Beyond The Local Anesthesia by Jonny Burga Sánchez in LOJPCR in Lupinepublishers
One of the most important events in dentistry history was the
discovery of local anesthetics in 1859 by Albert Niemann (1834
– 1861). In fact, this event represents the beginning of a new era
in dentistry. Despite the adverse and lethal effects of cocaine,
the first local anesthetic used in dentistry, this finding permitted
the develop of other local anesthetics with less adverse effects
and better safety index such as procaine, lidocaine, mepivacaine,
bupivacaine, prilocaine and more recently ropivacaine and
articaine. Local anesthetics constitute a group of elementary
drugs in the professional arsenal of dentistry and are the most
used drugs in this area. They act by preventing the conduction of
the nociceptive electrical impulses in a reversible way, generating
a loss of sensitivity to pain. Local anesthetics internally block Na+
voltage gated channels on neuronal fibers, thus decreasing nerve
conduction. Na+
voltage gated channels are complex structures
formed by two β subunits (β1
and β2
) and a large α subunit in whose
central part is located the entry pore for this ion.
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