Local Anesthesia in Dentistry E-Book

Jesús Calatayud

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1569

Veröffentlichungsjahr: 2024

Beschreibung

Local Anesthesia in Dentistry Distills the current body of knowledge in local anesthesia into a single, easy-to-use volume Local Anesthesia in Dentistry: A Locoregional Approach provides comprehensive coverage of all aspects of local anesthetics, including anatomic considerations, pharmacology, armamentarium, injection techniques, indications, contraindications, complications, novel anesthetics formulations, and more. In-depth chapters offer clear criteria and guidelines for patient care, supported by hundreds of evidence-based references. Alongside this, standalone appendixes are hosted on the book's companion website. In these appendixes, the authors have distilled a wide body of research, summarizing the findings of the seminal studies in the field, including historical landmark studies and clinical trial data to support practical aspects of locoregional anesthesia discussed in the textbook. This easy-to-use volume: * Provides students and professionals with a one-stop resource on local anesthesia in dentistry * Offers critical evaluations of research and literature on each topic and subtopic * Addresses all common local anesthetic techniques, including basic injection, mandibular and maxillary anesthesia, and local anesthesia in children * Features practical quantitative data and step-by-step information on situations encountered in daily practice Designed to support all levels of dental professionals, Local Anesthesia in Dentistry: A Locoregional Approach is written by two highly experienced practitioners, making this authoritative resource a must-have for dentists, dental nurses, dental technicians, hygienists, specialists, students, and researchers. It is also a valuable reference for other healthcare providers looking to support future study.

Leseprobe

Local Anesthesia in Dentistry

A Locoregional Approach

Jesús Calatayud, MD, PhD, DMD

Associate Professor (retired)Pediatric DentistrySchool of DentistryUniversidad Complutense. Madrid (Spain)

Mana Saraghi, DMD, DADBA

President, American Dental Board of AnesthesiologyDirector, Dental Anesthesiology Residency Program, Jacobi Medical CenterAssistant Professor of Dentistry, Albert Einstein College of MedicineBronx, New York (United States)

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Library of Congress Cataloging‐in‐Publication Data

Names: Calatayud, Jesús, author. | Saraghi, Mana, author.Title: Local anesthesia in dentistry: a locoregional approach / Jesús Calatayud, Mana Saraghi.Description: Hoboken, NJ: Wiley‐Blackwell, 2023. | Includes bibliographical references and index.Identifiers: LCCN 2023007820 (print) | LCCN 2023007821 (ebook) | ISBN 9781394180158 (cloth) | ISBN 9781394180165 (adobe pdf) | ISBN 9781394180172 (epub)Subjects: MESH: Anesthesia, Dental‐methods | Anesthesia, Local‐methods | Anesthesia, Dental‐adverse effects | Anesthesia, Local‐adverse effects | Anesthetics, LocalClassification: LCC RK510 (print) | LCC RK510 (ebook) | NLM WO 460 | DDC 617.9/676–dc23/eng/20230420LC record available at https://lccn.loc.gov/2023007820LC ebook record available at https://lccn.loc.gov/2023007821

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Preface

Dental local anesthesia is the principal means at our disposal for controlling the pain caused by our treatments and procedures. The importance of dental local anesthesia is so profound that it is impossible to imagine carrying out our work without it. This approach has considerable advantages and an excellent safety profile over other techniques for managing pain in our day‐to‐day activity as compared to sedation and general anesthesia. Furthermore, administration of local anesthesia is one of the most common procedures in clinical practice and is generally the first treatment administered. If its effect is inadequate, our work is complicated enormously.

Correct application of local anesthesia is very important in adults, since many patients may refuse to undergo dental treatment owing to their fear of needles and injections. Paradoxically, the method we use to control pain causes most anxiety for patients. Correct application is even more important in children, since traumatic experiences in childhood can be carried forward to adulthood: poor control of dental pain in children is one of the main factors underlying the development of anxiety over dental treatment at older ages.

We highlight a series of peculiar aspects in this book. Almost all of the techniques discussed are intraoral, and while extraoral techniques that cross the skin are used occasionally – mainly in hospitals – they have a negligible role in modern dentistry. In addition, many chapters and sections provide simple and practical quantitative data (percentages, means, ranges, etc.). This information has been obtained from many sources and studies with the aim of guiding dentists in the situations that arise in daily practice. The annexes found at the end of the book provide abundant information based on specific and practical data. They are presented separately so as not to interrupt the flow and reduce the effectiveness of this textbook.

