Scandonest contains the active substance: mepivacaine hydrochloride .
Additional components: sodium chloride and hydroxide, injection water.
Release form
Scandonest is available as an injection solution, packaged in 1.8 ml cartridges. The containers are packaged in packs of 10, 20, 30, 40, 50, 60, 80, 100 or 120 pieces.
pharmachologic effect
The solution is characterized by local anesthetic action.
Pharmacodynamics and pharmacokinetics
This local anesthetic drug is offered in the form of an injection solution, packaged in cartridges.
The use of this drug prevents the development of impulses in the area of nerve endings, as well as their passage along nerve fibers, helping to block sodium channels. Scandonest is the strongest local, the effect of which lasts for at least 1-3 hours. The drug occurs in the liver. As a result, substances are formed that exhibit a noticeable vasoconstrictor effect.
Indications for use
- therapeutic;
- surgical;
- dental interventions.
The drug can also be prescribed as an anesthetic during treatment. arterial hypertension, And coronary insufficiency.
Contraindications
- hypersensitivity to its components;
- severe liver diseases;
- children and old age;
- difficult cases .
Caution is necessary when treating patients suffering from cardiovascular and inflammatory diseases during the childbirth period.
Side effects
The use of this drug may be accompanied by weakness, motor restlessness, convulsions, and loss of consciousness.
Disturbances in the activity of the cardiovascular system are also possible. vascular system, for example: increase , bradycardia, .
In addition, activities may be affected excretory system, symptoms occur. Therefore, it is possible: involuntary urination, the appearance of a skin rash, , , numbness of lips and tongue and so on.
Scandonest, instructions for use (Method and dosage)
According to the instructions, the dose and treatment regimen of Scandonest depends on the type of intervention and the required anesthesia. On average, the dosage is 1-3ml.
When Scandonest is used in dentistry, adult patients are prescribed it in a single dosage at the rate of 6.6 mg per kg of weight, but not more than 400 mg.
Overdose
In case of overdose, symptoms such as hypotension, arrhythmia, loss of consciousness, increased muscle tone, and convulsive state may occur. , hypercapnia, dyspnea and even cardiac arrest.
In this case, treatment is carried out in the form of hyperventilation, maintaining adequate oxygenation, assisted breathing, stopping seizures, convulsions, and so on.
Interaction
special instructions
Before planning Scandonest injections, it is recommended to discontinue the use of MAO inhibitors at least 10 days in advance, for example, Procarbazine, Selegilina . The point is that they can increase downside risk blood pressure. Apply this drug It is possible only with a doctor's prescription.
Terms of sale
On prescription.
Storage conditions
The solution is stored in a dark and cool place, out of reach of children.
Best before date
Analogues of Scandonest
Level 4 ATX code matches:Analogues of this drug include: Mepivacaine, Mepivastezin And Scandinibsa.
Latin name: Scandonest
ATX code: N01BB03
Active substance: Mepivacaine
Manufacturer: Septodont, France
Release from the pharmacy: On prescription
Storage conditions: t no more than 25 C
Best before date: 3 years
Scandonest is a drug that is used for pain relief during various dental, surgical or therapeutic procedures.
Indications for use
In dentistry, the use of Scandonest is indicated for infiltration or conduction anesthesia.
The drug is used for a simple procedure of tooth extraction, as well as during the process of cavity preparation and hygienic treatment of tooth stumps before subsequent restoration or installation of orthopedic structures.
An anesthetic is also used if vasoconstrictor drugs are contraindicated.
Composition and release forms
A solution with a volume of 1.8 ml (1 cartridge) contains the only component, which is mepivacaine hydrochloride, its mass fraction is 54 mg.
Additional substances are presented:
- Saline solution
- Sodium hydroxide
- Purified water.
The solution poured into cartridges is transparent and practically colorless liquid, no visible inclusions are observed. Inside the contour packaging there are 10 or 20 cartridges. A pack can contain 1-6 contacts. packages
Medicinal properties
Mepivacaine is a local anesthetic, characterized by a rapid analgesic effect, this is due to the reverse inhibition of ion currents, which are responsible for the conduction of nerve impulses. Widely used in dental practice.
