The drug is used in radiation and combination therapy and has a non-hormonal, analgesic, and reparative spectrum of action. The unique composition allows it to be used for therapeutic and prophylactic purposes, for the treatment of wounds, trophic ulcers and anal fissures. The Russian medicine accelerates the restoration of the epidermis and mucous membrane after radiation exposure.
Features of the composition
The active ingredient of the drug is lidocaine hydrochloride, which is necessary for pain relief. Additional gel ingredients are presented:
- purified water;
- chlorhexidine hydrochloride;
- hydroxyethylcellulose.
Annotation from the manufacturer indicates that the drug has a nonspecific stimulating and antiradical spectrum of action. It helps to normalize the functioning of the immune system, accelerate recovery processes at the cellular level, stabilize the formation, development and maturation of blood cells.
The product applied to the skin inhibits nerve conduction by blocking endings and fibers. Lidocaine is superior in effectiveness to its closest analogue, procaine. During the treatment of oncological pathologies, the drug provides radioprotective effectiveness, reducing the susceptibility of healthy cellular structures and tissues to radiation therapy and its destructive properties.
Therapeutic manipulations make it possible to increase the volume of radiation dosages and reduce the intervals between sessions prescribed to patients with cancer.
Interaction of the solution with other drugs
Lidocaine is not recommended to be combined with the following groups of drugs at the same time:
- Analgesics of the narcotic group - threatens respiratory depression.
- Anticoagulants – increases the risk of bleeding.
- Cardiac glycosides – their effectiveness decreases.
- Novocaine group – increases muscle relaxation.
- The standard is a negative effect on respiratory function.
Lidocaine solution should be combined with extreme caution in diseases of the heart and nervous system, accompanied by systematic use of drugs.
Indications and contraindications
The drug is prescribed after radiation therapy in order to accelerate the regeneration of damaged cells. Coletex gel can also be used for other injuries:
- for abrasions, wounds, scratches;
- diabetic and trophic ulcers;
- vaginal injuries;
- anal fissures;
- punctures in the sinuses;
- suturing – after treatment of epidermal abscesses that have arisen;
- eruption of baby teeth;
- insertion of a probe through the nasal passages or oral cavity;
- performing rectoscopy manipulations.
The medication is suitable for performing resection of polyps located in the nasal cavity and simple operations related to the treatment of the organs of vision.
The main contraindications to the use of the gel include individual intolerance to individual components. In addition to hypersensitivity to the ingredients, special caution is required when using the medicine in people with persistently low blood pressure (hypotension) or sinoatrial block (impaired conduction of impulses to the ventricles and atria).
Constant medical monitoring of therapy is required for patients with a slow heartbeat, chronic and acute heart failure, and intraventricular conduction abnormalities.
Permanent makeup. How to choose an anesthetic cream?
In the permanent makeup industry, application anesthesia is widely used, which can be divided into primary and secondary. Primary anesthesia is applied exclusively to intact skin during the preparation stage. The secondary one is used only after the first punctures. Choosing an anesthetic is an important task for a permanent makeup artist. Together with laser pigment removal expert Vitaly Mikryukov and Akriol Pro project manager Anna Meyendorff, the specialized magazine iColor Magazine has prepared a special material about anesthetics. Chistovye thanks its partners for the information provided.
ADVANTAGES OF APPLICATION ANESTHESIA
- The anesthetic can remain effective for up to 4 hours
- The effect of the drug occurs 10-15 minutes after application
- The anesthetic will not enter the patient’s blood, but only deep into the skin
- The anesthetic does not interfere with control of the depth of needle insertion
ATTENTION! The speed of action of the anesthetic depends on the part of the body to which it is applied, the thickness of the skin and the speed of blood flow. It makes no sense to keep lidocaine + prilocaine cream on the patient’s face for more than 30-40 minutes, since the anesthetics will begin to wash out.
SYSTEMIC TOXICITY OF APPLICATION ANESTHESIA
Despite the ease and safety of using topical anesthesia, there are contraindications to this method of pain relief. Barriers include: acute skin diseases, lactation and pregnancy, elevated body temperature, individual intolerance to the drug, open inflammation and damaged skin areas. Also, the specialist should always keep in mind that topical anesthesia can cause systemic toxicity, which is accompanied by symptoms: from trembling, muscle twitching, nausea, impaired consciousness, orientation to apnea (stopping breathing).