The images and illustrations aim to explain concepts as clearly as possible. Consequently, most drawings are more schematic than strictly topographic, much in the same style as that of the famous illustrator Frank H. Netter, who expressed the idea perfectly: “Clarification of a subject is the aim and goal of illustration. No matter how beautifully painted, how delicately and subtly rendered a subject may be, it is of little value as a medical illustration if it does not serve to make clear some medical point.” Of course, we do not aim to surpass the artistic quality of Dr. Netter, although we do hope to follow his approach. We have endeavored to provide clear criteria and practice guidelines. While these may occasionally be debatable, we believe that one criterion is better than none. In any case, every effort has been made to present practical and actionable information.

We would like to express our gratitude to Hilding Björn, lecturer at the Universities of Malmo and Lund, for providing us with studies on dental local anesthesia. We are also grateful to his son, Lars Olof Björn, for providing us with information on his father. We thank Professors Rafael Rioboo and Antonio Bascones of Universidad Complutense for their inspiration and example over so many years. We appreciate the help provided by all of the libraries involved in the search for documentation, namely, the Kungliga Biblioteket in Stockholm, the Library of the Academy of Sciences in Saint Petersburg, the British Library, the Centro de Información y Documentación Científica (Spain), and, in particular, the Library of the School of Dentistry of Universidad Complutese and its directors Rosa Mª Rodríguez Durántez and Marian de la Casa, as well as all their staff. Special mention must be made of all those students from the School of Dentistry, Universidad Complutense de Madrid who, over the years, provided information, documents, and studies on dental local anesthesia

Finally, we would like to stress that the information we provide is the fruit of enormous efforts made by many. Therefore, we wish to thank all those great professionals who have played a key role in the history of dentistry, as well as the thousands of specialists (chemists, physicians, and dentists) who, while not part of this history, made essential contributions to the development of techniques that provide relief for millions of people every day throughout the world. We thank them all.

Jesús Calatayud

Associate Professor, School of DentistryUniversidad Complutense, Madrid, Spain

Mana Saraghi

Director, Dental Anesthesiology Residency Program,Jacobi Medical CenterAssistant Professor of Dentistry,Albert Einstein College of MedicineBronx, New York

About the Companion Website

This book is accompanied by a companion website:

www.wiley.com/go/Calatayud/local 

The website includes:

The Annexes 1 to 42

1History of Local Anesthesia in Dentistry

The development of anesthesia in general and local anesthetics in particular required a cultural change. The concept of pain (especially obstetrical pain) was linked to the concept of original sin, and the ability to endure pain was regarded as a sign of character and, in men, was even associated with virility (Greene 1971).

The changes taking place in Western Europe between 1750 and 1850, with the enlightenment, industrialization, progressive democratization, and humanization of society, created an atmosphere favorable to the discovery of anesthetics. Nothing comparable occurred in Asia, Russia, or the Islamic countries, where feudalism persisted in a variety of forms. This general process altered the cultural, political, and religious climate, affecting a significant number of individuals (Greene 1971).

Dentists, not medical doctors, were responsible for the discovery of anesthesia, given their close day‐to‐day contact with pain and hence their motivation to seek the means to alleviate it (Greene 1971). Doctors focused more on infections than on pain, for people were dying of pneumonia, diphtheria, gangrene, tuberculosis, tetanus, puerperal fever, and appendicitis (Greene 1971; Vandam 1973). Two dentists were the first to introduce anesthesia: Horace Wells (1815–1848), with nitrous oxide in 1844 (Wells 1847; Menczer and Jacobsohn 1992; Jacobsohn 1994), and William Thomas Green Morton (1819–1868), with ether in 1846 (Greene 1979).

Local anesthesia, the basis of modern local anesthetics for dentistry, developed later. This chapter reviews the discovery and evolution of local anesthesia from the Spanish discovery of the coca leaf in America to recently established forms of local anesthesia in dentistry.