The drug begins to act quite quickly (1-3 minutes after the injection), with a pronounced analgesic effect and high local tolerance.
It is worth noting that the mechanism of action is based on blocking special stress-dependent sodium channels, which are located inside the membranes of the nerve fiber itself. The anesthetic component first penetrates the nerve membrane and then enters the nerve cell as a basis. In this case, the active form is precisely the mepivacaine cation after the process of secondary proton addition. In the case of a reduced pH, which occurs, for example, in the presence of inflamed areas, only a small amount of the active substance remains in the primary form, this can reduce the effect of anesthesia.
The duration of anesthesia without adrenaline in dentistry is observed for 20-40 minutes; in the case of soft tissue anesthesia, the analgesic effect lasts up to 90 minutes.
Mepivacaine is absorbed fairly quickly. The connection with plasma proteins is no more than 78%. The half-life is about 2 hours.
After administration of the drug into a vein, the volume of distribution is 84 l, with a clearance of 0.78 l/min.
Metabolic transformations of mepivacaine occur in liver cells, metabolic products are excreted with the participation of renal system.
It should be noted that you can buy Scandonest without adrenaline only with a prescription.
Scandonest: instructions for use
Price: from 450 to 570 rubles.
Scandonest without adrenaline will need to be injected exclusively into the tissue, preventing the anesthetic solution from entering the vessels. During the injection, control by aspiration must be carried out.
The solution should be administered as slowly as possible, no faster than 0.5 ml over 15 seconds.
Adults are usually prescribed a dosage of 1-4 ml; more than 6 ml of anesthetic should not be administered over 2 hours or exceed daily dose 10 ml.
For children over 4 years of age, the required dosage is selected individually, taking into account body weight and character. surgical intervention. The average dosage for children is about 0.5 mg per 1 kg.
Elderly persons are advised to administer no more than ½ of the dosage, which is calculated for an adult patient.
When administering the drug, use the smallest volume of solution that will give the necessary analgesic effect.
Use during pregnancy and pregnancy
During pregnancy, anesthesia without adrenaline is contraindicated, since the pregnant body may react differently to this drug. If pain relief is necessary during breastfeeding, there is no need to interrupt breastfeeding.
Contraindications and precautions
The use of the drug is contraindicated in the following cases:
- Excessive sensitivity to the main component of the solution
- Pregnancy
- Severe liver pathologies
- Children's and old age
- Complicated course of myasthenia.
Caution will be required during treatment of persons who have been diagnosed with diseases of the cardiovascular system, renal system, inflammatory diseases, diabetes mellitus, as well as during the period of delivery.
It is worth noting that when using the drug Scandonest without adrenaline, patient reviews of possible side effects may differ, this is due to the individual reaction of the body.
Before planning pain relief with Scandonest, you will need to take some preparatory measures. In about 10 days. Before the intended anesthesia, you should stop using MAO inhibitors, for example, drugs such as Selegiline, Furazolidone, and Procarbazine. This is due to an unexpected decrease in blood pressure. Painkiller injections should be given only after consultation with the doctor.
Cross-drug interactions
The risk of hypotension increases with simultaneous use of MAO inhibitors.
A prolonged analgesic effect is observed in the case of simultaneous injections with vasoconstrictor drugs.
The negative effect of the anesthetic on the central nervous system may increase during the use of drugs that inhibit the activity of the nervous system.
When combined with anticoagulants, the risk of bleeding increases.
In the case of carrying out the procedure for disinfecting the injection site with preparations containing heavy metals, the risk of adverse symptoms increases.
The effect of muscle relaxants can be significantly enhanced in the case of combined use with an anesthetic.
Combination with narcotic analgesic drugs can provoke an additive effect. This combination of drugs is possible in the case of epidural anesthesia, but special care should be taken, as there is a risk of depression of respiratory function.
The use of antimyasthenic drugs provokes pronounced antagonism, as well as insufficient effectiveness of the drugs.