What increases the risk of developing symptoms of systemic toxicity?
- Elderly age
- Heart failure
- Cardiac ischemia
- Low plasma protein concentration
- Metabolic diseases
- Liver disease
- Metabolic or respiratory acidosis
- Prescribing drugs that inhibit sodium channels
All local anesthetics have a systemic effect on the central nervous and cardiovascular systems. For example, lidocaine in small concentrations increases blood pressure and has an anticonvulsant effect. However, as the dose of the drug increases, the pressure begins to drop, and the risk of developing convulsive seizures becomes possible.
EXPERT OPINION
“An allergic reaction can occur to absolutely any ingredient in an anesthetic, so when choosing an anesthetic, preference should be given to drugs that have been registered in the Russian Federation. These products include EMLA and ACRIOL PRO. Both drugs have the same composition – 2.5% prilocaine and 2.5% lidocaine, which is the optimal ratio,” says Vitaly Mikryukov.
HOW TO CHOOSE AN ANESTHETIC?
PRIMARY ANESTHESIA Primary anesthesia drugs are available in the form of a cream, emulsion or gel. The main active ingredient is lidocaine. When choosing an anesthetic, pay attention to the fact that the lidocaine content in the composition is no higher than 5-6%, since exceeding this value will make the skin harder. Most masters use products with a lidocaine concentration of up to 10%, which is acceptable.
SECONDARY ANESTHESIA Secondary anesthesia preparations must have a liquid consistency. The watery structure of the anesthetic makes it easier for the anesthetic components to penetrate deep into the skin and provide instant “freezing”. A good indicator would be the content of vasoconstrictor substances. They reduce lymph production, which has a positive effect on the distribution of pigment in the skin. To select the optimal anesthetic, you should take into account the area and technique of applying permanent makeup. When working in the eyebrow area, it is better to use water-based anesthetic creams and gels. The liquid consistency of the drug will ensure deep penetration of the anesthetic into the layers of the skin. To work with the upper eyelid, preference should be given to anesthetic agents with a thick texture. They are more suitable for this delicate area, as they do not spread and do not get into the eyes.
INGREDIENTS IN ANESTHETICS How do popular ingredients in local anesthetics work?
Lidocaine
It forms the basis of almost all anesthetic creams. Rarely causes allergic reactions, acts quickly and for a long time, does not cause local irritation, is well absorbed and dilates blood vessels. Not recommended for patients with liver disease, as well as for patients using beta-blockers due to the risk of developing hypotension.
Prilocaine
Unlike lidocaine, it has less analgesic effect. Rarely causes allergies, low toxicity. In case of overdose (more than 400 mg at a time), it can increase methemoglobin in the blood. As part of anesthetic creams in the Russian Federation, it is registered only in combination products with lidocaine.
Benzocaine (Anestezin)
It has minimal absorption and is suitable for use on mucous membranes. Insoluble in water. For superficial anesthesia, it is used in the form of a 5-20% oil or glycerin solution, 5-10% ointment. There are no registered drugs with benzocaine for skin pain relief in Russia.
Novocaine
Once in the body, it is hydrolyzed into diethylaminoethanol and para-aminobenzoic acid. Because of this, it often causes allergies. It has low toxicity and is contraindicated in patients with anemia and liver diseases. Intoxication is expressed in nausea, decreased blood pressure, and dizziness. The effect is short-lived and weak – 15-20 minutes. The product does not have a registered indication for superficial anesthesia.
Tetracaine
Highly effective local anesthetic from the ester group. It is often used for tattooing the eyelids, since when it comes into contact with the mucous membrane of the eye, it does not affect intraocular pressure. It is highly toxic (2 times more than cocaine, 10 times more than novocaine). Due to its vasodilatory properties, it is supplemented with vasoconstrictors to reduce the risk of intoxication. Not a single solution of tetracaine is registered in the Russian Federation.
Epinephrine
Epinephrine constricts blood vessels, making the master’s work bloodless. Also, it has an antiallergic effect.