The Coca Leaf

Coca leaves are taken from a shrub of the genus Erythroxylum, a member of the Erythroxylaceae family, so named by Patricio Browne because of the reddish hue of the wood of the main species (Loza‐Balsa 1992). Of the various species in this genus, Erythroxylum coca contains the highest concentration of the alkaloid known as cocaine in its leaves, up to 0.7–1.8% by weight (Caldwell and Sever 1974; Van Dyke and Byck 1982). Many species of this genus have been grown in Nicaragua, Venezuela, Bolivia, and Peru since pre‐Columbian times (Loza‐Balsa 1992).

The earliest cultivation and use of the coca leaf in the Bolivian and Andean region date back to 700 BCE (Loza‐Balsa 1992), although recent discoveries in Ecuador indicate human usage more than 5000 years ago (Van Dyke and Byck 1982). Alfred Bühler premised that the Arhuaco, a tribe from the Negro River region, were the first to discover the properties of the drug and spread this knowledge to neighboring peoples (Bülher 1944a,b).

Sixteenth century Spanish chroniclers associated the appearance of coca with Francisco Pizarro's (1475–1541) conquest of the Inca or Tahuantinsuyo empire in 1532. The earliest chroniclers made no mention of the plant. The reason for the belated mention of the coca leaf and its consumption may lie, as the sixteenth century Spanish chroniclers aver, in the fact that its use was restricted to the ruling class of the Inca Empire and to certain religious rites, but did not extend to the population as a whole (Calatayud and González 2003). Modern authors have verified those assumptions; noting that after the fall of the empire in 1532 coca consumption became popular among the population at large (Gutierrez‐Noriega and Zapata 1947; Loza‐Balsa 1992) as the entire social system underwent drastic change, particularly after 1540 (Loza‐Balsa 1992).

The first reliable account of coca leaf consumption is a manuscript letter from the Bishop of Cuzco, Friar Vicente de Valverde (15..–1542), to Emperor Charles V in 1539 (Carta1864). His letter is important because Valverde accompanied Francisco Pizarro throughout the conquest of Peru and was present at all the significant events. The second reliable reference is another manuscript, also a letter, from the President of the Peruvian Assembly, member of the clergy and man of letters Pedro de la Gasca (1485–1567), to the Council of the Indies in 1549, in which he described the measures taken by Francisco Pizarro to distribute coca (Carta 1954). The third reference, and the first to be published in print, is attributed to traveler Pedro Cieza de León (1520–1554) whose chronicle of Peru, published in Seville in 1553, refers to the chewing of coca leaves with a chalk‐like powder to assuage hunger, and increase strength and stamina (Cieza de Leon 1553). Pedro Cieza traveled through America between 1530 and 1550, and lived in Peru from 1548 to 1550 (Cieza de Leon 1984). All these chroniclers observed that coca consumption was widespread throughout the population (Table 1.1).

The first reference to the anesthetic effects of coca is attributed to Spanish Jesuit Bernabé Cobo (1582–1657) (Torres 1943), who, in his 1653 manuscript work on the new world, mentioned that toothaches could be alleviated by chewing coca leaves (Cobo 1890).

In subsequent centuries, most writers tended to be apologists, stressing the stimulant effects of coca but paying little or no heed to its dangers. Physicians such as Peruvian José Hipólito Unanúe (1755–1833) (Vicuña‐Mackenna 1914) recommended the use of coca leaves in 1794 (Unanúe 1914) while Austrian physician Sigmund Freud (1856–1939) recommended cocaine itself in 1884. Scholar Francisco Falcon draw attention to the dangers of coca for the first time, in 1582, on the grounds of the mortality it produced among the aboriginal peoples (although this was mainly due to disease acquired during its cultivation) and the difficulty of ridding oneself of the “custom” of using it. The choice of that word in sixteenth century usage is indicative of certain characteristics of addiction. Falcon also recommended measures to restrict its consumption (Representación1946), but it was not until the nineteenth century that the voice of alarm was sounded about the negative effects of coca abuse. German doctor Eduard Friedrich Pöppig (1798–1868), who drew a detailed picture of coca leaf addiction after a voyage to the Amazon in 1827–1832, stressed the digestive changes, migraine, weakness, weight loss, and alterations of personality it induced and the low public opinion of coca consumption and its consumers, who were more poorly regarded than alcoholics in Europe, and unable to give up their habit (Poeppig 1836). The most important landmarks in connection with the coca leaf are outlined in Table 1.1.

