Pulpal anesthesia dependent on epinephrine dose in 2% lidocaine

Knoll-Köhler, E; Förtsch, Gabriele

doi:10.1016/0030-4220(92)90091-4

Cited by 36 publications

(19 citation statements)

References 17 publications

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“…It has been reported that the onset time of local anesthetic action is about 1 -5 minutes, which is affected by the types and concentration of local anesthetics or vasoconstrictors and the histological structure of the site of administration [1][2][3][4][5][6][7][8][9][10][11][12][13] . There were few studies that reported the tissue distribution of local anesthetic after regional injection into oral tissue.…”

Section: Introductionmentioning

confidence: 99%

Distribution of Lidocaine in Alveolar Tissues in Rabbits

Yamazaki

Mamiya

Ichinohe

et al. 2009

J. Hard Tissue Biology.

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This study was intended to determine the tissue distribution of lidocaine in mandibular mucosa and alveolar bone marrow after local infiltration. Tissue distribution of local anesthetics shortly after regional injection has been unclear. We used macro autoradiography to visually examine the tissue distribution of lidocaine shortly after local anesthetic infiltration. Male Japan White rabbits received an injection of 14 C-labeled 2% lidocaine with or without 1:80,000 epinephrine. The areas of infiltration and proportion of distribution 1, 5 and 10 minutes after administration were measured. After the administration of 2% lidocaine with 1:80,000 epinephrine, infiltration area increased over time. Ratios of distribution in alveolar bone marrow at the level equivalent to the root apex increased in 1 to 5 minutes after administration, and then decreased. In contrast, after the administration of plain lidocaine, infiltration was hardly detected. These results suggest that infiltration of lidocaine with epinephrine diffused to a wider area over time after administration and then gradually absorbed into the capillaries.

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Section: Introductionmentioning

confidence: 99%

Distribution of Lidocaine in Alveolar Tissues in Rabbits

Yamazaki

Mamiya

Ichinohe

et al. 2009

J. Hard Tissue Biology.

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“…Furthermore, computer‐controlled local anaesthetic delivery (C‐CLAD), which has a slow and stable rate of delivering agents, might be used for ensuring less pain and more comfort in local anaesthesia in dentistry. However, the 2% mepivacaine with 1:100,000 epinephrine groups suffered from less pain than the 2% lidocaine with 1:100,000 epinephrine groups during the injection phase, probably because of the presence of adrenaline in the mepivacaine, which is proved to have the functions of pain control and increasing depth of anaesthesia.…”

Section: Discussionmentioning

confidence: 95%

“…1). The presence of adrenaline in local anaesthetic solutions was confirmed to be beneficial with regard to duration, depth of anaesthesia, reduction of bleeding and systemic toxicity of the anesthetics. Mepivacaine has milder vasodilating ability than lidocaine, which might explain why with the same vasoconstrictor, mepivacaine has dramatically superior effect to that of lidocaine.…”

Section: Discussionmentioning

confidence: 95%

Efficacy and safety of mepivacaine compared with lidocaine in local anaesthesia in dentistry: a meta-analysis of randomised controlled trials

Liu

Yang

et al. 2014

International Dental Journal

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The objective of the study was to assess the efficacy and safety of mepivacaine compared with lidocaine used in local anaesthesia in dentistry. Medline, Cochrane Central Register of Controlled Trials, EMBASE, Chinese BioMedical Literature Database, China National Knowledge Infrastructure and WHO International Clinical Trials Registry Platform were searched electronically. Relevant journals and references of studies included were hand-searched for randomised controlled trials comparing mepivacaine with lidocaine in terms of efficacy and safety. Twenty-eight studies were included, of which 15 had low risk of bias and 13 had moderate risk of bias. In comparison with 2% lidocaine with 1:100,000 adrenaline, 3% mepivacaine showed a lower success rate (P = 0.05), a shorter onset time of pulpal anaesthesia (P = 0.0005), inferior pain control during injection phase and superior inhibition of heart rate increase (P < 0.0001). In contrast, 2% mepivacaine with 1:100,000 adrenaline gave a higher success rate (P < 0.00001), a similar onset time of pulpal anaesthesia (P = 0.34) and superior pain control during injection phase (P < 0.0001); 2% mepivacaine with 1:20,000 levonordefrin had the same success rate (P = 0.69) and similar onset time of pulpal anaesthesia (P = 0.90). In addition, 3% mepivacaine had shorter onset time (P = 0.004), same level of success rate (P = 0.28) and similar pain control during injection and postinjection compared with 2% lidocaine with 1:50,000 adrenaline. Given the efficacy and safety of the two solutions, 2% mepivacaine with vasoconstrictors is better than 2% lidocaine with vasoconstrictors in dental treatment. Meanwhile, 3% plain mepivacaine is better for patients with cardiac diseases.

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“…As concentration of vasoconstrictor (Knoll‐Köhler & Förtsch ) and the anaesthetic volume of solution (Aggarwal et al . ) influence the success of IANB, 1.8 mL of an admixture of 2% lidocaine with clonidine 15 μg mL −1 (32.4 μg lidocaine and 27 μg clonidine) was used in the experimental group and a standard cartridge of 1.8 mL of 2% lidocaine with epinephrine 1:80 000 (36 μg lidocaine and 22.5 μg epinephrine) in the control group.…”

Section: Discussionmentioning

confidence: 99%