Adrenalin
Adrenaline is added to anesthetics to prolong the effect. It causes vasospasm, due to which the anesthetic is carried more slowly by the bloodstream. The substance is already present in the body, so it does not cause allergies.
IS IT POSSIBLE TO MAKE ANESTHETIC DRUGS YOURSELF?
Recently, the practice of independently producing anesthetic preparations for the permanent makeup procedure from ingredients available for purchase in pharmacies has begun to gain popularity among permanent makeup artists. Experts strongly recommend refraining from such an initiative due to the risk of harm to the client. In the conditions of “non-pharmaceutical” production, it is impossible to fully comply with all the subtleties of manufacturing: the accuracy of the formulation, the quality of mixing, and sterility. Use only certified products for work!
EXPERT OPINION
Interview with the head of the Akriol Pro project, Anna Meyendorff.
How do you feel about the fact that beauty industry professionals make their own anesthetic cocktails from ingredients purchased at the pharmacy?
Anna:
Extremely negative, because now even dermatologists, who are well versed in skin problems, are moving away from prescription production towards industrially produced drugs in pharmaceutical factories, since there they can maintain precise dosage, good mixing of ingredients, as well as aseptic and antiseptic rules .
How dangerous is adrenaline in its pure form as an anesthetic?
Anna:
Adrenaline added in therapeutic doses promotes greater vasoconstriction, which means it can increase the duration of action of the drug and reduce its systemic toxicity. It began to be added to local anesthetics at the beginning of the 20th century. Most local anesthetics also have a vasoconstrictor effect, and the addition of epinephrine may not greatly affect the effect. In addition, when using anesthetics registered as cosmetics, you cannot always count on the fact that they contain adrenaline, even if it is indicated on the box.
What ingredients should be included in a numbing cream?
Anna:
The composition of the anesthetic cream should be as pure as possible: without preservatives and ether anesthetics that increase the risk of developing allergies (novocaine, tetracaine, benzocaine). An example of the composition of an anesthetic cream per 100 g: lidocaine - 2.5 g, prilocaine - 2.5 g; PEG-54 hydrogenated castor oil – 1.9 g; carbomer – 1.0 g; sodium hydroxide – 0.52 g; purified water – up to 100 g.
Why is lidocaine 2.5% + prilocaine 2.5% emulsion considered the standard in skin anesthesia?
Anna:
Lidocaine and prilocaine enhance each other's effects. When the concentration increases above 5%, the power does not increase, and the risk of developing toxic reactions increases. Clinical trials have proven that the emulsion lidocaine + prilocaine 5% anesthetizes 2 times better than single-component lidocaine, even at a concentration of 40%. In the lidocaine + prilocaine emulsion, the concentration of anesthetics in each fat drop reaches 80%. It is important that the ratio of lidocaine and prilocaine should be 1:1.
The absence of pain and discomfort during an appointment with a permanent makeup artist is 50% of the success of the work result. Relief of pain with the help of anesthesia is mandatory when applying tattooing to the lips and eyelids, because these parts of the face belong to hypersensitive areas. Eyebrow tattooing is not such a painful procedure, therefore, at the request of the client, it can be performed without the use of anesthetics. In this case, the master must take into account that a sudden wince of the client can negatively affect the result of the work.
Features of application
The gel is evenly applied to the affected areas - mucous membrane or skin in small quantities. The drug can be administered into the vaginal and rectal areas; if indicated, the drug can be used as a basis for therapeutic dressings.
The dosage is determined by the attending physician based on the results of a laboratory diagnostic examination, after determining the stage and severity of the disease. Over the course of 24 hours, manipulations are repeated no more than 4 times.
The drug is not recommended for use by pregnant and lactating women and, for minors under 18 years of age, the drug is prescribed with extreme caution and regular checks of general condition.
Adverse reactions
If used incorrectly, adverse reactions may occur:
- Dizziness, drowsiness, convulsions, sensory disturbances.
- Tinnitus.
- Changes in blood pressure, cardiac dysfunction.
- Nausea, vomiting.
- Feeling of heat, swelling at the injection site.
- Burning sensation, thrombophlebitis.
The list of adverse reactions is much wider, so it is necessary to monitor the patient’s condition after administration of the lidocaine solution.
