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      Articaine: a review of its use for local and regional anesthesia

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          Abstract

          Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects were not generally significantly different from those of other short-acting local anesthetics like lidocaine, prilocaine, and chloroprocaine, and there is no conclusive evidence demonstrating above-average neurotoxicity. Articaine proved to be suitable and safe for procedures requiring a short duration of action in which a fast onset of anesthesia is desired, eg, dental procedures and ambulatory spinal anesthesia, in normal and in special populations.

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          Review of local anaesthetic agents.

          H McLure, Michael Rubin (2005)
          The currently available local anaesthetic agents are capable of providing high quality nerve blockade in a wide variety of clinical circumstances. Our understanding of the mechanisms and consequences of toxicity is increasing rapidly. Knowledge of the chemistry of local anaesthetics has enabled clinicians to exploit the increased safety of single isomer agents. However, the extent, if any, of this improvement in toxicity has yet to be proven. Established toxicity may be very difficult to treat and no specific reversing therapy is yet available. Until this occurs it is essential that practitioners of regional anaesthesia maintain their knowledge base and skill in techniques of administration of local anaesthetic, are able to recognise impending disaster, and constantly update their skills in resuscitation.
          Article 0 comments Cited 33 times – based on 0 reviews     Review now
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            Age-related changes in peripheral and central nerve conduction in man.

            Adam Dorfman, T Bosley (1978)
            Somatosensory evoked potential (SEP) latencies, motor and sensory nerve conduction velocities (CVs), and F-wave latenies were measured in 15 elderly normal subjects (mean age 74.1 years), and the results were used to derive indirect estimates of spinal cord CVs. These measurements were compared to those from 15 younger normal adults (mean age 31.6 years), and the nerve conduction characteristics of all 30 subjects were analyzed with respect to age. Peripheral motor and sensory CVs slowed progressively, and the onset latencies of F-waves and SEPs increased gradually with advancing age. Spinal cord CVs showed little change until approximately age 60, and declined sharply thereafter. In addition, the latencies of F-waves and SEPs were positively associated with height. Human clinical and experimental studies utilizing SEP and F-wave measurements must allow for morphologic differences between individuals, and for the systematic changes which accompany normal aging.
            Article 0 comments Cited 27 times – based on 0 reviews     Review now
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              A comparison between articaine HCl and lidocaine HCl in pediatric dental patients.

              S F Malamed, Alexandre Gagnon, D Leblanc (2015)
              Three identical single-dose, randomized, double-blind, parallel-group, active-controlled multicenter studies were conducted to compare the safety and efficacy of articaine HCl (4% with epinephrine 1:100,000) to that of lidocaine HCl (2% with epinephrine 1:100,000) in patients aged 4 years to 79 years, with subgroup analysis on subjects 4 to < 13 years. Fifty subjects under the age of 13 years were treated in the articaine group and 20 subjects under the age of 13 were treated with lidocaine. Subjects were randomized in a 2:1 ratio to receive articaine or lidocaine. Efficacy was determined on a gross scale immediately following the procedure by having both the subject and investigator rate the pain experienced by the subject during the procedure using a visual analog scale (VAS). Safety was evaluated by measuring vital signs before and after administration of anesthetic (1 and 5 minutes post-medication and at the end of the procedure) and by assessing adverse events throughout the study. Adverse events were elicited during telephone follow-up at 24 hours and 7 days after the procedure. Pediatric patients received equal volumes, but higher mg/kg doses, of articaine than lidocaine during both simple and complex dental procedures. Pain ratings: Articaine: VAS (Visual Analogue Scale) scores (from 0 to 10 cm) by patients 4 to < 13 years of age were 0.5 for simple procedures and 1.1 for complex procedures, and average investigator scores were 0.4 and 0.6 for simple and complex procedures, respectively. Lidocaine: patients 0.7 (simple) and 2.3 (complex); investigators 0.3 (simple) and 2.8 (complex). Adverse events: No serious adverse events related to the articaine occurred. The only adverse event considered related to articaine was accidental lip injury in one patient. VAS scores indicate that articaine is an effective local anesthetic in children and that articaine is as effective as lidocaine when measured on this gross scale. Articaine 4% with epinephrine 1:100,000 is a safe and effective local anesthetic for use in pediatric dentistry. Time to onset and duration of anesthesia are appropriate for clinical use and are comparable to those observed for other commercially available local anesthetics.
              Article 0 comments Cited 25 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Local Reg Anesth
                Journal ID (iso-abbrev): Local Reg Anesth
                Title: Local and regional anesthesia
                Publisher: Dove Medical Press
                ISSN (Electronic): 1178-7112
                Publication date Collection: 2012
                Publication date (Electronic): 05 June 2012
                Volume: 5
                Pages: 23-33
                Affiliations
                Department of Anaesthesia, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
                Author notes
                Correspondence: M Snoeck, Department of Anaesthesia C40-01, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ Nijmegen, The Netherlands, Tel +31 24 365 8702, Fax +31 24 365 8830, Email m.snoeck@ 123456cwz.nl
                Article
                Publisher ID: lra-5-023
                DOI: 10.2147/LRA.S16682
                PMC ID: 3417979
                PubMed ID: 22915899
                SO-VID: da1d6fe5-a862-41cd-915b-7098f6349df8
                Copyright © © 2012 Snoeck, publisher and licensee Dove Medical Press Ltd
                License:

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                Categories
                Subject: Review

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: therapeutic use,articaine,pharmacodynamics,neurotoxicity,regional anesthesia,pharmacokinetics,tolerability
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: therapeutic use, articaine, pharmacodynamics, neurotoxicity, regional anesthesia, pharmacokinetics, tolerability

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