Lokalni anestetici u stomatološkoj praksi

master's thesis

• Author: Duška Radičević
• Mentor: Ileana Linčir (mentor)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2006, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Lokalni su anestetici lijekovi koji se koriste za uklanjanje boli. Stomatolog ih svakodnevno koristi u svome radu. Vrlo su slične kemijske građe, a razlikuju se po vezama koje vežu aromatsku jezgru s tercijarnom amino skupinom. Po vrsti veza dijele se na amidne i esterske. Mehanizam njihova djelovanja jest zatvaranje natrijskih kanalića u membrani živčane stanice čime se prekida depolarizacija i zaustavlja propagacija akcijskog potencijala u živcu. Prvo bivaju zahvaćene najtanje senzorne živčane niti.
Lokalni anestetici primjenjuju se površinski, direktno parenteralno submukozno (infiltracijska anestezija) ili u blizini živca područja koje se želi učiniti neosjetljivim (provodna anestezija ili perineuralna). Nepoželjne reakcije očituju se kao toksične reakcije, alergijske reakcije, maligna hiperpireksija i vazovagalna reakcija. Toksične reakcije očituju se na središnjem živčanom sustavu i srcu. Na središnjem živčanom sustavu se manifestiraju kao stimulacija i depresija. Toksični učinci na srce manifestiraju se prestankom disanja te cijanozom kože i sluznica zbog depresije rada srca. Alergijske reakcije na amidne lokalne anestetike veoma su rijetke, a nešto češće na esterske. Lokalno se manifestiraju kao urtikarija, osip i angioedem, a sistemski kao anafilaktički šok. Kontraindikacije za primjenu lokalnih anestetika odnose se na alergijske reakcije, upalu te kontraindikacije za primjenu vazokonstriktora. Lokalni anestetici ulaze u interakciju s beta adrenergičkim blokatorima, depresorima središnjeg
živčanog sustava, tricikličkim antidepresivima i neurolepticima. Pri primjeni lokalnih anestetika kod pacijenata sa sistemskim oboljenjima, djece, trudnica i dojilja te ljudi starije životne dobi treba prilagoditi vrstu i koncentraciju lokalnog anestetika.

Abstract (english)

Local anesthetics are drugs used to reduce pain. Dentists use them in dental practice every day. Local anesthetics are very similar in chemical composition that is different only by bond between aromatic nucleus and tertiary amino group.
According to bond types they are divided into the amides and esters. Mechanism of their action is closing the sodium channels in the nerve cell membrane which then decreases the rate of depolarisation and stops the propagation of the action potential on nerve fibers. Local anesthetics are used superficialy, submucously parenterally (infiltration anesthesia) or near the nerve that needs to loose sensation (regional anesthesia). The adverse reactions appear as toxic and allergic ones, malignant hiperthemia, and vasovagal reaction. Toxic reactions manifest themselves on the central nervous system and the heart. On the central nervous system they appear as stimulation and depression. Toxic effects on the heart are manifested as respiratory depression and skin and mucous membrane cianosis caused by depression of the heart function.
Allergic reactions are very rare to the amides, but more frequent to the esthers. They are manifested locally as nettle- rash, rash and angioedema, and systemically as anaphylactic shock. Counterindications for local anesthetic application include
allergic reactions, inflammation as well as the counterindications for the vasoconstictory agents use. Local anesthetics get in drug interactions with beta adrenrgic blockers, central nervous system depressants, tricyclic antidepressants and
neuroleptics. In local anesthetic administration to the patients with systemic disease, children, pregnant and nursing patients and elderly people, the type and the concentration of the local anesthetic should be adjusted.

• Keywords: anestezija u stomatologiji
• Keywords (english): Anesthesia in Dentistry
• Language: croatian
• URN:NBN: urn:nbn:hr:127:182577
• Study programme: Title: dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Closed access
• Created on: 2024-06-04 07:53:30