Dental Implantation: What Anesthesia is Used?
Principle of Action of Local Anesthesia in Implantology
Local anesthesia remains the gold standard for pain relief in dental implantology in Spain according to 2026 protocols. Drugs based on articaine hydrochloride block sodium channels in the membranes of nerve fibers, completely interrupting the transmission of pain impulses from the surgical field to the brain. During implant placement, the patient feels no pain, although they may perceive tactile contact from instruments. Clinics in Barcelona exclusively use cartridge technology: disposable anesthetic cartridges inserted into a special syringe with an ultra-thin needle. This ensures sterility and allows the implant surgeon to dose the drug with precision down to tenths of a milliliter, considering the patient's weight and the complexity of the operation.
Types of Anesthesia in Dental Implantation
Modern Spanish implantology utilizes several types of anesthesia, the choice depending on the extent of the intervention and the patient's psycho-emotional state. Infiltration anesthesia is used for placing one or two implants in the upper jaw: the drug is injected into the periosteum area, providing instant effect within 1-2 minutes. Conduction anesthesia (torusal or mandibular) is indicated for work on the lower jaw in the molar area, where bone tissue has higher density. For complex cases, including sinus lift or bone grafting, intraligamentary or intraseptal techniques may be used, where the anesthetic is injected directly into the periodontal ligament or the spongy bone tissue.
Modern Anesthetics and Vasoconstrictors
In Barcelona dental clinics in 2026, only latest-generation anesthetics based on articaine hydrochloride are used. These include Ultracaine, Septanest, and their generics, approved by the Spanish Agency for Medicines. The key feature of these drugs is the presence of vasoconstrictors (epinephrine or adrenaline) in precisely calculated concentrations. Vasoconstrictor components are necessary for the anesthetic to remain longer in the tissues, avoid entering the systemic bloodstream, and provide deep analgesia throughout the operation. The standard epinephrine concentration for implantation is 1:100,000, although for patients with higher risk, a lower concentration of 1:200,000 is used.
Contraindications to Anesthesia Use
Before implantation, a detailed medical history is mandatory to identify contraindications to certain types of anesthesia. Absolute contraindications include individual intolerance to drug components, myocardial infarction within the last six months, acute liver failure, and refractory arrhythmias. For patients with diabetes mellitus, anesthetics without vasoconstrictor or with minimal content are recommended. In cases of hypertension, dentists prefer drugs with low epinephrine concentration (1:200,000), and in severe cases, completely adrenaline-free solutions such as Ultracaine D.
Anesthesia in Dental Implantation: Local or General?
For the vast majority of implantation surgeries in Barcelona, high-quality local anesthesia is sufficient. Even when placing 6-8 implants for full-arch rehabilitation, which can take from one and a half to three hours, the patient experiences no pain. General anesthesia is used exclusively as a last resort for patients with panic fear of treatment. It is important to understand that dental implantation under general anesthesia can only be performed in clinics with an intensive care unit and a licensed anesthesiologist. Otherwise, such procedures carry serious risks to the patient's health and life.
Sedation as an Alternative to General Anesthesia
In Spanish dental protocols for 2026, sedation is considered the optimal method for anxious patients requiring extensive implantation. The patient is induced into a state of medicated sleep intravenously or by inhalation using xenon. In this state, the person is relaxed, experiences no stress, but maintains the ability to hear the doctor and follow simple instructions. It is critical to remember: sedation has no analgesic effect, so it is always combined with local anesthesia. Only this combination guarantees complete comfort and safety during the operation.
Anesthetics for Pregnant and Breastfeeding Patients
The issue of pain relief during implantation in pregnancy requires a special approach. According to Spanish protocols for managing pregnant patients in dentistry, lidocaine-based drugs, belonging to category B, are recognized as the safest. When implantation or other interventions are necessary, anesthetics with minimal vasoconstrictor content (1:200,000) are preferred, reducing the peak blood concentration of the drug and minimizing the risk of transfer into breast milk. For patients with hypertension or fetal hypoxia, vasoconstrictors are completely contraindicated, using instead lidocaine-based drugs without adrenaline or Ultracaine D.
Possible Side Effects and Their Prevention
With adherence to injection technique and correct drug selection, the risk of side effects is minimal. However, it is important to be aware of possible body reactions. In case of accidental intravascular injection of adrenaline, tachycardia, a feeling of heat, and increased sweating may occur. Anesthetic overdose manifests as tinnitus, dizziness, and tremor. The most serious complication is nerve injury from the needle during mandibular anesthesia, which can cause prolonged paresthesia or weakness of facial muscles. Dental clinics must have an emergency kit for anaphylactic shock, and treatment of neurological complications should begin as quickly as possible.
Allergic Reactions to Local Anesthesia
Before implantation, the dentist always inquires about the patient's allergic history. A reaction to pollen, animal dander, or household chemicals is a risk factor for developing cross-allergy to anesthetic components or preservatives in its composition. For allergic patients, preservative-free drugs such as Ultracaine D are preferred. In Barcelona, many clinics practice preliminary allergy testing before complex interventions, completely eliminating the risk of anaphylaxis and ensuring implantation safety.
Conclusion and Specialist Recommendations
The choice of pain relief method in dental implantation is an individual process depending on many factors: the scope of surgery, location, patient's health status, and psycho-emotional state. Modern pharmacology allows even the most complex interventions to be performed completely painlessly, using non-toxic latest-generation drugs. The main rule for successful implantation is trusting communication with the doctor, who will explain all stages of anesthesia in detail and choose the optimal option for you. Do not fear pain: quality anesthesia and the surgeon's professionalism make the implant placement process comfortable and safe.
