scholarly journals Tackling Local Anesthetic Failure in Endodontics

2021 ◽  
Author(s):  
Krishnamachari Janani ◽  
Kavalipurapu Venkata Teja ◽  
Harini K ◽  
Kaligotla Apoorva Vasundhara ◽  
Jerry Jose
Keyword(s):  
Sodium Channel ◽  
Local Anesthesia ◽  
Local Anesthetic ◽  
Endodontic Treatment ◽  
Nerve Membrane ◽  
Inflammatory Conditions ◽  
Base Form ◽  
Anesthetic Failure ◽  
Mandibular Teeth ◽  
Irreversible Pulpitis

Achieving anesthesia in a hot tooth or tooth with inflamed pulp is challenging, especially during endodontic treatment. In the presence of symptomatic irreversible pulpitis, mainly in mandibular teeth, pose even more challenge to attain profound anesthesia. Tetradoxin resistant channel is a class of sodium channel that is found to be increased in such condition and is found to resist local anesthesia. The pH also determines the success of local anesthesia. In inflammatory conditions, the surrounding area\'s pH, which eventually decreases the amount of base form of local anesthetic penetration into the nerve membrane, thereby causing anesthetic failure. In such conditions, the excitability threshold is reduced, leading to failure in achieving anesthesia. This chapter highlights and discusses the cause of anesthetic failure and its management in obtaining profound anesthesia during endodontic treatment.

scholarly journals Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis

2012 ◽  
Vol 2 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Aisha Wali ◽  
Talha Mufeed Siddiqui ◽  
Nauman Qamar ◽  
Rabia Khan ◽  
Nausheen Jawaid
Keyword(s):  
Success Rate ◽  
Local Anesthesia ◽  
Nerve Block ◽  
Naproxen Sodium ◽  
Inferior Alveolar Nerve ◽  
Endodontic Treatment ◽  
Inferior Alveolar Nerve Block ◽  
Female Patients ◽  
Experienced Pain ◽  
Irreversible Pulpitis

ABSTRACT Pain is considered to be the major cause for seeking emergency endodontic treatment. Pain management is of vital importance in endodontics with no exception. Local anesthesia is considered to be the primary method to control pain. An effective local anesthesia cannot be obtained if pulp is inflamed. Clinician prescribes nonsteroidal anti-inflammatory drugs (NSAIDs) as premedication on a routine basis for mild to moderate pain to reduce pulpal inflammation before injecting anesthesia. These drugs are beneficial in providing relief from pain and inflammation in irreversible pulpitis and helps in providing effectiveness of inferior alveolar nerve block. Moreover, they have a short half life, which would make them ideal for a single dosage prior to the management of severe pain. Aim To conduct a randomized-placebo controlled clinical trial to compare the effectiveness of premedication with analgesics vs placebo for success of inferior alveolar nerve block in irreversible pulpitis. Materials and methods The study consisted of 80 adult patients attending operative Outpatient Department in Baqai Dental College. Informed Consent was obtained from each participant. Subjects were randomly divided in four groups comprising of 20 subjects in each group. Group A received piroxicam (Feldene 20 mg, Pfizer), group B received diclofenac potassium (Fastaid Plus, 50 mg platinum pharmaceutic), group C received naproxen sodium (Synflex 550 mg, ICI), and group D received a placebo drug becefol (Abbott). Medication was given 1 hour before initiating endodontic treatment. After 1 hour of oral administration of tablets, inferior alveolar nerve block using 1.8 ml of 2% lidocaine containing 1: 200,000 epinephrine was given. After 15 minutes, access cavity preparation was initiated and patients were asked to inform if they experienced pain. Patients were excluded from the study if they experienced pain but if the patient did not feel pain endodontic treatment was continued. p-value was set at 0.05. Data was analyzed by using Chi-square test (SPSS 19). Results The result showed that out of 80 patients who participated in the study, success rate for piroxicam came out to 90% (10 male and 8 female patients), followed by diclofenac potassium with 75% success rate (9 male and 6 female patients), naproxen sodium with 35% success rate (3 male and 4 female patients) and placebo with 10% success (1 male and 1 female patient). Conclusion The current study concludes that premedication given 1 hour before injecting anesthesia is helpful in reducing pain intensity and thus causing inferior alveolar nerve block to be effective. How to cite this article Wali A, Siddiqui TM, Qamar N, Khan R, Jawaid N. Effectiveness of Premedication with Analgesics vs Placebo for Success of Inferior Alveolar Nerve Block in Irreversible Pulpitis. Int J Prosthodont Restor Dent 2012;2(1):5-9.

