What is Novocaine?
Moderately active anesthetic Procaine, also known as Novocain, is one of the perfect means of anesthesia when working with teeth, due to its versatility and low price.
As a substitute for cocaine in medicine, Novocain reduces the excitability of nerve fibers, myocardium, and motor areas of the cerebral cortex. The degree of its absorption depends on the following parameters :
- place of administration;
- blood flow velocity;
- what volume of an injection;
Novocain reduces the excitability of nerve fibers, myocardium and motor areas of the cerebral cortex.
The drug has a short anesthetic activity – from 30 to 60 minutes with infiltration, therefore, how much the anesthetized patient leaves is determined by the complexity of the procedure.
The anesthetic Procaine was first made in 1905 by the German chemist Alfred Einhorn and introduced by the surgeon Heinrich Braun in the medical practice.
In contrast to the previously used cocaine Procaine no longer mood-enhancing and addictive. Today, there are many related local anesthetics on the market that have more favorable properties, which is why procaine is not used so often.
How does anesthesia work?
The nerve tracts in the body conduct “messages” in the form of electrical signals either from the brain to other parts of the body (efferent nerves) or from these regions to the brain (afferent nerves). The latter information can be sensory perceptions, temperature and touch sensations, but also painful stimuli. To suppress the latter, local anesthetics such as procaine are used.
In the case of a pain stimulus, the information is directed from the place of action via nerve tracts to the brain. The conduction is similar to that in a power cable via electrical charges that are transported along the nerve.
It is done mainly using sodium ions, which flow into the nerve tract through so-called sodium channels. The sodium ions have a positive charge, which gets into the interior of the nerve and is transported on through further sodium channels along the nerve. Once in the brain, the stimulus is then interpreted as pain.
Local anesthetics such as procaine are usually injected directly to the site where pain suppression is desired – such as to the dentist directly to the nerve that supplies the area to be treated. There Procaine blocks the sodium channels, whereby no sodium enters the nerve and thus no (pain) stimulus is triggered. It allows painless surgery in the anesthetized region.
How long does Novocaine last?
The duration of the effect of dental anesthesia may vary depending on the amount and type of drug injected, from the point of execution of the injection but also the rate of metabolization of the drug by the patient.
Usually, the effect tends to fade after 1 hour from the injection, but the effect can also last for 2 hours or more if a larger dose was injected.
Types of anesthesia at the dentist
To work better on the patient’s mouth, the dentist can use different types of anesthesia based on the problem and the state of agitation. Among these we have:
- Local superficial or topical anesthesia: it involves the application of anesthetic drugs in the form of a spray or solution on the area in which it will operate. The effect is rapid and is excellent for minor interventions. The drugs used are mainly based on Benzocaine or Xylocaine.
- Local infiltration anesthesia: the anesthetic is injected into the tissues, just under the tooth on which you want to operate, without localizing the nerves.
- Truncular local anesthesia or nerve block: involves the injection of the anesthetic drug in localized areas where the nerves pass, to desensitize a larger area.
- Intraligamentous local anesthesia: the injection is performed at the level of the periodontal ligament, near the bone, through special syringes. It should be performed mainly on patients who want to avoid bleeding, as for hemophiliacs.
- Local anesthesia intrapulpare: the anesthetic is injected directly into the dental pulp to operate on teeth affected by pulpitis or for higher sensitivity.
- Sedation: provides the administration of nitrous oxide, also known as “euphorizing gas,” which has highly analgesic and anxiolytic properties, but not correctly anesthetic. Sometimes it can be associated with fruity aromas to be given to children. Conscious sedation can also be achieved by oral anxiolytic drugs and in more complex cases, intravenously. It is ideal to allow the dentist to work freely, especially in long and complex operations, such as extractions or sutures.
- General anesthesia: more powerful anesthetics are administered intravenously or by inhalation, mainly for maxillofacial surgery, under the supervision of an anesthesiologist. The most used drugs are ketamine, propofol, fentanyl, sevoflurane. This type of anesthesia is usually performed in the hospital, keeping a close watch on the patient’s vital parameters, such as heart rate, blood pressure, oxyhemoglobin saturation.
Currently among the local anesthetics, the most used is Lidocaine, but also Bupivacaine, Prilocaine, Mepivacaina and Dibucaine, the great-grandchildren of Novocaine and Procaine. Vasoconstrictors may also be associated, to reduce the bleeding caused by the puncture and the intervention itself and to avoid a massive absorption of the drug that could cause allergic or toxic reactions.
