Is Clonidine an Adequate Alternative to Epinephrine as a Vasoconstrictor in Patients With Hypertension?

Anaesthetic efficacy of lidocaine/clonidine for inferior alveolar nerve block in patients with irreversible pulpitis

“…Brkovic et al . () and Patil & Patil () also demonstrated that the intensity of maxillary infiltration anaesthesia produced by a combination of L+Clo was similar to those obtained with L+Epi, which might be because of the site of drug deposition (mandible versus maxilla) as well as the type of injection administered (nerve block versus infiltration) that has an influence on the characteristics of local anaesthesia.…”

“…There are only a few studies that investigated the anaesthetic effectiveness of clonidine in the field of dentistry, and no dental study has compared a solution of L+Clo with a standard lidocaine solution for IANB in patients with irreversible pulpitis (Brkovic et al . , , Patil & Patil ). Brkovic et al .…”

“…Clinical studies have also suggested that clonidine might have hemodynamic advantages compared with epinephrine as a vasoconstrictor because of its central hypotensive effect (Brkovic et al . , Patil & Patil ). The possible limitation of the present study is the simple randomization process which has a potential for sampling bias.…”

“…The present study revealed a significant increase in HR and SBP 5 min after administration of L + Epi solution, similar to the study of Brkovic et al . () on mandibular third molar surgery, and the study of Patil & Patil () on maxillary third molar extraction. The hemodynamic response in the clonidine group was significantly better than that in the epinephrine group, with HR and SBP being significantly lower than L + Epi 5 min after administration, consistent with the results reported by Patil & Patil () and Brkovic et al .…”

“…Endodontic studies in patients with irreversible pulpitis have reported failure rates of the IANB of 44-81% (Aggarwal et al 2009(Aggarwal et al , 2010 due to activated nociceptors in an inflamed pulp, which leads to a decrease in pain threshold and decreased efficacy of the IANB (Rood & Pateromichelakis 1981). Therefore, considerable ongoing research is directed at improving the success rate of IANB in patients with irreversible pulpitis, by exploring different injection techniques, anaesthetic solutions (Aggarwal et al 2010(Aggarwal et al , 2011, supplemental infiltration techniques (Jung et al 2008), pre-medication before performing the IANB (Simpson et al 2011) and addition of an adjunct for local anaesthetic formulations (Bigby et al 2007, Kreimer et al 2012, Patil & Patil 2012.…”