Local anesthesia destroys the liver and brain

16-09-2009
Local anesthesia destroys the liver and brain
The main ways to use local anesthesia in dentistry – injectable and ointment. Anesthetic agent has an impact on various systems, organs, tissues. After absorption in the tissues of anesthetic is distributed throughout the body.


In dentistry, local anesthetic injected into the tissues of the maxillofacial area and the oral mucosa, in which there are significant vascular formation, located in the soft tissue and the spongy substance of bone. This can lead to high concentrations of anesthetic in the blood. Anestitik accumulates in the liver, kidneys, brain, exerting an impact on these bodies.


Metabolism of local anesthetics in the tissues depends on many factors, in particular on the chemical structure of the anesthetic (esters or amides). Amide local anesthetics are metabolized more complicated way than the esters, transformed in the liver. Relatively small part of them undergoes transformation in blood plasma. For the clinician is extremely important to know that patients with liver disease are more sensitive to increased concentrations of amide anesthetics. Part of anesthetics and their substrates metabolism of the kidneys.


Central nervous system most affected by local anesthetic. This is due to the proximity of the zone administration of the compound, where the agent is almost freely enters the brain through the blood vessels. An important role is played by the dosage of the drug, its concentration and intravascular route of administration. All Local anesthetics are CNS depressants, affecting the membrane of brain cells. The initial signs of toxic reaction is the excitation, which may be accompanied by dizziness, tremor of hands. In the case of severe CNS toxicity is possible convulsive reaction. For the state of excitation to be a compensatory period of clinical depression. As the deepening depression changes the function of organs and systems. After a brief period of activity occurs reduction of respiratory function, depression develops coronary circulation. It should be noted that the amide anesthetics (lidocaine, mepivukain) is significantly longer than the esters, are in the blood, not metaboliziruyas in the vascular bed.


Effect of anesthetic on the cardiovascular system is different from symptoms, depending on the degree of toxicity. Intoxication by local anesthetics decrease myocardial contractility and cardiac output until cardiac arrest. The direct effect of anesthetic agent at the injection site appears in vasodilation of vessels. There are exceptions to this rule. In particular, cocaine – a powerful vasoconstrictor and vasodilator mebipuvakain is not. Systemic vascular reactions to local anesthesia is essentially characterized by the development of vasodilation and depends on the dose. Clinically, this reaction is manifested in the form of hypotension, which in combination with respiratory depression may pose a threat to human life.
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