From an anatomical point of view, at the level of the areas of interest of the dentist, we find mainly the branches of the Trigeminal nerve, in particular, the Ophthalmic, the maxillary and the mandibular. The techniques and branches involved are different depending on the area to be desensitized:
Anesthesia from the dentist at the maxillary level
About anesthesia in the maxillary area, mainly the techniques that involve the injection of the drug into the tissue, the periodontal ligament and the areas near the nerve, which usually do not correspond with the site on which the intervention. It can be performed in various ways:
for a single tooth: suitable for incisors, canines and premolars, soft tissues and pulp anesthesia Posterosuperior alveolar nerve: for the pulp, gums and alveolar bone corresponding to the molars. The needle is inserted between the first and second molars with an angle of forty-five degrees superiorly and medially to the axis for a depth of about fifteen or twenty millimeters Middle-superior alveolar nerve: for premolars; the needle is inserted between the first and second premolars for a depth of ten or fifteen millimeters, in an almost vertical direction Antero-superior alveolar nerve: for incisors, canines, and soft tissues, at the point superior to the second incisor Infraorbital nerve: for the tissues, the incisors, the canines, and the first and second premolars or if you want to desensitize more than one or two teeth of the upper arch. The effect also extends to the zygomatic level, to the side of the affected nose, and the upper lip. It is performed by lifting the upper lip, inserting the needle at the level of the first premolar or of the canine until it reaches the bone of the infraorbital region from the inner portion: for the mucosa and the bone of the palate Nasal-palatine nerve: located in the central front part of the palate, and anesthetizing it, the soft and hard tissues of the anterior palatal portion between the two canines are desensitized. The needle penetrates the incisor hole for about ten millimeters until it reaches the incisive papilla Nerve range palatine: to anesthetize the soft palate or the teeth beyond the canine. The needle is inserted into the palatine portion, moving away about one centimeter from the first or second molar, until it reaches the point from which the nerve emerges
Anesthesia from the dentist at the jaw level:
Lower alveolar nerve: this anesthesia is performed posteriorly to the last molar, and desensitizes a vast area of the mandible Akinosis technique: useful in patients with infections in this region, fractured jaws, and children. It is performed with the mouth closed. Mental nerve: desensitizes the incisors, the canine, and the premolars, and also the lower lip
Anesthesia at the dentist and possible side effects
Possible side effects of dental anesthesia can be:
- Damage due to needle breakage, caused by strong pressure during injection
- Mandibular trismus
- Burning or pain
- Excessive duration of anesthetic effect
- Paralysis of the facial nerve
- Injuries from herpetic viruses, aft, and stomatitis
Drug-related damage may also occur, for example for toxic or hypersensitivity reactions.
- Respiratory difficulties
Allergic reactions: usually they are linked to preservatives or other substances present together with the anesthetic.
Urticaria Cutaneous erythema Respiratory difficulty Hypotension Anaphylactic shock
Allergy to novocaine
More serious side effects are associated with allergies to novocaine, but they are rare. Symptoms of Allergy to novocaine include:
• difficulty breathing
• loss of consciousness
Other rare side effects that require emergency medical care include:
• chest pain
It is essential that the person tells the dentist about the drugs he is taking, as some drugs can interact with novocaine.
It is also important that people inform the dentist about the state of health to choose the best anesthesia and the right dose.
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Dentist anesthesia: Does it hurt?
The discomfort caused by dental anesthesia may vary from individual to individual, from the injection method and the type of tissue involved.
The perceived sensation is mainly linked to the time of injection of the drug into the tissue, so if this is fed into thicker or harder tissue, it will take longer to adapt and be absorbed.
It is mostly a tingling sensation when the needle is injected and when the anesthetic is injected. In any case, after a few seconds, the area will already be numb, so any discomfort related to anesthesia ceases immediately.
Food to go
Novocaine is generally used for procedures that last less than 90 minutes. It is because the effects of novocaine are short-lived. Novocaine usually lasts between 30 and 90 minutes. How long it lasts depends on the procedure you are having and if you use epinephrine with Novocaine.
However, novocaine is not used as often today compared to other local anesthetics. Your doctor or dentist may choose to use lidocaine (Xylocaine). This medication tends to last longer than Novocaine (around 1.5 to 2 hours, depending on whether epinephrine is used or not).
If you have any questions or questions about the local anesthetic used during your medical or dental procedure, consult your doctor or dentist.
Read more: How Long Does Dental Anesthesia Last?
The duration of action of procaine
Novocaine is a short-acting local anesthetic. Its effect usually lasts from 30 to 60 minutes. If novocaine is used together with adrenaline, the action can last up to 90 minutes.
The duration of novocaine is influenced by several factors, including:
The dosage of novocaine administered will depend on the procedure performed. The higher the dose of novocaine, the longer the numbness will continue.
The dose depends on:
• type of procedure performed;
• the number of pain nerves;
• the size of the treated area.
Presence of infection
Anesthesia is less effective when used on an infected tooth. The infection causes the tissue surrounding the tooth to become acidic and local anesthesia to be sensitive to pH levels.
Inflammation also reduces the effectiveness of local anesthesia, especially during dental procedures. Because of this, the dentist may need to use more novocaine on an infected tooth than on a healthy tooth.
The use of adrenaline
The use of epinephrine with novocaine is an important factor in determining the length of time the area will remain numb. Adrenaline causes constriction of blood vessels. It lowers the blood flow around the injection site and keeps the embryo more than normal. Adrenaline also reduces bleeding.
People with some medical conditions, such as heart disease or high blood pressure, anesthesia is best done without adrenaline.
When will Procaine be used?
Procaine is primarily used for local anesthetics in dentistry and other minor procedures. It is also used in analgesic ear drops for pain in the external auditory canal or otitis media, usually together with another analgesic.
In the field of alternative medicine, neural therapy also uses procaine as an infusion into blood vessels or as an injection to the nerve node (procaine syringe).
When is the effect of novocaine?
Usually, the effects of novocaine pass when blood circulation increases and transfers the drug into the bloodstream.
Local anesthesia can be faster if a person goes for a walk or is engaged in activity after treatment. Physical activity increases blood flow in the body. However, you must obtain permission from your doctor before exercising after the procedure.
In recent years, new local anesthetics, including lidocaine (Xylocaine) and articaine, have been used instead of novocaine. These drugs are also safe to use, and their effect lasts longer than novocaine.