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Articaine hydrochloride + epinephrine is a combination local anesthetic solution widely used in clinical dentistry for infiltration and nerve block anesthesia. Articaine is an amide-type local anesthetic that contains an additional ester group, which allows for rapid metabolism by plasma esterases. Its primary mechanism of action involves the reversible blockade of voltage-gated sodium channels, preventing the influx of sodium ions and the subsequent conduction of nerve impulses. Epinephrine is a sympathomimetic amine that acts as a vasoconstrictor by stimulating alpha- and beta-adrenergic receptors. By inducing local vasoconstriction, epinephrine reduces the rate of systemic absorption of articaine, thereby increasing the depth and duration of anesthesia while minimizing systemic toxicity and local bleeding. This combination is commonly marketed under brand names such as Septanest and Septocaine. Tanta University conducted a randomized clinical trial to evaluate the efficacy and hemodynamic stability of a 4% articaine with 1:100,000 epinephrine formulation compared to mepivacaine in hypertensive patients undergoing dental extractions.
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