The rate of elimination of mepivacaine is affected by cholinesterase inhibitors.
Side effects and overdose
When using an anesthetic drug, severe headaches may occur in combination with dizziness and lethargy. It is possible that the activity of the cardiovascular system may be disrupted, convulsive syndrome, loss of consciousness, as well as severe motor restlessness.
In addition, there may be Negative influence local anesthetic on the functioning of the excretory system, allergy manifestations are possible. In this regard, skin rashes and itching, involuntary frequent urination, Quincke's edema, numbness of some parts of the face.
The following symptoms may be observed:
- Increased muscle tone
- Convulsive syndrome
- Acidosis
- Impaired oxygen supply and respiratory function
- Decreased blood pressure
- Pathological conditions of the cardiovascular system
- Changes in acid-base balance.
Analogs
Espe Dental AG, Germany
Price from 1420 to 2100 rub.
A drug that is used for local anesthesia, his tradename does not match the name active substances(epinephrine, articaine). Applicable in state clinics and private clinics during various dental procedures. Ubistezin is available in the form of a solution.
Pros:
- Quick analgesic effect (for toothache)
- Can be used during pregnancy
- Characterized by low systemic toxicity.
Minuses:
- Can only be purchased with a prescription
- Should not be combined with tricyclic antidepressants
- After the injection, the occurrence of local edema cannot be ruled out.
Sanofi Aventis, France
Price from 506 to 5336 rub.
Remedy for local anesthesia without adrenaline (adrenaline) and ananephrine. The active ingredients are articaine with epinephrine. Characterized by the same action as Ubistezin. Ultracain is available in the form of an injection solution.
Pros:
- Widely used in dentistry
- Used during lactation
- Rarely provokes side effects(according to numerous reviews).
Minuses:
- You can buy drugs only with a prescription
- Contraindicated in bronchial asthma
- High price.
From this article you will learn:
- anesthesia in dentistry - drugs,
- types of anesthesia for dental treatment,
- pain relief during pregnancy and breastfeeding.
The article was written by a dental surgeon with more than 19 years of experience.
Local anesthesia is a type of anesthesia, the meaning of which is to block the transmission of pain impulses from the area where the intervention is performed. Options for local anesthesia in dentistry include infiltration, conduction or application anesthesia. They allow you to anesthetize only the area where the intervention is planned (this could be a group of teeth or a fragment of the jaw), while the patient is conscious.
For local anesthesia in dentistry they are used medicines, which are called “local anesthetics”. But in some cases, for example, with volumetric surgical interventions ah or panic fear a person before treatment or tooth extraction - can also be used, in which, along with pain sensitivity, the patient’s consciousness is temporarily turned off. General anesthesia is carried out using narcotic analgesics administered intravenously or inhaled (Fig. 3).
Local and general anesthesia in dentistry –
The very first local anesthetic in dentistry was , which, however, did not allow for significant anesthesia and practically did not anesthetize inflamed tissues. Later, it appeared, which was already about 2-2.5 times stronger in effectiveness, but like novocaine, it did not allow achieving a great depth and duration of anesthesia. The real revolution occurred with the advent of articaine anesthetics (based on articaine hydrochloride), which additionally contained vasoconstrictors.
The most popular local anesthetics in dentistry based on articaine are Ultracaine, Ubistezin, Alfacaine, Septanest and others. For higher magnification the depth and duration of anesthesia, vasoconstrictors began to be added to these drugs. The latter narrow blood vessels at the site of injection of the anesthetic, thereby reducing the rate of its leaching from the tissues. Currently most often used as vasoconstrictors epinephrine at a concentration of 1:100000 and 1:200000.
Local anesthesia for treatment and extraction of teeth –
If previously novocaine and lidocaine were produced in the form of vials or ampoules, and injections with these drugs were performed using ordinary disposable syringes of 5.0 ml - now all modern anesthetics are produced in the form of disposable carpool(cartridges). Each carpule usually contains 1.7 ml of anesthetic, and before anesthesia it is inserted into a special carpule syringe. Next, a very thin needle is screwed on (many times thinner than ordinary needles on disposable syringes), after which the syringe is ready for use.
