Terminal, or so-called superficial, anesthesia is a form of local anesthesia. To eliminate sensitivity, a special solution is applied to the required area, a gel or an injection is performed. The local method of analgesia is actively used in dental practice, urology, otolaryngology and obstetrics. It is also often used for cystoscopy, bronchoscopy, laryngoscopy and gastroscopy.
Spray "Lidocaine Asept" - this is perhaps the most inexpensive and popular anesthetic, which is intended for superficial local anesthesia. Its properties, composition and method of application are described below.
Composition, description of the product and packaging of the anesthetic
Spray "Lidocaine Asept" contains such active substances as lidocaine and chlorhexidine. Also, the composition of the drug includes auxiliary components in the form of ethanol (ethyl alcohol 96%), propylene glycol, levomenthol, sodium hydroxide and purified water.
The local anesthetic in question is sold in polyethylene bottles (with a spray nozzle) that are filled with a clear, colorless or yellowish liquid with a characteristic odor of menthol and ethyl alcohol.
Drug action
What is Lidocaine Asept Spray? The instruction reports that this is a combination agent that has a local anesthetic and antiseptic effect.
Its active substance (lidocaine) is a local anesthetic. The principle of action of this component is associated with blockade of Na channels in nerve endings and is due to inhibition of nerve conduction. This effect of the drug prevents the conduct of a pain impulse along nerve fibers, as well as its generation in sensitive nerve endings.
When used locally, Lidocaine Asept Spray promotes vasodilation. However, it does not cause a locally irritating effect. The effect of the drug develops 1-5 minutes after its application to the skin or mucous membranes and lasts about a quarter of an hour.
The second active substance of the local anesthetic - chlorhexndine - is an antiseptic. It is active against gram-positive bacteria, as well as protozoa and gram-negative microorganisms.
Pharmacokinetics
What pharmacokinetic properties does Lidocaine Asept spray (50ml, 10%) have? According to the instructions, this tool is absorbed quite quickly from the mucous membranes. The absorption rate of the drug depends on the blood supply in the application area, the dose used, the location of the sensitive area and the duration of the application.
If you apply the spray "Lidocaine Asept" (10%) on the mucosa of the upper respiratory tract, the drug is partially swallowed, then inactivated in the digestive tract.
The maximum concentration of anesthetic in the blood is reached after 10-20 minutes. The binding of the drug to plasma proteins depends on its concentration and is about 60-80%. The medication is fairly quickly distributed over the good blood supply organs, as well as over fat and muscle tissues.
The active substances of the Lidocaine Asept Spray penetrate the placental and blood-brain barriers and are excreted in human milk.
The metabolism of the drug occurs in the liver with the participation of microsomal enzymes.
A medication is excreted along with bile and through the kidneys.
When applied locally, chlorhexidine is almost not absorbed.
When to use?
The use of the spray "Lidocaine Asept" is indicated for disinfection and local anesthesia in:
- case of opening abscesses (superficial);
- gynecology and obstetrics (for the purpose of anesthesia of the perineum during the processing of the incision or episiotomy);
- the case of removal of bone fragments in dentistry and swaying milk teeth;
- dermatology (for burns, bites, small wounds and contact dermatitis);
- case of disinfection of the injection site before terminal anesthesia;
- ENT practice during coagulation (in the treatment of nosebleeds).
Also, this drug can be used for:
- fixing bridges and crowns in dental practice;
- suturing mucous membranes;
- treatment of periodontopathy and gum disease;
- extirpation of the interdental papilla, increased in size;
- removal of tartar;
- surgical interventions on the nasal septum and during the removal of nasal polyps, as well as for disinfecting and anesthetizing the injection site (during injection) before removing the tonsils, while eliminating the pharyngeal reflex;
- making a dentition impression (using elastic material);
- puncture of the maxillary sinus (as an additional anesthesia), with the opening of abscesses (peritonsilar);
- X-ray examination, in order to eliminate the pharyngeal reflex and possible nausea;
- removal of stitches;
- endoscopic and instrumental examinations;
- treatment of wounds of festering suppuration;
- disinfection and anesthesia of the surgical field (on the vagina, cervix), etc.
