A clinical evaluation of local anaesthetic solutions containing graded epinephrine concentrations

Abstract

A double-blind study using five local anaesthetic solutions and 542 patients was conducted by a group of dentists. The following properties of the anaesthetic solutions were evaluated: (1) speed of onset of anaesthesia, (2) efficacy of anaesthesia, (3) duration of soft tissue anaesthesia, (4) degree of haemostasis, (5) toxic symptoms. In comparing the anaesthetic solutions tested, it was found that solutions with 1 300,000 epinephrine were as satisfactory as solutions with 1 100,000 epinephrine, whether the local anaesthetic was lidocaine or propitocaine. Propitocaine without epinephrine compared favourably with any of the solutions with epinephrine when used in mandibular blocks, and in operative dentistry. A less favourable anaesthetic efficacy was obtained for propitocaine without epinephrine when used in infiltration anaesthesia and in surgery. The experiments support the idea that solutions with lower epinephrine concentrations can be used for effective dental anaesthesia, thus reducing the danger of epinephrine toxicity due to intravascular injection.