What does a carpule syringe look like?
Cost of anesthetics and anesthesia –
The cost of one carpule of anesthetic at the end of 2020 (be it ultracaine, ubistezin, septanest or others) will be approximately 40-50 rubles. This is the price at which dental clinics purchase anesthetics. But the full cost of anesthesia for dental treatment in dental clinic will be about 400-500 rubles for 1 carpule of anesthetic.
It is also worth noting that pain relief during the treatment and extraction of teeth in dentistry is included in the guarantee program of the health insurance fund. Therefore, anesthesia in government dental clinics should be carried out free of charge, but only when using Lidocaine or Novocaine (imported anesthetic will be paid for). Next, we will talk about the types of anesthesia in dentistry.
Types of anesthesia in dentistry - infiltration, conduction, application
As we said above, local anesthesia can be application, infiltration or conduction. Topical anesthesia in dentistry is used to numb the oral mucosa by applying 10% lidocaine in the form of a gel or spray. This type of anesthesia is especially often used in children to pre-numb the place where the needle is inserted. Lidocaine spray is often sprayed onto the root of the tongue in patients with an increased gag reflex.
Infiltration anesthesia in dentistry - most often performed during the treatment and removal of any teeth upper jaw, as well as in the area of the front teeth lower jaw. In this case, the injection is carried out in the area transitional fold in the projection of the root of the tooth that we will remove or treat (the transition fold is the zone of transition of the tightly attached mucous membrane into the mobile mucous membrane of the cheek or lip). After the anesthetic is introduced into the tissue, an infiltrate is formed in them, from which the anesthetic quickly penetrates into the bone tissue of the jaw.
Conductive anesthesia - in dentistry it is most often used to anesthetize 6-7-8 lower teeth (less often than other teeth). This is due to the fact that bone the lower jaw is denser and thicker - especially at the last teeth. And therefore, if we perform infiltration anesthesia on the lower molars, the anesthetic simply will not penetrate into the bone and, accordingly, the patient will experience pain. And in in this case Conduction anesthesia (mandibular or torus) will help us - the injection is made into the nerve trunk, which runs approximately in the middle inner surface branches of the lower jaw.
Infiltration and conduction anesthesia (video 1-2) –
How long does it take for dental anesthesia to last?
the effect of infiltration anesthesia on the upper jaw occurs within a few minutes, and lasts from 15 to 45 minutes (this depends on the type of anesthetic and the concentration of the vasoconstrictor in it). The onset of anesthesia is signaled by the appearance of numbness in the cheek area or upper lip. The effect of conduction anesthesia on the lower jaw occurs in 5-10 minutes, but it can last from 1 hour to several hours. We will be informed about the onset of anesthesia following symptoms– there must be pronounced numbness of half lower lip, as well as the tip of the tongue.
Important : if after conduction anesthesia on the lower jaw, the numbness of half the lip is weak or completely absent, then the doctor missed and was unable to remove the anesthetic near the inferior alveolar nerve (it is this nerve that runs on the inner surface of the branch of the lower jaw, providing pain sensitivity to the teeth on this side). And in this case, you should either ask the doctor to repeat the anesthesia, otherwise the treatment will be painful.
Yes, and I would like to note that in most cases, poor anesthesia is associated only with doctor errors, i.e. with violation of the technique of conduction anesthesia. This type of anesthesia is the most difficult during a general dental appointment, and not all doctors confidently perform conduction anesthesia. However, there are a number of patients in whom it is impossible to achieve good anesthesia in principle. These include patients who abuse analgesics, as well as alcohol and drugs.
What to do if you are afraid of anesthesia -
Indeed, an anesthetic injection can be painful. The pain will depend both on the patient’s pain sensitivity threshold and on the doctor’s anesthesia technique. According to the rules, a solution of one anesthetic carpule (1.7 ml) is excreted into the tissue within 40-45 seconds. If the doctor saves time, then it is logical that rapid administration of the solution will cause pain.
