Abstract
BackgroundThe most commonly used local anesthetic in dentistry is lidocaine. For decades, mannitol is the most widely used agent in the management of raised intracranial pressure and as prophylaxis against acute renal failure surgeries.Material and Methods120 patients were randomly divided into four groups, 30 patients in each group. Group A was administered 2% lidocaine with 1:80000 epinephrine; group B, 2% lidocaine with 1:80000 epinephrine and 0.5 M mannitol; group C, 2% lidocaine and 0.5 M mannitol; and group D (control group), 2% lidocaine for achieving local anesthesia. Extraction of lower erupted tooth was done under inferior alveolar nerve block. Parameters taken were onset of anesthesia, duration of anesthesia and pain. Heft-Parker visual analogue scale was taken to evaluate the pain response during procedure after every 10 minutes until complete return of sensation by probing. The Chi-square test was used to compare the pain among the groups. The continuous variables were compared among the groups by one way analysis of variance (ANOVA) followed by Tukey’s post-hoc comparison tests. The p-value <0.05 was considered significant.ResultsThe onset of tingling sensation was higher among the patients of group C (1.53±0.57) than group B (1.50±0.58), group D (1.48±0.51) and group A (1.45±0.62) but difference among the groups was statistically insignificant (p >0.05). The total time in return of sensation was higher among the patients of group C (70.30±4.34) than group A (65.94±3.45), group B (62.23±7.47) and group D (47.70±8.04) but difference among the groups was found to be statistically significant (p=0.0001). There was no significant (p >0.05) difference in the pain at baseline and at start. No pain was found among all the patients from 10 minutes to subsequent time intervals.ConclusionsMannitol was effective in increasing the efficacy of lidocaine as an adjuvant to local anesthetic solution in inferior alveolar nerve block. Key words:Inferior alveolar nerve block, lidocaine, local anesthesia, mannitol.
Highlights
Since the beginning of time surgeons have been searching for the substances that can be used to make procedures painless
Group A was administered 2% lidocaine with 1:80000 epinephrine; group B, 2% lidocaine with 1:80000 epinephrine and 0.5 M mannitol; group C, 2% lidocaine and 0.5 M mannitol; and group D, 2% lidocaine for achieving local anesthesia Type of anesthesia included in the study was inferior alveolar nerve block and surgical procedure included was lower erupted tooth indicated for extraction
For group B, 1.5 ml of 2% lidocaine with 1:80000 epinephrine and for group C, 1.5 ml of 2% lidocaine were withdrawn from standard dental cartridge into a 3.0 ml Luer-Lok disposable syringe with 24 gauage X 25 mm needle followed by addition of 0.9 ml of 0.5 M mannitol into both syringes
Summary
Since the beginning of time surgeons have been searching for the substances that can be used to make procedures painless. The most commonly used local anesthetic in dentistry is lidocaine. An ideal solution is where profound anesthesia is achieved and maintained throughout the procedure and followed by early and complete recovery of sensation. The hyperosmolar solution of mannitol did not induce an inflammatory cell infiltrate when the tissue was examined histologically (1). There is paucity of literature mentioned use of mannitol with local anesthetic solution. Our study focuses on this aspect of combination of mannitol with local anesthesia and its possible use in oral and maxillofacial surgery. The aims and objectives of the study were to assess whether 0.5 M of mannitol could increase the efficacy of lidocaine with or without epinephrine in inferior alveolar nerve block
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