RESUMEN
This randomized, double-blind trial tested the null hypothesis that speed of deposition has no influence on the injection discomfort, efficacy, distribution, and duration of pulp anesthesia after incisive/mental nerve block in adult volunteers. Thirty-eight subjects received incisive/mental nerve blocks of 2.0 mL lidocaine with 1:80,000 epinephrine slowly over 60 seconds or rapidly over 15 seconds at least 1 week apart. Pulp anesthesia was assessed electronically to 45 minutes after injection. Injection discomfort was self-recorded on visual analogue scales. Overall, 48.7% of volunteers developed pulp anesthesia in first molars, 81.8% in bicuspids, and 38.5% in lateral incisors. The mean duration of pulp anesthesia was 19.1 minutes for first molars, 28.5 minutes for bicuspids, and 19.0 minutes for lateral incisors. Speed of injection had no significant influence on anesthetic success or duration of anesthesia for individual teeth. Slow injection was significantly more comfortable than rapid injection (P < .001). The null hypothesis was supported, although slow injection was more comfortable.
Asunto(s)
Anestésicos Locales/administración & dosificación , Pulpa Dental/inervación , Bloqueo Nervioso/métodos , Adulto , Diente Premolar/inervación , Estudios Cruzados , Método Doble Ciego , Epinefrina/administración & dosificación , Femenino , Humanos , Incisivo/inervación , Inyecciones/efectos adversos , Lidocaína/administración & dosificación , Labio/inervación , Masculino , Mandíbula/inervación , Nervio Mandibular/efectos de los fármacos , Diente Molar/inervación , Dimensión del Dolor , Sensación/efectos de los fármacos , Factores de Tiempo , Vasoconstrictores/administración & dosificaciónRESUMEN
This randomized double-blind crossover trial investigated the efficacy and discomfort associated with slow (60 seconds) and rapid (15 seconds) inferior alveolar nerve blocks (IANB) using 2.0 ml of 2% lidocaine with 1:80,000 epinephrine in securing mandibular first molar, premolar and lateral incisor pulp anesthesia in 38 healthy adult volunteers. Episodes of maximal stimulation (80 microA) without sensation on electronic pulp testing were recorded. Injection discomfort was self-recorded by volunteers on 100 mm visual analogue scales. Data were analyzed by McNemar, Friedman, Wilcoxon Signed Ranks, and paired t tests. Slow IANB produced more episodes of no response to maximal pulp stimulation than rapid IANB in molars (220 episodes versus 159, p < 0.001), premolars (253 episodes versus 216, p = 0.003) and lateral incisors (119 episodes versus 99, p = 0.049). Slow IANB was more comfortable than rapid IANB (p = 0.021).
Asunto(s)
Nervio Mandibular , Bloqueo Nervioso/métodos , Adulto , Anestésicos Locales/administración & dosificación , Diente Premolar/inervación , Estudios Cruzados , Pulpa Dental/inervación , Prueba de la Pulpa Dental , Método Doble Ciego , Epinefrina/administración & dosificación , Femenino , Humanos , Incisivo/inervación , Inyecciones/métodos , Lidocaína/administración & dosificación , Masculino , Diente Molar/inervación , Bloqueo Nervioso/efectos adversos , Dolor/etiología , Dimensión del Dolor , Sensación/efectos de los fármacos , Factores de Tiempo , Vasoconstrictores/administración & dosificaciónRESUMEN
This randomized crossover double-blind trial compared the efficacy of buccal infiltration with 4% articaine and 2% lidocaine (both with 1:100,000 epinephrine) in securing mandibular first molar pulp anesthesia. Injections were given at least 1 week apart in 31 healthy adult volunteers. Electronic pulp testing was undertaken at baseline and at 2 minute intervals until 30 minutes postinjection. A successful outcome was recorded in the absence of pulp sensation on two consecutive maximal pulp tester stimulations (80 muA). 64.5% of articaine and 38.7% of lidocaine infiltrations were successful (p = 0.008). Articaine infiltration produced significantly more episodes of no response to maximum stimulation in first molars than lidocaine (236 and 129, respectively, p < 0.001). Mandibular buccal infiltration is more effective with 4% articaine with epinephrine compared to 2% lidocaine with epinephrine. Both injections were associated with mild discomfort.