Articaine

Overview
Articaine is a dental local anesthetic. It is manufactured and distributed by Septodont under the brand name Septocaine. Articaine hydrochloride 4% with epinephrine 1:100,000 injection. Septocaine was first approved for use in Germany in 1976 and throughout Europe shortly after. Canada approved usage in 1982, with the US FDA following in 2000. Qualities such as fast acting nature and strength of dosage have made it more appealing for use by dentists than other available anesthetics such as novocaine and lidocaine.

Structure and Metabolism
Articaine is unique among local anesthetics because it contains a thiophene group, and also because it contains both ester and amide groups. Articaine is an amide anesthetic due to the amide intermediate chain, and undergoes hepatic metabolism. However, the associated ester group also allows plasma metabolism via pseudocholinesterase, purportedly increasing the rate of breakdown and reducing its toxicity. This difference in metabolism gives articaine the distinct advantage of having a 30 minute half life, as opposed to drugs such as lidocaine that have a 90 min. half life.

Complications
NO Serious complications have been associated with Septocaine. Long-term or transient paresthesia is among the worst of the reported side effects of Septocaine but does not occur as frequently as with lidocaine. (JD)

It should be noted that almost all recorded cases of long term numbness or parasthesia in a dental setting are associated with a mandibular nerve block type injection and simple infiltration injections are generally thought to be immune from such complications. For this reason many dentists have abandoned using articaine for mandibular nerve blocks.