2) Ubistezin - instructions for use
3) Septanest: instructions for use
4) Scandonest: instructions for use
Which anesthetic is right for you - summary
- For bronchial asthma or high allergies –
here you need an anesthetic without preservatives (usually sodium disulfite is used in anesthetics, which is needed to stabilize epinephrine or adrenaline). Therefore, the anesthetic “Ultracain D”, which does not contain any preservatives, is best suited for such patients.
- For diseases thyroid gland, diabetes mellitus –
in this case, you also do not want to use anesthetics containing vasoconstrictor components - adrenaline, epinephrine. The drug of choice, for example, Ultracaine D, Scandonest or Mepivastezin. But, choosing between these three anesthetics, I would give preference to the first.
- If you have high blood pressure and heart disease –
for moderate hypertension and compensated heart disease, the optimal choice is anesthetics containing a concentration of epinephrine (adrenaline) - 1:200000. This can be anesthetics “Ultracain DS” or “Ubistezin 1:200000”.In case of severe hypertension, decompensated heart disease, it is necessary to use anesthetics that are completely free of adrenaline and epinephrine. Then, for example, “Ultracain D” will do.
- If you healthy man
–
If you do not have the above diseases, then you can safely administer anesthetics containing epinephrine/adrenaline in a concentration of 1:100,000. Moreover, a person weighing about 70 kg can be given up to 7 carpules of anesthetic inclusive. An example of such anesthetics is Ultracain DS Forte, Ubistezin Forte and analogues.
Anesthesia in dentistry during pregnancy and breastfeeding –
One of the most frequently asked questions– Is it possible to treat teeth for pregnant women with anesthesia? Anesthesia in dentistry during pregnancy and breastfeeding really has its own characteristics. The safest anesthetic here is considered to be Lidocaine (safety category “B”), and it is advisable to use it with a small concentration of vasoconstrictor 1:200,000.
The presence of the latter not only makes it possible to enhance anesthesia, but also to reduce the peak concentration of the anesthetic in the blood, which will further reduce the effect of the anesthetic on the fetus, and also reduce its entry into the fetus. breast milk. Drugs with vasoconstrictors are contraindicated in pregnant women only if high blood pressure and with chronic fetal hypoxia. Therefore, the most optimal anesthetic would be Xylonor(a preparation of 2% lidocaine in carpules, containing 1:200,000 epinephrine), or any similar lidocaine-based anesthetics.
As for drugs based on articaine, they will already belong to the safety category “C”, which, in principle, is also considered quite safe, but a little less. Of the anesthetics during pregnancy based on articaine, it is better to choose Ultracaine DS (with an epinephrine content of 1:200000). And only if the pregnant woman has high blood pressure or fetal hypoxia, we choose an anesthetic without a vasoconstrictor, for example, Ultracaine D.
Some doctors use the anesthetics Scandonest or Mepivastezin (they do not contain adrenaline or epinephrine) for pain relief in pregnant women. But it is undesirable to use such anesthetics in pregnant and lactating women, because due to the absence of a vasoconstrictor component, they are quickly absorbed into the blood. It leads to high concentration anesthetic in the blood, which will allow it to more easily penetrate the placenta. In addition, both Scandonest and Mepivastezin are 2 times more toxic than novocaine. We hope that our article on the topic: Local anesthesia for dental treatment was useful to you!
Sources:
1. Higher prof. author's education in surgical dentistry,
2. Based on personal experience work as a dental surgeon,
3. National Library of Medicine (USA),
4. “Local anesthesia in dentistry” (Baart J.),
5. “Propaedeutics of surgical dentistry” (Soloviev M.).
Pain relievers used in modern dental practice can work wonders. After an anesthetic injection, the patient does not feel any pain, or even particularly discomfort. To ensure that the injection itself is painless, before the procedure the doctor “freezes” the injection site with a special preparation with a delicious smell of cherry, lemon, or apple.
