Hemodynamic changes associated with a novel concentration of lidocaine HCl for impacted lower third molar surgery

Abstract

BackgroundThe authors studied the hemodynamic effect influent by using the novel high concentration of lidocaine HCl for surgical removal impacted lower third molar. The objective of this study was to evaluate the hemodynamic change when using different concentrations of lidocaine in impacted lower third molar surgery.MethodsSplit mouth single blind study comprising 31 healthy patients with a mean age of 23 years (range 19-33 years). Subjects had symmetrically impacted lower third molars as observed on panoramic radiograph. Each participant required 2 surgical interventions by the same surgeon with a 3-week washout period washout period. The participants were alternately assigned one of two types of local anesthetic (left or right) for the first surgery, then the other type of anesthetic for the second surgery. One solution was 4% lidocaine with 1:100,000 epinephrine and the other was 2% lidocaine with 1:100,000 epinephrine. A standard IANB with 1.8 ml volume was used. Any requirement for additional anesthetic and patient pain intra-operation was recorded. Post-operatively, patient was instructed to fill in the patient report form for any adverse effect and local anesthetic preference in terms of intra-operative pain. This form was collected at the seven day follow up appointment.ResultsIn the 4% lidocaine group, the heart rate increased during the first minute post-injection (P < 0.05). However, there was no significant change in arterial blood pressure during the operation. In the 2% lidocaine group, there was a significant increase in arterial blood pressure and heart rate in the first minute following injection for every procedure. When the hemodynamic changes in each group were compared, the 4% lidocaine group had significantly lower arterial blood pressure compared to the 2% lidocaine group following injection. Post-operatively, no adverse effects were observed by the operator and patient in either local anesthetic group. Patients reported less pain intra-operation in the 4% lidocaine group compared with the 2% lidocaine group (P < .05).ConclusionsOur results suggest that a 4% concentration of lidocaine HCl with 1:100,000 epinephrine has better clinical efficacy than 2% lidocaine HCl with 1:100,000 epinephrine when used for surgical extraction of lower third molars. Neither drug had any clinical adverse effects.

4% lidocaine versus 4% articaine for inferior alveolar nerve block in impacted lower third molar surgery

“…A previously published study used a 3-4 week interval between the first and second surgeries for patients with bilateral lower third molar surgery [ 3 4 12 ]. Therefore, we chose a 3-week interval between the surgeries in this study so that postoperative sequelae of the local anesthetic injection, such as pain and numbness, were reduced.…”

“…In many previous studies, researchers have tried to manipulate the physical and chemical properties of local anesthetics to improve their effectiveness when used for the inferior alveolar nerve (IAN) block. Researchers have compared different types and volumes [ 2 3 4 ] of local anesthetics and have modified the concentration of the buffering agent in the local anesthetic cartridge. Previous studies have commonly reported on the onset, duration of action, and success rate of pulpal anesthesia observed with the different methods [ 5 6 7 8 9 10 11 ].…”

“…Ping et al [ 2 3 4 ] studied the efficacy and hemodynamic changes of high concentration (4%) lidocaine and 2% lidocaine; however, no studies have compared 4% lidocaine with 4% articaine.…”

Hemodynamic changes and pain perception-related anxiety after experiencing an impacted-tooth removal: clinical practice outcome

“…Measurement of the patient's anxiety in this study was performed using alterations of hemodynamic parameters, such as blood pressure and heart rate [ 20 21 22 23 24 ]; however, the results showed no statistically significant difference in both the groups. Hence, decreased blood pressure and heart rate might not be accurate parameters for determining the anxiety of patients in a clinical setting.…”

Dental anesthesia for patients with allergic reactions to lidocaine: two case reports

“…Lidocaine and other local anesthetics, drugs commonly used in dentistry, may cause various adverse effects, although these are low in frequency [ 5 ]. Such adverse effects include immune response-mediated allergic reactions and others that are unrelated to the immune response [ 1 ].…”