CARACTERÍSTICAS DOS ANESTÉSICOS LOCAIS (MALAMED E ANDRADE)

Summary

This video script provides an in-depth look at anesthetic agents used in dentistry, focusing on their characteristics, effects, and dosages. It discusses key factors such as vasodilation, duration of action, metabolism, and toxicity. The script emphasizes the importance of plasma protein binding for longer anesthetic effects and considers the safety of certain drugs for pregnant women. It also addresses post-operative care, highlighting how longer-acting anesthetics can reduce the need for additional medications. The speaker encourages viewers to explore additional resources and courses to deepen their understanding.

Takeaways

• 😀 Anesthetics with a long duration of action often bind well to plasma proteins, which extends their effect, differing from initial expectations about their vasodilation properties.
• 😀 Mepivacaine, though it stays longer in the body, is less toxic due to efficient elimination, making it safer than expected, especially for pregnant women with an underdeveloped liver.
• 😀 The potency of certain anesthetics is higher, making them more effective, and they bind strongly to plasma proteins, which contributes to their extended duration of action.
• 😀 There are risks associated with using certain anesthetics during pregnancy due to insufficient research and studies on their safety for fetuses.
• 😀 Anesthetic agents like Mepivacaine can provide a prolonged anesthesia duration, reducing the need for postoperative pain management, including opioid analgesics.
• 😀 The onset of anesthesia varies between agents, with some requiring longer times (6-10 minutes) to take effect before providing full anesthesia.
• 😀 Soft tissue anesthesia can last significantly longer, with durations ranging from 90 minutes to 9 hours, depending on the anesthetic used.
• 😀 Maximum recommended doses for anesthetics differ between sources, with Malamed suggesting 2 mg/kg and Android suggesting 1.3 mg/kg as the safe upper limits.
• 😀 Long-lasting anesthetics like Boop allow for a reduction in the total amount of postoperative pain medication needed, making them useful for minimizing opioid use.
• 😀 The speaker encourages viewers to explore further resources, including online courses and practice tests, to better prepare for dentistry exams and other related certifications.

Q & A

What is the key factor that determines the long duration of certain anesthetics?

The long duration of certain anesthetics is due to their strong binding to plasma proteins, which helps maintain their effects over an extended period.

Why do anesthetics with longer durations not necessarily have smaller concession bases?

Anesthetics with longer durations typically have larger concession bases, as their long duration is due to their effective binding to plasma proteins rather than the size of their base.

How does the metabolism of anesthetics like Mepivacaine affect its toxicity?

Mepivacaine remains longer in the body due to slower elimination, making it potentially more toxic, especially for fetuses, whose livers are not fully developed.

Why is an anesthetic like the one described in the video considered less toxic despite a longer duration in the body?

Although this anesthetic stays in the body longer, it is well eliminated, which makes it less toxic compared to others that may accumulate and pose higher risks.

How much more potent is the anesthetic discussed compared to lidocaine?

The anesthetic discussed is four times more potent than lidocaine, which is why it has a longer duration of action.

What is the recommended usage of this anesthetic during pregnancy?

The anesthetic should not be recommended for pregnant women due to a lack of studies on its safety during pregnancy, despite its potential benefits in anesthesia.

How long does it take for the anesthetic to begin taking effect?

The anesthetic described in the video takes approximately 6 to 10 minutes to start taking effect.

What is the anesthesia duration for different tissues according to the speaker?

For soft tissue, the anesthesia lasts between 140 and 540 minutes (up to 9 hours), while the pulp anesthesia lasts for about 4 hours.

Why is Boop considered a good anesthetic option for reducing post-operative medication?

Boop is effective for reducing post-operative medication because it keeps the patient anesthetized and free from pain for a longer time, decreasing the need for additional analgesics like opioids.

What is the maximum dose of the anesthetic discussed in the video?

The maximum dose of the anesthetic is much smaller than others, with recommendations from Malamed suggesting 2 mg per kilogram, while Android suggests 1.3 mg per kilogram.