Local anesthesia is the main method of pain relief used in dental practice. With local anesthesia, the patient remains fully conscious, and this allows the doctor to fully control the entire course of treatment, communicate with the patient, and monitor your reaction.
The quality of dental interventions depends on the results the doctor obtained during local anesthesia.
Therefore, achieving 100% pain relief is necessary not only for the patient, but also for the doctor, in order to carry out treatment calmly, slowly, and efficiently. Hence the following requirements for local anesthetics:
they must have a strong analgesic effect, easily penetrate into tissues and remain there for as long as possible;
have low toxicity, causing a minimum number of both general and local complications.
Scandonest and application in dentistry
Scandonest is a local or local-regional anesthesia for use in dentistry.
This anesthetic is recommended for any type of intervention, in particular for patients arterial hypertension, as well as for patients suffering coronary insufficiency and diabetes. It is recommended for all patients who use is contraindicated vasoconstrictor component.
Mepivacaine is another type of anesthetic. The vasoconstrictor substance is usually not included in the mepivacaine carpule, because Mepivacaine itself has the ability to constrict blood vessels. However, the effectiveness of this drug is slightly lower than the effectiveness of articaine. But this drug can be used for anesthesia in children, pregnant women, people with hypertension and in other patients for whom the administration of adrenaline is contraindicated. In these cases, our clinic uses a drug based on mepivacaine, produced in France, called Scandonest.
Despite all the advantages of modern anesthetics, there is always a risk of allergic reactions to any drug. Therefore, you should always warn your doctor about the presence of allergies and allergic manifestations in past. If you want to completely protect yourself from possible allergic reaction for anesthesia, you can take a blood test in advance to check for hypersensitivity to the drugs used in the clinic.
Pharmaceutical form and properties of Scandonest
Injection.
Pack of 50 cartridges of 1.8 ml, in blisters of 10 cartridges.
Pack of 10 cartridges of 1.8 ml in a blister.
Designed for professional use in dentistry.
Mepivacaine hydrochloride is topical anesthetic amide type. We are talking about 1M-methylpipecolic acid dimethylanilide hydrochloride or mepivacaine hydrochloride. When given by injection near sensory nerve branches, mepivacaine reversibly blocks the passage of painful nerve sensations.
Unlike most active substances in anesthetic solutions, which have, among other things, vasodilator properties, mepivacaine has a vasoconstrictor effect, which allows in many cases the use of a solution with a reduced content of the vasoconstrictor component.
Scandonest contains mepivacaine, which is an amide-type local anesthetic.
Mepivacaine reversibly blocks nerve impulses due to its effect on ion transport across the cell membrane. Mepivacaine begins to act quickly and has high frequency anesthesia and low toxicity.
After the blockade peripheral nerve The action of mepivacaine begins within 5 minutes.
Pulp anesthesia typically lasts 25 minutes after maxillary infiltration and 40 minutes after mandibular alveolar nerve anesthesia, while soft tissue anesthesia lasts for 90 minutes and 165 minutes after maxillary infiltration and 40 minutes after mandibular alveolar nerve anesthesia. nerve, respectively.
Indications for use of Scandonest
If the patient is at risk (with concomitant diseases severe form, in particular cardiovascular pathology), you need to completely stop using an anesthetic solution with adrenaline, a vasoconstrictor.
In such cases, Scandonest is used. This anesthetic exhibits a vasoconstrictor effect, i.e. has vasoconstrictor properties and can therefore be used without adrenaline, which means that the drug does not contain sulfites and can also be used in patients with bronchial asthma and allergic conditions (after an allergy test).
Scandonest is a medium-strength anesthetic; provides anesthesia, depending on which part of the jaw the doctor disconnects from pain sensitivity, for 20 - 90 minutes, which sets it apart from the group of other non-adrenaline anesthetics.
Use of Scandonest for children
It should be noted separately the features of local anesthesia in children. The technique of local anesthesia in children must be planned so that 100% pain relief is achieved at all stages of treatment, otherwise it will be impossible to carry out the necessary manipulations.
