Use of Articaine in loco-regional anesthesia for day care surgical procedures

Abstract

The popularity of day case surgical procedures has increased immensely over the last few years. Though various techniques are available for carrying out day-case anesthesia, preference for a technique depends upon the type of procedure, patient profile, associated co-morbidities, available infrastructure and back-up facilities, monitoring devices and comfort of the attending anesthesiologist with the technique. Day-case spinal anesthesia for ambulatory surgery has gained a wider acceptance and numerous drugs are available for use in loco-regional anesthesia. Articaine is one such amide local anesthetic drug which is increasingly being used in day care surgeries. Properties of articaine such as faster onset, shorter elimination time and rapid recovery from sensory and motor blockade make it a very useful agent in local and regional anesthesia for day care surgical procedures. This article aims to review these properties of articaine so as to evaluate how useful articaine can be for ambulatory surgical procedures.

Maxillary Posterior Teeth Removal Without Palatal Injection –Truth or Myth: A Dilemma for Oral Surgeons

“…Although, articaine is assumed to be a safe local anaesthetic, a few contraindications to its use in clinical practice includes the patients allergic to amide-type local anaesthetics, patients allergic to metabisulfites (a preservative present in the formula to extend the half life of epinephrine) [22].…”

Local anesthetics and advances in their administration – an overview

“…The presence of the amide and ester linkage reduces the risk of overdosing, which could lead to a toxic reaction. Elimination of articaine is through the kidneys [5]. Many local anaesthetics have epinephrine added to them to cause vasoconstriction of the neighbouring capillaries, which results in slower absorption of the anaesthetic and increased the time of action.…”

“…However, they are capable of producing local and systemic toxicity [13,14]. Minor adverse effects may include post-procedural pain, headache, facial oedema, infections, gingivitis and transient paresthesia [5]. Ischemic necrosis may also occur following an injection of a local anaesthetic due to a combination of the irritability of the agent itself, the pressure with which the agent is injected, and the amount of constriction caused by the vasopressors [14].…”

“…This is noticed amongst patients undergoing local anaesthesia of the hard palate. Overdosing on local anaesthetics may cause unconsciousness, apnoea, hypotention, hypoxia, bradycardia, and potentially seizures [5]. Concentrations of 2-3% lidocaine carry little risk of producing toxicity, although formulations of 4% articaine and prilocaine have an increased risk.…”

Anesthetic management of primary hyperparathyroidism: A role rarely noticed and appreciated so far

“…[1819] There is a renewed interest in regional anaesthesia with the advent of α-2 agonists such as clonidine and dexmedetomidine which are being extensively used as adjuvants with newer local anaesthetics such as ropivacaine and articaine in neuraxial anaesthesia. [202122] However, in modern day anesthesia practice, GA with tracheal intubation and muscle relaxants has been widely accepted throughout the globe.…”