesthetic is required is determined not only by the
>potency of the anesthetic, but also the depth of anesthesia required. A
>root canal (for example) will require much greater depth of anesthesia
>than a scaling.
> The duration of anesthesia is also influenced by the location and mode
>of administration. Generally upper teeth can be anesthetized by
>depositing anesthetic in the gum next to the roots of the tooth. This
>generally does not work for lower back teeth (though some maintain it
>does with certain newer anesthetics) and so the anesthetic is deposited
>on the inside of the lower jaw where the nerve trunk enters the jawbone.
> This type of injection (nerve conduction block) generally gives
>longer-lasting anesthesia than depositing next to the roots of the upper
>teeth (infiltration anesthesia).
>
>Hope this helps,
>Steve
>
>>
.
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