High performance liquid chromatography determination of dexamethasone in plasma to evaluate its systemic absorption following intra-space pterygomandibular injection of twin-mix (mixture of 2 % lignocaine with 1:200,000 epinephrine and 4 mg dexamethasone): randomized control trial

Abstract

Intra-space (pterygomandibular space) administration of dexamethasone can achieve statistically similar plasma concentration of the drug as when the same dose is administered intramuscularly with demonstration of similar clinical effects.

Twin Mix Inferior Alveolar Nerve Anaesthesia for Transalveolar Extraction of Mandibular Third Molar Surgery: Review of Current Evidence

“…The studies relevant to the use of twin-mix solution are summarized in table 1. 9,10,11, 26,27,28,29,30,31,32 Bhargava D et al first proposed clinical use of the twin mix anaesthesia for mandibular nerve block in 2013 by evaluating this anaesthetic technique and the admixture of drugs through their prospective clinical randomized double-blind study to evaluate latency & efficacy of twin-mix solution & 2% lignocaine with 1:200,000 adrenaline for the transalveolar extraction of impacted mandibular third molars. 9 Gaur S et al conducted a randomized controlled trial evaluating the altered twin mix local anaesthesia using two long acting amide local anesthetic solutions: bupivacaine & ropivacaine with/without 4 mg/ml dexamethasone solution for patients undergoing 3 rd molar surgical extraction.…”

“…Pharmacokinetics following intra-space pterygomandibular twin-mix injection has demonstrated that dexamethasone can attain statistically similar plasma concentration as when same dose is administered intramuscularly with comparable clinical consequence. 32 The pain associated with lidocaine infiltration is reduced when the pH of the drug is raised. 9,16 when dexamethasone is mixed with local anesthetic solution pH of resultant solution is increased from 4.5 to 6.…”

“…3 Bhargava D Validation of data on the use of Apert from the clinical benefits, the UV et al 2015 10 twin mix in minor oral surgery: spectrometry analysis for dexamethasone comparative evaluation of efficacy and local anaesthetic in the twin-mix of twin mix versus 2 % lignocaine solution indicated no change in the with 1:200000 epinephrine based active pharmacological agents. on power analysis and an UV spectrometry study for chemical stability of the mixture 4 Bhargava D High performance liquid chromato Pterygomandibular space administration et al 2016 32 -graphy determination of dexame of dexamethasone can achieve similar -thasone in plasma to evaluate its plasma concentration as when the same systemic absorption following dose is administered intramuscularly intra-space pterygomandibular injection of twin-mix (mixture of 2 % lignocaine with 1:200,000 epinephrine and 4 mg dexamethasone): randomized control trial 5…”

A comparative evaluation of the effect of addition of 8 mg dexamethasone to 2% lignocaine with adrenaline in mandibular third molar surgery: a split mouth randomised double blind study

“…The anti-inflammatory action of dexamethasone is 20-30 times higher than cortisol, and a t1/2 of 36-54 h makes it the drug of choice as a single dose in the management of collateral effects associated with surgical removal of third molars (60,61).…”

Preparation of an anti-dexamethasone monoclonal antibody and its use in development of a colloidal gold immunoassay

“…Recently, various analytical methods have been developed for detecting DEX, such as high-performance liquid chromatography (Bhargava et al, 2016;Dési, Kovács, Palotai, & Kende, 2008;Lasić, Bobarević, & Nikolin, 1989;Tsuei, Ashley, Moore, & McBride, 1978), gas chromatography-mass spectrometry (Amendola, Garribba, & Botrè, 2003;Bagnati et al, 1996;Huetos Hidalgo, Jiménez López, Ajenjo Carazo, San Andrés Larrea, & Reuvers, 2003), liquid chromatography-mass spectrometry (LC-MS) (Chen et al, 2011;Creaser, Feely, Houghton, Seymour, & Teale, 1996), radioimmunoassay methods (Meikle, Lagerquist, & Tyler, 1973), and enzyme immunoassay (Hassan, Rowell, Hambleton, & Jackson, 1998;Vdovenko, Gribas, Vylegzhanina, & Sakharov, 2012;Yadav et al, 2013;Yoshino, Yoshiharu, Noriko, Kiyoshi, & Fukuko, 1992). Each method has its own strong and weak points.…”