Contraindications
When should you not use Lidocaine Asept Spray (50ml)? Contraindications to the use of this drug are the following conditions:
- cardiogenic shock;
- high sensitivity of the patient to chlorhexidine, lidocaine or other components of the drug;
- sick sinus syndrome;
- severe myasthenia gravis;
- atrioventricular block;
- severe disturbed liver function;
- epileptiform convulsions:
- children's age up to eight years.
Cautious use
Spray "Lidocaine Asept" is used with extreme caution in debilitated patients with local infections (with injuries to the mucous membranes or skin), as well as acute diseases, in old age, young children, during pregnancy and lactation. In the latter cases, the drug in question is prescribed only according to indications.
Spray "Lidocaine Asept": instructions for use
Anesthetic is used topically and topically. Before using the drug, the protective cap is removed from the vial, after which a spray nozzle is installed on the pump rod. The tip of the latter is brought to the application area and pressed onto the head, holding the container strictly upright.
A single press allows you to select one dose of the product. The number of doses may vary depending on the nature of the treated surface and its size.
To avoid absorption of the drug into the general bloodstream, it is necessary to use a minimum dosage that provides a sufficient therapeutic effect. As a rule, 1-3 presses are enough for local anesthesia.
Precautions
What should a patient know before using Lidocaine Asept Spray? Reviews of experts say that during the use of the drug, one should beware of its ingress into the respiratory tract (due to the risk of aspiration).
The use of the drug in the throat requires special care.
Therapy of the elderly and weakened people should be carried out in small doses, taking into account the general condition and age of the patient.
Side effects
At the place of application of the spray "Lidocaine Asept", erythema and mild burning are possible. The latter effect is usually eliminated after the onset of anesthesia. Also, the drug can cause allergic reactions such as itching, skin rash, bronchospasm, anaphylactic shock and angioedema. In addition, when using the spray, the following side effects are likely:
- headache, dizziness, increased blood pressure;
- convulsions, bradycardia, tremor;
- anxiety, blurred vision, tinnitus;
- urethritis, agitation, respiratory depression, depression;
- euphoria, a feeling of fear, a feeling of cold, fever.
Overdose cases
When using increased doses of the drug, the following symptoms are possible: collapse, headache, decreased blood pressure, nausea, bradycardia, vomiting, cardiac arrest, pallor of the skin, tremors, blurred visual perception, tonic-cramp convulsions, tinnitus, arrhythmia, diplopia, psychomotor excitation.
Therapy: at the first signs of intoxication, the patient is transferred to a horizontal position, after which O 2 inhalation begins. Dialysis with an overdose of lidocaine is ineffective.
Interaction with other means
The propranolol and cimetidine drugs reduce the hepatic clearance of lidocaine, and also increase the risk of toxic effects such as drowsiness, stupidity, paresthesia, bradycardia, etc.
When using the product with substances such as aymalin, phenytoin, verapamil, quinidine and amiodarone, the negative inotropic effect may increase .
Concurrent administration with beta-blockers increases the risk of developing bradycardia. With the simultaneous use of lidocaine and sleeping pills, the inhibitory effect of the latter on the central nervous system may increase. Cardiac glycosides reduce the cardiotonic effect of the drug in question, and curariform-like drugs enhance muscle tissue relaxation.
A substance such as procainamide increases the excitability of the central nervous system and the risk of hallucinations.
The drug "Lidocaine Asept" is incompatible with soap and detergents that contain an anionic group (in particular, sodium lauryl sulfate, saponins, sodium carboxymethyl cellulose). The medication is compatible with agents containing a cationic group (in particular benzalkonium chloride).
Reviews
According to consumer reviews, Lidocaine Asept Spray is a highly effective local anesthetic. Patients claim that such a tool must be present in every home medicine cabinet, especially in families where there are children from 8 years old.
This drug not only reduces and eliminates pain effects, but also disinfects mucous surfaces and skin integuments.
Universality is the main advantage of Lidocaine Asept Spray. It can be used in dentistry, and in dermatology, and in gynecology, etc. However, before using the drug, be sure to read the instructions, since it has many contraindications and can cause various side effects.