As mentioned above, children under 5 years of age are given an anesthetic without adrenaline (Scandonest 3%, or Septanest 4%).
Children over 5 years old can use an anesthetic with low concentration adrenaline (1:200,000 - Ultracaine DS). The dose of drugs is selected depending on age. Pain relief is performed in children in 3 stages:
- first, a superficial anesthetic gel is applied;
- then a small dose (0.1-0.2 ml) of anesthetic is administered;
- after which, after 60-90 seconds (time sufficient for effective anesthesia of the needle path in soft tissues) the remaining amount of the planned dose of anesthetic is administered.
We wait 5-10 minutes until complete anesthesia occurs. The child, feeling complete absence pain, gains confidence in the doctor and makes it possible to carry out the necessary intervention.
Contraindications for Scandonest
- myasthenia gravis;
- serious illnesses liver;
- porphyria;
- childhood up to 4 years;
- pregnancy;
- hypersensitivity to the components of the drug.
Carefully:
- renal failure;
- progression of cardiovascular failure;
- conditions accompanied by a decrease in hepatic blood flow (for example, with liver diseases, chronic heart failure, diabetes mellitus);
- pseudocholinesterase deficiency;
- inflammatory diseases or infection of the injection site; age over 65 years.
- severe arterial hypotension;
- decompensated chronic heart failure;
- severe cardiac conduction disturbances, including atrioventricular block;
- bradycardia.
Side effects of Scandonest
from the central nervous system: pupil dilation, motor restlessness, drowsiness, headache, visual and hearing impairment, motor and sensory block, nystagmus, diplopia, trismus, weakness, dizziness, tremor, convulsions, impaired consciousness up to its loss;
from the vascular system: pain in chest, a sharp decline blood pressure, arrhythmias, collapse (peripheral vasodilation), tachycardia or bradycardia (in some cases it can develop into atrioventricular block);
from the outside digestive system: nausea, involuntary defecation, vomit;
from the respiratory system: apnea, dyspnea;
from the urinary system: involuntary urination;
from the blood: methemoglobinemia;
allergic reactions: local – skin rash, itching, urticaria, swelling and inflammation at the injection site;
systemic – pharyngeal edema, bronchospasm, angioedema;
V severe cases– cardiopulmonary failure caused by anaphylactic shock;
other: numbness and paresthesia of the tongue and lips, hypothermia, prolongation of anesthesia.
Side effects usually occur in case of hypersensitivity to the drug, increased absorption or accidental extravascular administration of the solution.
Scandonest is used for conduction and infiltration local anesthesia during therapeutic and surgical interventions in the oral cavity.
Don’t be afraid of the dentist and put off visiting the clinic, because today you can cure or remove a tooth and even install an implant without experiencing any pain!
Local anesthesia with Ultracaine during tooth extraction
Scandonest is a drug used for pain relief and is classified as a local anesthetic. Often used for carrying out in dentistry.
Recommended for patients with hypertension, coronary disease hearts and diabetes mellitus. In other words, for all patients for whom the use of adrenaline and other vasoconstrictors is not recommended.
Composition and release form
The anesthetic Scandonest contains:
- mepivacaine hydrochloride in the amount of 54 mg;
- sodium chloride;
- sodium hydroxide;
- water for injections.
The drug is available in the form of carpules with a volume of 1.8 ml. One package contains 50 of them, 10 pieces in one blister.
Pharmacological properties
The main active component of the drug mepivacaine belongs to the amide group anesthetics. Injected near the nerve endings, it stops the conduction of nerve impulses and relieves pain.
Its main difference from others local anesthetics– vasoconstrictor effect. That is why there is no adrenaline in the composition. Other 
anesthetic substances have the ability to dilate blood vessels, which does not allow their use without the introduction of any means that reduce the lumen of blood vessels.
The effect develops 2-3 minutes after administration. The duration of the anesthetic effect is 30-40 minutes.
Maximum amount The drug can be detected in the blood half an hour after its use. The half-life is 90 minutes.
