Anesthetic efficacy of the supplemental intraosseous injection of 3% mepivacaine in irreversible pulpitis

Reisman, Deron; Reader, Al; Nist, Robert; Beck, Mike; Weaver, Joël M.

doi:10.1016/s1079-2104(97)90372-3

Cited by 156 publications

(162 citation statements)

References 15 publications

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“…ical problems because the teeth may not be numb for procedures requiring complete pulpal anesthesia. Practitioners should consider supplemental techniques, such as intraosseous 14,15,18,20 or periodontal ligament injections 17 when an IAN block fails to provide pulpal anesthesia for a particular tooth. Because we studied a young adult population, the results of this study may not apply to children or the elderly.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12][13] Failure rates of 7 to 75% have been reported in experimental studies. [1][2][3][4][5][6][7][8][9][10][11][12][13] Clinical studies in endodontics [14][15][16][17][18][19][20] have found failure with the IAN block occurring between 44 and 81% of the time. Therefore, it would be advantageous to improve the success rate of the IAN block.…”

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Anesthetic Efficacy of Lidocaine/Meperidine for Inferior Alveolar Nerve Blocks

Goodman¹,

Reader²,

Nusstein³

et al. 2006

Anesthesia Progress

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The authors, using a crossover design, randomly administered, in a single-blind manner, inferior alveolar nerve blocks using 36 mg of lidocaine with 18 g of epinephrine or a combination of 36 mg of lidocaine with 18 g epinephrine plus 36 mg meperidine with 18 g of epinephrine, at 2 separate appointments, to 52 subjects. An electric pulp tester was used to test for anesthesia, in 4-minute cycles for 60 minutes, of the molars, premolars, and central and lateral incisors. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes and the 80 reading was continuously sustained for 60 minutes. Using the lidocaine solution, successful pulpal anesthesia ranged from 8 to 58% from the central incisor to the second molar. Using the lidocaine/meperidine solution, successful pulpal anesthesia ranged from 0 to 17%. There was a significant difference (P Ͻ .05) between the lidocaine and lidocaine/meperidine solutions for the lateral incisors through the second molars. We conclude that the addition of meperidine to a standard lidocaine solution does not increase the success of the inferior alveolar nerve block.Key Words: Meperidine; Inferior alveolar nerve block; Lidocaine.T he inferior alveolar nerve (IAN) block is the most frequently used injection technique for achieving local anesthesia for mandibular restorative and surgical procedures. However, the IAN block does not always result in successful pulpal anesthesia.1-13 Failure rates of 7 to 75% have been reported in experimental studies. [1][2][3][4][5][6][7][8][9][10][11][12][13] Clinical studies in endodontics [14][15][16][17][18][19][20] have found failure with the IAN block occurring between 44 and 81% of the time. Therefore, it would be advantageous to improve the success rate of the IAN block.Meperidine was first introduced in 1939 as an analgesic, sedative, and antispasmodic agent.21 It is also known as pethidine or Demerol. Meperidine is a phen- ylpiperidine derivative of the opioids. 22,23 The molecular weight and pKa of meperidine are closer to lidocaine than other opioids. 22 Clinically, meperidine has local anesthetic activity. A number of clinical and experimental studies [24][25][26][27][28][29][30][31][32][33][34][35][36] have shown that meperidine induces spinal anesthesia and blocks action potentials, providing segmental and sensory blocks comparable to those provided by lidocaine. In medicine, it has been administered intrathecally, 22,24,28,30,32 spinally, 27,34 and as a saddle block, 25 as well as locally for intravenous regional anesthesia, 35 block, 29 and infiltration 36 for the effects of analgesia, anesthesia, or both.The exact mechanism of meperidine's local anesthetic activity is unknown. It is possible that meperidine acts peripherally through opioid-specific receptors. However, Pang and colleagues 37 found that meperidine was effective in reducing propofol injection pain, and this result was not reversible by the addition of naloxone.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Anesthetic Efficacy of Lidocaine/Meperidine for Inferior Alveolar Nerve Blocks

Goodman¹,

Reader²,

Nusstein³

et al. 2006

Anesthesia Progress

Self Cite

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show abstract

“…Dentre as inervações acessórias dos dentes inferiores, o nervo milohióideo é o mais documentado (Sutton, 1974;Chapnick, 1980;Bajrovic, 1999;Keiser, 2002;Madan et al, 2002;Meechan, 1999Meechan, , 2002Bennet;Townsend, 2001 Para solucionar esses problemas, bloqueios anestésicos locais alternativos têm sido desenvolvidos há algum tempo, tendo como alvo o nervo alveolar inferior no triângulo pterigomandibular (Gow-Gates, 1973;Akinosi, 1977). Outra alternativa é o uso de injeções complementares, como a intraligamentar (Cohen et al, 1993;Shabazfar et al, 2014) ou a intra-óssea (Reisman et al, 1997;Parente et al, 1998;Nusstein et al, 2005;Prohic et al, 2005;Bigby et al, 2006).…”

Section: Falhas No Bloqueio Do Nervo Alveolar Inferior (Bnai)unclassified

“…Portanto, quando o BNAI falhar em pacientes com pulpite irreversível, recomenda-se utilizar técnicas anestésicas complementares como a injeção no ligamento periodontal , injeção intra-óssea (Reisman et al, 1997;Nusstein et al, 1998;Nusstein et al, 2010), injeção infiltrativa bucal inferior com articaína (Matthews et al, 2009;Nusstein et al, 2010), injeção intrapulpar ou estratégias para prevenir a falha do BNAI (Sampaio et al, 2012).…”

Section: Falhas No Bloqueio Do Nervo Alveolar Inferior (Bnai)unclassified

“…Para uma anestesia pulpar bem sucedida, as taxas de sucesso absoluto com BNAI variam de 42% a 73% para polpas sem inflamação (Dunbar et al, 1996;Childers et al, 1996) e valores ainda menores para os casos de pulpite irreversível (Cohen et al, 1993;Reisman et al, 1997;Nusstein et al, 1998;Potocnick;Bajrovic, 1999;Kennedy et al, 2003;Claffey et al, 2004;Mikesell et al, 2005;Bigby et al, 2007;Lindemann et al, 2008;Tortamano et al, 2009;Aggarwal et al, 2009;Simpson et al, 2011;Fowler;Reader, 2013;Aggarwal et al, 2014;Rogers et al, 2014;Singla et al, 2014 ).…”

Section: Introductionunclassified

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