Clinical evaluation of different epinephrine concentrations for local dental anesthesia

Abstract

BACKGROUND AND OBJECTIVES: Clinical trials comparing lidocaine associated to different epinephrine concentrations are scarce. This study aimed at comparing cardiovascular parameters, anesthetic efficacy and level of discomfort during the injection of two 2% lidocaine solutions associated to 1:100,000 or 1:200,000 epinephrine. METHODS: Participated in this cross-sectional double blind study 30 patients (24.3±4.7 years) who were submitted to anamnesis, vital signs evaluation and baseline threshold measurement of right upper canine tooth. In each clinical session, with 15 days interval, 1.8mL of one of the anesthetic solutions were administered. Anesthetic efficacy was measured with electric stimulation and vital parameters were evaluated in three periods: 5 minutes before, during and soon after anesthesia. At the end of each session, the visual analog scale was applied to evaluate injection pain sensitivity, which was repeated 24h later. RESULTS: All volunteers had satisfactory pressure levels to carry out the trial. There has been no statistically significant differences in systolic blood pressure (p=0.33), diastolic blood pressure (p=0.1505), heart rate (p=0.9464) and oxygen saturation (p=0.9297) considering each local anesthetic solution in each moment (during and after anesthesia). Formulations of 2% lidocaine with 1:100,000 and 1:200,000 epinephrine have shown no statistical differences for all anesthetic parameters (p>0.05). CONCLUSION: Considering the volume used in this study, decreased epinephrine concentration on lidocaine solution has not affected its clinical efficacy and has not influenced cardiovascular parameters.