Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in inferior alveolar nerve block: Effects on the vital signs and onset, and duration of anesthesia

Abstract

BackgroundThis prospective, randomized, double-blind, clinical study was conducted to compare the effects of 4% articaine with 1:100,000 epinephrine (A100) and 4% articaine with 1:200,000 epinephrine (A200) on the vital signs and onset and duration of anesthesia in an inferior alveolar nerve block (IANB).MethodsIn the first appointment, an IANB was performed by injecting A100 or A200 in 1 side of the mouth (right or left) randomly in patients referred for extraction of both their first mandibular molars. In the second appointment, the protocol was repeated and the other anesthetic solution was injected in the side that had not received the block in the previous session. Systolic and diastolic blood pressures (SBP and DBP) and pulse rate were measured during and 5 min after the injection. The onset and duration of anesthesia were also evaluated. Data were analyzed using t-test and Mann-Whitney U-test, and p-value was set at 0.05.ResultsSBP and pulse rate changes were slightly more with A100; however, DBP changes were more with A200, although the differences were not significant (P > 0.05). There were no statistically significant differences in the parameters evaluated in this study. The onset and duration of anesthesia, and the changes in SBP, DBP, and pulse rate during and 5 min after the injection were the same in both the groups.ConclusionsFor an IANB, A200 and A100 were equally efficient and successful in producing the block. Epinephrine concentration did not influence the effects of 4% articaine.

Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery

“…The duration of anesthesia for a DC of 4% articaine in this study had soft tissue anesthesia for approximately 292.9 ± 79.66 minutes. This is consistent with the results of a previous study in which soft tissue anesthesia with 2% lidocaine and 1:100,000 epinephrine ranged from 240 to 300 min [ 19 20 21 ]. On the other hand, the duration of anesthesia for a DC of 4% articaine was statistically superior to that of a SC of 4% articaine.…”

Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery

“…The duration of anesthesia for a DC of 4% articaine in this study had soft tissue anesthesia for approximately 292.9 ± 79.66 minutes. This is consistent with the results of a previous study in which soft tissue anesthesia with 2% lidocaine and 1:100,000 epinephrine ranged from 240 to 300 min [ 19 20 21 ]. On the other hand, the duration of anesthesia for a DC of 4% articaine was statistically superior to that of a SC of 4% articaine.…”

Cardiovascular Effects of 4% Articaine with 1:100,000 versus 1:200,000 Epinephrine during Inferior Alveolar Nerve Block: A Prospective Randomized Double-Blind Clinical Study

“…Recent systematic reviews and clinical studies have confirmed the overall safety of epinephrine-containing dental anesthetics within recommended doses, while emphasizing the importance of evaluating concentration-dependent hemodynamic responses ( 7 , 8 ). Third-molar extraction continues to represent a reliable clinical model for investigating anesthetic efficacy and systemic responses because of its bilateral symmetry, procedural standardization, and reproducibility ( 9 , 11 ). In this context, articaine is particularly suitable due to its high lipid solubility, rapid onset, and favorable safety profile ( 4 ).…”

Evaluation of Anxiety and Vital Signs in Adults Undergoing Different Dental Procedures: A Prospective Study

“…In most treatments, local anesthetics are administered. However, this triggers fear in patients, which is one of the main reasons for anxiety (Fukayama & Yagiela, 2006;Parekh et al, 2014;Lasemi et al, 2015;Marques-Ferreira et al, 2017). Based on the results of the three clinics that regularly use local anesthesia, the periodontics clinic stood out for presenting the lowest respiratory rate during the procedure.This may have been influenced due to the adequate and correct use of analgesia, as well as the correct management of the patient.…”

Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery

“…The duration of anesthesia for a DC of 4% articaine in this study had soft tissue anesthesia for approximately 292.9 ± 79.66 minutes. This is consistent with the results of a previous study in which soft tissue anesthesia with 2% lidocaine and 1:100,000 epinephrine ranged from 240 to 300 min [ 19 20 21 ]. On the other hand, the duration of anesthesia for a DC of 4% articaine was statistically superior to that of a SC of 4% articaine.…”

Cardiovascular Effects of 4% Articaine with 1:100,000 versus 1:200,000 Epinephrine during Inferior Alveolar Nerve Block: A Prospective Randomized Double-Blind Clinical Study

“…Recent systematic reviews and clinical studies have confirmed the overall safety of epinephrine-containing dental anesthetics within recommended doses, while emphasizing the importance of evaluating concentration-dependent hemodynamic responses ( 7 , 8 ). Third-molar extraction continues to represent a reliable clinical model for investigating anesthetic efficacy and systemic responses because of its bilateral symmetry, procedural standardization, and reproducibility ( 9 , 11 ). In this context, articaine is particularly suitable due to its high lipid solubility, rapid onset, and favorable safety profile ( 4 ).…”

Evaluation of Anxiety and Vital Signs in Adults Undergoing Different Dental Procedures: A Prospective Study

“…In most treatments, local anesthetics are administered. However, this triggers fear in patients, which is one of the main reasons for anxiety (Fukayama & Yagiela, 2006;Parekh et al, 2014;Lasemi et al, 2015;Marques-Ferreira et al, 2017). Based on the results of the three clinics that regularly use local anesthesia, the periodontics clinic stood out for presenting the lowest respiratory rate during the procedure.This may have been influenced due to the adequate and correct use of analgesia, as well as the correct management of the patient.…”

Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery

“…The duration of anesthesia for a DC of 4% articaine in this study had soft tissue anesthesia for approximately 292.9 ± 79.66 minutes. This is consistent with the results of a previous study in which soft tissue anesthesia with 2% lidocaine and 1:100,000 epinephrine ranged from 240 to 300 min [ 19 20 21 ]. On the other hand, the duration of anesthesia for a DC of 4% articaine was statistically superior to that of a SC of 4% articaine.…”

Cardiovascular Effects of 4% Articaine with 1:100,000 versus 1:200,000 Epinephrine during Inferior Alveolar Nerve Block: A Prospective Randomized Double-Blind Clinical Study

“…Recent systematic reviews and clinical studies have confirmed the overall safety of epinephrine-containing dental anesthetics within recommended doses, while emphasizing the importance of evaluating concentration-dependent hemodynamic responses ( 7 , 8 ). Third-molar extraction continues to represent a reliable clinical model for investigating anesthetic efficacy and systemic responses because of its bilateral symmetry, procedural standardization, and reproducibility ( 9 , 11 ). In this context, articaine is particularly suitable due to its high lipid solubility, rapid onset, and favorable safety profile ( 4 ).…”

Evaluation of Anxiety and Vital Signs in Adults Undergoing Different Dental Procedures: A Prospective Study

“…In most treatments, local anesthetics are administered. However, this triggers fear in patients, which is one of the main reasons for anxiety (Fukayama & Yagiela, 2006;Parekh et al, 2014;Lasemi et al, 2015;Marques-Ferreira et al, 2017). Based on the results of the three clinics that regularly use local anesthesia, the periodontics clinic stood out for presenting the lowest respiratory rate during the procedure.This may have been influenced due to the adequate and correct use of analgesia, as well as the correct management of the patient.…”