Преглед на Локална Анестезия - Техники

Chapter 1
Overview of Local Anesthesia Techniques
Mohammad Ali Ghavimi, Yosef Kananizadeh,
Saied Hajizadeh and Arezoo Ghoreishizadeh
Additional information is available at the end of the chapter
http://dx.doi.org/10.5772/59214
1. Introduction
Down through centuries, efforts have been made to use local anesthesia for treatments. In the
ancient times, the Assyrians applied pressure over the carotid artery in order to obtain a certain
degree of anesthesia, explaining why this artery is called “the artery of sleep” in the Greek
literature. In 1532, the Indians of Peru chewed the leaves of coca shrubs to relieve fatigue and
hunger and to produce a feeling of exhilaration. A chemical with some anesthetic property
was first introduced in the nineteenth century. A German chemist in 1859, however, reported
the anesthetic properties of the coca leaf. In 1859, cocaine was first extracted in its pure form
by Albert Neimann, a German chemist. In the mid-1860s, Sir Benjamin Ward Richardson
introduced the effect of ether spray for skin anesthesia. Around the same time the adverse
effects of cocaine on the mood and psyche were demonstrated. As known today, side effects
of cocaine include cardiac stimulation, peripheral vasoconstriction, excitation of the central
nervous system (CNS) and addiction. In 1943, lidocaine-the first amide local anesthetic was
introduced with greater potency, more rapid onset and less allergenicity as compared to the
previously introduced esters.
Pain control in dentistry presents one of the greatest challenges. Pain leads to increased stress,
release of endogenous catecholamines and unexpected cardiovascular responses. Before
anesthetization, dentists should evaluate the medical history of each patient and document
data on the systemic and psychological status of the patients in order to determine whether
the patient is able to tolerate the treatment with no risk from the systemic and psychological
points of views. Before the injection of the local anesthetic, the dentist should recognize the
potential risks. However, most adverse reactions to local anesthetics are not related to the drug
itself, but to the injection of the