Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
9092602 | Best Practice & Research Clinical Anaesthesiology | 2005 | 16 Pages |
Abstract
Quicker onset and shorter elimination time favours (±) articaine as a short-acting local anaesthetic for regional anaesthesia in day-case settings, e.g. arthroscopy (shoulder, knee), hand and foot surgery, and dentistry, because patients treated with articaine will be 'drug free' more quickly than those who receive other local anaesthetics. Articaine diffuses better through soft tissue and bone than other local anaesthetics. The concentration of articaine in the alveolus of a tooth in the upper jaw after extraction was about 100 times higher than that in systemic circulation. Articaine is metabolised via hydrolysis into articainic acid, 75% of which in turn is excreted as such and 25% in the glucuronidated form by the kidneys.The half-lives of elimination (t½α and t½β) of articaine are 0.6 and 2.5 hours, whereas the apparent half-life of the metabolite articainic acid is 2.5 hours. Intrinsic half-lives of articainic acid are: t½α 12 minutes, and t½β 64 minutes (1 hour). In dentistry, articaine is the drug of choice in the vast majority of literature. In other regional anaesthesia techniques (intravenous regional anaesthesia, epidural, spinal and plexus blocks) there are not enough data to prove that (±) articaine is safer and more effective than the short-acting local anaesthetics lidocaine, (±) prilocaine or (±) mepivacaine.
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Authors
Tom (Research Scientist, Chemist-pharamacologist and Senior staff member), Mathieu J.M. (Research and Senior anaesthesiologist and Senior staff member),