Table 1.1 Earliest descriptions of the coca leaf, its anesthetic effect, and harmful side effects.

Earliest writings on the coca leaf

1539 Friar Vicente de Valverde. Manuscript letter

1549 Pedro de la Gasca. Manuscript letter

1553 Pedro Cieza de León. First book in print

First description of the anesthetic effect

1653 Bernabé Cobo. Manuscript

First references to harmful effects

1582 Francisco Falcon

1836 Eduard Friedrich Pöppig

Cocaine

The active principle of the coca leaf was first isolated in 1860 at Friedrich's laboratory in Göttingen by German chemist Albert Niemann (1834–1861) (Niemann 1860; Bühler 1944b), who called it “cocaine.” Although Niemann unfortunately died the following year, his work was carried on by his disciple Wilhelm Lossen (1838–1906) (Bühler 1944b), who determined the correct molecular formula, C17H21NO4, in 1865 (Lossen 1865). The structural formula of the new alkaloid was far from obvious and in fact was not fully known until chemist Richard Willstätter (1872–1942) analyzed it successfully in 1898 (Figure 1.1). He and his colleagues in Munich, and the Merck Laboratory in Darmstadt, synthesized artificial cocaine in 1923 (Willstätter 1898; Willstätter et al. 1923).

From the time cocaine was isolated, steps were taken to apply it as the first local anesthetic. Nothing had changed since the early reference to the anesthetic effect of the coca leaf by Jesuit Bernabé Cobo in 1653 (Cobo 1890). In 1860, Niemann reported and clearly demonstrated numbness of the tongue caused by the new alkaloid, an observation corroborated by Lossen in his 1865 paper (Lossen 1865). The first experimental study on cocaine, however, was conducted by Peruvian Thomas Moreno y Maïz, ex‐naval surgeon, as part of his doctoral thesis published in Paris in 1868. While observing that injecting a cocaine solution in animals induced insensitivity to pain, he made no mention of its use in surgery (Moréno y Maïz 1868). In 1880, Russian aristocrat and physician Vassily von Anrep of the University of Würzburg published a paper on his experiments on animals, animal tissues and organs, and, especially, himself and recommended the use of cocaine as a surgical anesthetic (Anrep 1880).

Figure 1.1 Structural formula for cocaine.

The ground was laid but the final step had yet to be taken when Viennese ophthalmologist Carl Koller (1857–1944) rose to the challenge (Liljestrand 1967). Koller was working in the Wiener Allgemeines Krankenhaus (Viennese General Hospital) where he got to know and become friends with Sigmund Freud. Freud, interested in the stimulant effects of cocaine to overcome morphine addiction, encouraged Koller to participate in a series of experiments with cocaine during the spring and summer of 1884 (Buess 1944; Liljestrand 1967). Koller noted the numbing effect on his tongue when he swallowed the cocaine (Koller 1928). In July 1884, Freud published a review on cocaine and his experiments, again noting but without lending any particular attention to the alkaloid's anesthetic effect on mucous membranes (Freud 1884). It was Koller who grasped its importance, experimenting with animal corneas (Leonard 1998) as well as on himself and on patients (Koller 1884a). On 11 September 1884, he performed the first operation using local anesthetic on a patient suffering from glaucoma (Fink 1985). The German Ophthalmologyt Society Congress met in Heidelberg on 15–16 September 1884, but Koller was unable to attend. However, he asked Dr. Josef Brettauer, an ophthalmologist from Trieste passing through Vienna on his way to Heidelberg, to read his paper at the Congress (Fink 1985). The impact was instantaneous. Koller himself read his paper on 17 October in the Wiener Medizinische Gesellschaft (Vienna's medical society) (Koller 1884a, 1928; Liljestrand 1967) and it was published on 25 October (Leonard 1998). Dr. Henry D. Noyes of New York, who attended the Heidelberg Congress, sent a summary highlighting Koller's work to the New York Medical Record, who published it on 11 October (Noyes 1884). Dr. Bloom translated Koller's article into English and had it published in The Lancet on 6 December (Koller 1884b). The news of Koller's findings appeared in other publications of the time and sparked the development of regional and local anesthesia. Between September 1884 and late 1885, 60 publications concerning local anesthesia using cocaine appeared in the United States and Canada (Matas 1934a).

