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Many local anesthetics fall into two general chemical classes, amino esters (top) and amino amides (bottom). A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, [1] providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes ...
Structurally, amino esters consist of three molecular components: a lipophilic part (ester); an intermediate aliphatic chain; a hydrophilic part (amine); The chemical linkage between the lipophilic part and the intermediate chain can be of the amide-type or the ester-type, and is the general basis for the current classification of local anesthetics.
Articaine is a dental amide-type local anesthetic. It is the most widely used local anesthetic in a number of European countries [ 2 ] and is available in many countries. It is the only local anaesthetic to contain a thiophene ring , meaning it can be described as 'thiophenic'; this conveys lipid solubility.
Local anesthetics can be either ester- or amide-based. Ester local anesthetics are generally unstable in solution and fast-acting, are rapidly metabolised by cholinesterases in the blood plasma and liver, [4] and more commonly induce allergic reactions. Amide local anesthetics are generally heat-stable, with a long shelf life (around two years).
Amide benzocaine: Anbesol, Orajel Ester - Aminobenzoic Short benzonatate: Tessalon bupivacaine: Marcaine, Sensorcaine, Vivacaine 1957 (Ekenstam) 1963 (Widman and Telivuo) Amide Moderate butacaine: ester- aminobenzoic butanilicaine: Amide chloroprocaine: Nesacaine Ester - Aminobenzoic cinchocaine (INN)
Local anesthetic injections are given in specific areas of the mouth, rather than the whole body. Although several different medications are available, the most commonly used local anesthetic to prevent pain in the area around a tooth is lidocaine (also called xylocaine or lignocaine). Lidocaine's half-life in the body is about 1.5–2 hours. [2]
Etidocaine, marketed under the trade name Duranest, is an amide-type local anesthetic given by injection during surgical procedures and labor and delivery.Etidocaine has a long duration of activity, and the main disadvantage of using during dentistry is increased bleeding during surgery.
Like lidocaine, bupivacaine is an amino-amide anesthetic; the aromatic head and the hydrocarbon chain are linked by an amide bond rather than an ester as in earlier local anesthetics. As a result, the amino-amide anesthetics are more stable and less likely to cause allergic reactions.