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Summary of clinical problems of oral anesthetic-Bilan

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Oral special injection of local anesthetic agent produced by the French company “Bilan”, in clinical application, summed up problems, for your reference.

1.Bilan is the name of commodity, the product name for Articaine Hydrochloride and Epinephrine Tartrate Injection. Main ingredients: articaine hydrochloride 4%, epinephrine 1:10 million. Articaine and lidocaine are amide injection of local anesthetic agent.

2.Bilan: Anesthesia onset time is fast (about 2-3 minutes), To invasive strong organization (normal mucosa under local infiltration method can complete on, after mandibular Asia tooth extraction, tooth preparation and the pulp treatment such as surgery), High anesthetic efficacy (low dose injection can achieve the desired effect of anesthesia), the characteristics of small toxic side effects.

3.Biran will belong to the same amide local anesthetics and lidocaine, if users do not have a history of allergies, the lidocaine so of articaine should not allergic. According to the latest approval of the use of the specification, the use of the prior to the first injection of 5%-10% before the first test if there is an allergic reaction.

4.Bilan with adrenaline 1:10 million, so the hypertension patients and the elderly should be used with caution, but not disabled. The doctor also according to the actual situation of the user to decide, in addition, because the use of a small amount of conventional use, and the general use of mucosal infiltration injection method, so the actual injection into the body of the adrenaline is little. But should pay attention to the speed of injection should be slow, injection speed shall not exceed 1ml/ minutes.

5.When you use Bilan, usually only use local infiltration injection method can achieve mucosal anesthesia effect, But does not rule out will can be used to block anesthesia. On the contrary, in the treatment of multiple teeth, method of one-shot block anesthesia for conduction block more simple. But at this time should pay attention to the return of blood, avoid the need to inject into the blood vessels. Finishing injection speed, 1ml/ minutes.

6.Mandibular posterior teeth for tooth extraction, the only local infiltration of mucosal injection method can also achieve the desired effect. It should be noted that there is an individual patient after tooth extraction, there may be a tooth slot congestion incomplete, which is because of the role of adrenaline. At this time, in order to avoid the emergence of dry socket, after tooth extraction should be scraping gum, so that the extraction slot congestion completely, and then oppression hemostasis.

7.Bilan must be a specification for the 1.7ml/ branch, 50 / box. Routine, a single tooth local injection of 0.8ml, multi-root tooth injection 1.5-1.7ml

8.Bilan has been at the end of 2004 months in the domestic market, not only for each box label, English logo (specify ingredients, indications and import registration card number), and each cylinder will have blue glass ampoule for Chinese words. This is one of the main differences with the illegal import of narcotics.

9.One of the main ingredients of Bilan is articaine hydrochloride (68 mg / support). Adult A Tikan (articaine) the maximum amount not more than 7mg/kg/ days, children over the age of 4 for the maximum amount of cocaine is not more than 5mg/kg/ days.

10.Bilan containing adrenaline 1:100 000 (that is, 0.017mg/ branch). According to the New York Heart Association recommends that when epinephrine is applied to local anesthetics, the maximum amount of adrenaline used in healthy people is less than 0.2mg, while heart disease patients are less than 0.04mg.

11.Clinically, hypertensive patients are prudent to use Bilan, but not banned. When the patient's systolic blood pressure is greater than or equal to 200mmHg or diastolic blood pressure is greater than or equal to 115mmHg should be prohibited by the use of agents containing blood vessel contraction agent.

12.Use must be used to block anesthesia, must pay attention to the blood sucking, and the injection rate is slow, injection speed shall not exceed 1ml/ minutes.

13.After mandibular direct pulp extirpation of pulp, the submucosal infiltration anesthesia (1.2ml-1.5ml) combined with root canal injection (about 0.2ml), the effect will be bette. In addition, it can be used in the injection of periosteum, periodontal ligament or mandibular nerve block anesthesia method.

14.Proper installation of Bilan and needle in the syringe is a necessary condition to produce the blood sucking function during injection.

The way is:

1.The first installation will blue in the syringe chamber

2.Embedding the fork of the syringe into the rubber plug of the Bilan

3.The needle is screwed in the syringe


15.Needle models are 30G (0.3mm × 16mm, 0.3mm × 21mm), 27G (0.4mm × 21mm), 25G(0.5mm×8mm0.5mm×35mm). It can meet the requirements of different injection methods in clinic. When ordering, please apply to the agent you need models. Needle packing specifications are 100 (the same model). Usually, the use of 0.3*21mm can be.

16.According to the State Administration of commodity prices, the sales price of Bilan isRetail price of 455 yuan / tube (that is, 9.1 yuan / Branch), the wholesale price of 409.6 yuan / barrel (ie, 8.192 yuan / Branch) of the dilution of the blood vessel contraction agent 1000ml refers to 1:1000 liquid 1g (or 1000mg) blood vessels.

17.1:1000 refers to the 1.0mg/ml, so 1:100 000 refers to the ML fluid containing a vascular contraction agent 0.01mg, that is, 0.01mg/ml.

Department of Stomatology anesthesia agents often have the following proportion

1:50 000 (that is, 0.02mg/ml)

1:80 000 (that is, 0.0125mg/ml)

1:100 000 (that is, 0.01mg/ml)

1:200 000 (i.e. 0.005mg/ml) 1:1 000 (i.e. 1.0mg/ml)

1:200 000 (that is, 0.005mg/ml)

1:1 000 (that is, 1.0mg/ml)

For emergency treatment, intramuscular injection and other treatment of allergic response 1:10 000 hours (ie 0.1mg / ml) for emergency treatment, intravascular drip treatment of cardiac arrest vasoconstrictor - clinical application of epinephrine

1.Treatment of acute allergic reactions

2.Treatment of bronchial spasm

3.Treatment of cardiac arrest


5.In the local agent as a vasoconstrictor, to reduce the absorption of cardiovascular system

6.In the local agent as a vasoconstrictor to increase its anesthesia time

7.Scattered pupil