Vassily von Anrep (1852–1927) published the first report of a truncal block in an intercostal nerve on 15 November (Yentis and Vlassakov 1999) and Dr. William Stewart Halsted (1852–1922) and his co‐worker Richard John Hall (1856–1897) read Noyes's report and immediately became interested in local anesthesia (Olch and William 1975). On 6 December 1884, Hall published a report on the first mandibular block. Dr. Nash of New York was able to block the infraorbital plexus with 8 minims (about 0.5 ml) of 4% cocaine hydrochloride to obturate an upper incisor, while Dr. Halsted performed a mandibular block of the inferior alveolar nerve in a medical student using 9 minims of the same solution (Hall 1884). In 1892, François Franck coined the term “block” to describe this type of local anesthesia (Matas 1934b). The most significant milestones in the discovery of local anesthesia based on cocaine in late 1884 are listed in Table 1.2.

Table 1.2 Stages in the discovery of the local anesthetic effect of cocaine in late 1884.

Month and day in 1884

Landmark

July

Sigmund Freud publishes his paper on cocaine (Freud

1884

)

11 September

First operation using cocaine as a local anesthetic, performed by Carl Koller on a glaucoma patient (Fink

1985

)

15–16 September

German Ophthalmological Society congress at Heidelberg (Liljestrand

1967

)

11 October

Henry D. Noyes publishes a summary of the Heidelberg proceedings in the

New York Medical Record

(Noyes

1884

)

17 October

Carl Koller reads his paper at the Vienna Medical Society (Koller

1928

; Liljestrand

1967

)

25 October

Carl Koller publishes his paper in the

Wiener Medizinische Wochenschrift

(Koller

1884a

)

15 November

von Anrep reports implementing the first intercostal block (Yentis and Vlassakov

1999

)

6 December

J.N. Bloom translates Koller's paper and publishes it in

The Lancet

(Koller

1884b

)

Richard John Hall describes the first application of local anesthesia in dentistry and the first mandibular block, effected by William Stewart Halsted (Hall

1884

)

The Development of the Syringe

The development of local anesthesia was contingent on the invention of the hypodermic syringe for subcutaneous injections. Subcutaneous administration of medication had already begun by way of incisions in the skin. Von Neuner developed an early syringe in 1827 to introduce fluids into animals (McAuley 1966), and in 1841 the American firm Zophar Jayne, working out of Illinois, began to market its syringe, but to be used it required a prior incision in the skin (McAuley 1966). According to Charles Pfender's studies of the origin of hypodermic medication (Pfender 1911) the first to use injection by syringe was Irish surgeon Francis Rynd (1801–1861) of Meath Hospital. In 1845, he reported two cases of morphine acetate injection (Rynd. 1845). One of the cases was an injection in the vicinity of the supraorbital nerve to treat neuralgia. Rynd failed to publish the design of his syringe until 1861 (Rynd 1861). In 1853, veterinary surgeon Charles Gabriel Pravaz (1791–1855) of Lyon developed a syringe to inject iron perchloride into animals to treat aneurysm (Pravaz 1853). At almost at the same time, in 1855, the Scottish physician Alexander Wood (1817–1884) (Pfender 1911) published a report of nine cases treated with muriate of morphia, which he had injected via a syringe (Wood 1855). From then on, the hypodermic syringe was readily available to the medical community. Wood was instrumental in the extension of its use, although it was Charles Hunter who first used the term “hypodermic” to refer to these subcutaneous methods of injection in 1859 (Pfender 1911; Matas 1934a).

The Dangers of Cocaine

After Koller's discovery of its local anesthetic powers, the use of cocaine spread rapidly, but since it was administered in high concentrations, on the order of 10–30% (Pernice 1890; Mayer 1924; McAuley 1966), practitioners soon began to report its alarming side‐effects. Between 1884 and 1891, 200 cases of systemic intoxication and 13 deaths attributable to the drug were recorded (Anonymus 1979), quenching enthusiasm for it and prompting physicians to turn to gases such as nitrous oxide and ether, particularly for minor surgical procedures, including dentistry (Sauvez 1905). Around this time, the dependence liability of cocaine also began to emerge as several early users, Freud and Halsted among them, fell victims to it (Liljestrand 1967; Olch and William 1975).