Main active substance actively enters into metabolic processes. Only 5-10% of the drug is excreted by the kidneys without any changes. The main depot of metabolites is the liver, so any pathology of the organ leads to their accumulation.
Indications and contraindications for use
The medication is used in the following cases:
- treatment of teeth for orthopedic structures;
- surgical interventions on the oral mucosa or bone;
- closing the communication with the maxillary sinus;
- installation of metal plates at .
Contraindications to Scandonest injections:
- individual intolerance to the components of the drug;
- severe myasthenia gravis;
- low levels of cholinesterase in the blood;
- porphyria;
- serious disturbances in liver function;
- renal failure.
Use with caution when:
- diseases associated with the functioning of peripheral vessels;
- ventricular arrhythmias;
- heart failure;
- atrioventricular block;
- epilepsy;
- porphyria;
- treatment with antiplatelet agents and antiarrhythmic drugs.
10 days before the expected visit to the dentist, you must stop using monoamine oxidase inhibitors.
How is the drug administered?
For each individual patient, the required dose may vary and depends on the area where anesthesia is performed, the degree of its vascularization, individual tolerance of the drug components and the technique used.
It is necessary to use the smallest amount of the drug that provides a sufficient depth of pain relief. Usually 1-3 medication cartridges of 1.8 ml each are sufficient for 1 intervention.
The maximum dose of mepivacaine at one time is 4.4 mg/kg.
Childhood
Scandonest can only be used when treating children over 4 years of age. The recommended dose would be 0.75 mg/kg. The maximum amount of substance that is allowed to be administered per visit is 3 mg of mepivacaine per 1 kg of child weight.
For all patients, the rate of anesthetic administration should not exceed 1 ml per minute.
Pregnancy and lactation
Using Scandonest for dental treatment pregnant and lactating women is possible, since there is no data indicating the direct effect of the components of the drug on the fetus.
However, a risk to newborns cannot be excluded. In addition, there is evidence of the penetration of mepivacaine through the blood-placental barrier and into breast milk. Therefore, it is not recommended to breastfeed your baby within 10 hours after using the drug.
special instructions
During the process of anesthesia, an aspiration test must be carried out to prevent the solution from entering the lumen of the vessels. 
Otherwise, the patient may experience seizures, disruption of the central nervous system, or cardiorespiratory depression and coma.
Athletes should use Scandonest with caution.
During doping control, the reaction may be positive.
Side effects and cases of overdose
Undesirable effects after using an anesthetic are similar to reactions that occur with other groups of amide-type drugs. Most often they are associated with exceeding the recommended dose and can occur with overdose, rapid absorption or accidental intravascular injection.
The following symptoms are observed:
- impact on nervous system manifests itself in the form of headaches, drowsiness, weakness, dizziness and motor restlessness, convulsions, impaired consciousness, tremor, possible diplopia, nystagmus;
- The sense organs also change their normal functioning - visual and hearing impairments appear;
- on the part of the heart and blood vessels, a decrease in blood pressure, arrhythmia, collapse, bradycardia develops;
- violation normal operation The gastrointestinal tract manifests itself in nausea, vomiting, and involuntary defecation;
- involuntary urination;
- respiratory failure to the point of complete depression;
- methemoglobinemia;
- allergies in the form of itching, skin rash, angioedema, anaphylactic shock, urticaria may appear on the skin and mucous membranes;
- fetal bradycardia;
- Swelling and an inflammatory reaction are possible at the injection site.
Overdose symptoms depend on the amount of substance administered. The severity of the condition may increase over time. All changes occur as part of neurological disorders with further toxic effects on the heart, blood vessels and respiratory system.
If you suspect an overdose, you should immediately stop using the drug. Access to oxygen must be ensured and, if necessary, an air duct is inserted and the artificial ventilation lungs. In addition, the patient is placed in a supine position.
If convulsions begin, barbiturates are administered intravenously. In case of cardiac arrest, emergency cardiopulmonary resuscitation is performed.
What can be replaced?
The price for 10 Scandonest carpules is 400-600 rubles, also available for purchase the following analogues medications:
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