Local Anesthetics – Substances with Multiple Application in Medicine

2016 ◽  
Vol 4 (1) ◽  
pp. 17
Author(s):  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Cezar Laurențiu Tomescu ◽  
Cristina Luiza Erimia ◽  
Stelian Paris ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Medical Care ◽  
Local Anesthesia ◽  
Short Duration ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Nerve Roots ◽  
Nervous Control ◽  
Painful Sensation ◽  
Action Groups

Local anesthetics are substances which, by local action groups on the runners, cause loss of reversible a painful sensation, delimited corresponding to the application. They allow small surgery, short in duration and the endoscopic maneuvers. May be useful in soothe teething pain of short duration and in the locking of the nervous disorders in medical care. Local anesthesia is a process useful for the carrying out of surgery and of endoscopic maneuvers, to soothe teething pain in certain conditions, for depriving the temporary structures peripheral nervous control. Reversible locking of the transmission nociceptive, the set of the vegetative and with a local anesthetic at the level of the innervations peripheral nerve, roots and runners, a trunk nervous, around the components of a ganglion or coolant is cefalorahidian practice anesthesia loco-regional. Local anesthetics summary and semi-summary have multiple applications in dentistry, consulting, surgery and obstetrics, constituting "weapons" very useful in the fight against the pain.

A COMPARATIVE EVALUATION OF ANESTHETIC EFFICACY OF 4% ARTICAINE WITH 1:100000 EPINEPHRINE AND 2% LIDOCAINE WITH 1:100000 EPINEPHRINE FOR INFERIOR ALVEOLAR NERVE BLOCK AND LONG BUCCAL NERVE BLOCK DURING ROOT CANAL TREATMENT: AN IN VIVO STUDY

2021 ◽  
pp. 56-59
Author(s):  
Nupur Vasava ◽  
Chintan Joshi ◽  
Vaishali Parekh
Keyword(s):  
Local Anesthesia ◽  
Nerve Block ◽  
Root Canal ◽  
Inferior Alveolar Nerve ◽  
Mean Value ◽  
Root Canal Treatment ◽  
Anesthetic Techniques ◽  
Inferior Alveolar Nerve Block ◽  
The Mean ◽  
Irreversible Pulpitis

Background: It is important to control the pain associated with root canal treatment (RCT) in endodontic. Pain accompanying fear and anxiety due to endodontic treatment can be reduced by anesthetic techniques. The present study aims to compare the effect of articaine versus lidocaine local anesthesia for inferior alveolar nerve block (IANB) and long buccal nerve block on pain during RCT. METHODS: Twenty patients diagnosed with symptomatic irreversible pulpitis of mandibular posterior tooth were selected. The patients randomly received either cartridge of lidocaine or articaine using IANB and long buccal nerve block. The patients were randomly divided into two groups of ten. Group 1: patients received IANB and long buccal nerve block 2% lidocaine with 1:100000 epinephrine. Group 2: patients received IANB and long buccal nerve block with 4% articaine with 1:100000 epinephrine. Before the Injection, the patient received all information about the visual analysis scale (VAS). Pain was evaluated using VAS scale in numberic value 1 to 10 number. The pain was evaluated at three different stages: before administration of LA, after immediate access opening, and after immediate obturation procedure. Data were analyzed using various suitable statistical tests. RESULT: The mean value of efcacy of pain before administration of local anesthesia (LA) was 8.50 ± 0.97 for lidocaine and 8.30 ± 0.48 for articaine had no signicant difference. A signicant difference was observed at two different duration after immediate access opening and after immediate obturation where articaine has a lower mean value 3.60 ± 1.08 and 1.60 ± 0.17 respectively (P>0.05) as compared to the mean value of lidocaine 4.10 ± 1.10 and 1.60 ± 0.17 respectively Conclusion: Within the limitations of the study, in cases of symptomatic irreversible pulpitis articaine 4% did not alleviate pain much and showed better anesthetic efcacy than 2% lidocaine with IANB and long buccal nerve block.

Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem F El-Shahawy ◽  
Sherif F El-Mekkawi ◽  
. Haitham F Mohmmed ◽  
Hend M Afifi
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Breast Feeding ◽  
Local Anesthetic ◽  
Elective Caesarean Section ◽  
Control Group ◽  
Cesarean Section Delivery ◽  
Anesthetic Effect

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000

Differential Interaction ofR-Mexiletine with the Local Anesthetic Receptor Site on Brain and Heart Sodium Channel α-Subunits

1999 ◽  
Vol 56 (6) ◽  
pp. 1238-1244 ◽  
Author(s):  
Thomas Weiser ◽  
Yusheng Qu ◽  
William A. Catterall ◽  
Todd Scheuer
Keyword(s):  
Sodium Channel ◽  
Local Anesthetic ◽  
Receptor Site ◽  
Differential Interaction ◽  
Α Subunits

pH dependence of kinetics and steady-state block of cardiac sodium channels by lidocaine

1993 ◽  
Vol 264 (5) ◽  
pp. H1588-H1598 ◽  
Author(s):  
D. J. Wendt ◽  
C. F. Starmer ◽  
A. O. Grant
Keyword(s):  
Steady State ◽  
Sodium Channel ◽  
Local Anesthetic ◽  
Ph Dependence ◽  
Membrane Depolarization ◽  
Low Ph ◽  
Proton Exchange ◽  
Phasic Block ◽  
Cardiac Sodium Channels ◽  
External Ph

The local anesthetic-class antiarrhythmic drugs produce greater depression of conduction in ischemic compared with normal myocardium. The basis for this relatively selective action is uncertain. A model of the pH-dependent interaction of tertiary amine drugs with the sodium channel suggests that the low pH occurring during ischemia slows drug dissociation from the channel by changing the drug's protonation. The importance of the proton exchange reaction and the effect of overall slowing of drug dissociation on steady-state sodium channel blockade is uncertain. We have measured whole cell sodium channel current in rabbit atrial myocytes during control and exposure to lidocaine while external pH was varied between 6.8 and 7.8 at membrane potentials of -140, -120, and -100 mV. Tonic blockade was little influenced by external pH. Decreasing the external pH from 7.8 to 6.8 slowed both the rate of development of phasic block and recovery from the block. Decreasing the membrane potential from -140 to -100 mV increased the degree of phasic block attained in the steady state. Block was further enhanced when low pH was combined with membrane depolarization. Experiments in which deuterium ions were substituted for protons suggest that the kinetics of proton exchange is not rate limiting in the dissociation of drugs from the sodium channel. We conclude that it is the combined effect of low pH and membrane depolarization that may be critical in the enhanced blocking action of local anesthetic-class drugs during ischemia.

scholarly journals The Effect of Photobiomodulation on the Depth of Anesthesia During Endodontic Treatment of Teeth With Symptomatic Irreversible Pulpitis (Double Blind Randomized Clinical Trial)

2017 ◽  
Vol 9 (1) ◽  
pp. 11-14
Author(s):  
Sholeh Ghabraei ◽  
Nasim Chiniforush ◽  
Behnam Bolhari ◽  
Mohsen Aminsobhani ◽  
Abbas Khosarvi
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Endodontic Treatment ◽  
Depth Of Anesthesia ◽  
Double Blind ◽  
Irreversible Pulpitis

Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients

2015 ◽  
Vol 39 (5) ◽  
pp. 470-474 ◽  
Author(s):  
M Mittal ◽  
A Kumar ◽  
D Srivastava ◽  
P Sharma ◽  
S Sharma
Keyword(s):  
Heart Rate ◽  
Local Anesthesia ◽  
Study Design ◽  
Local Anesthetic ◽  
Pain Perception ◽  
Pediatric Patients ◽  
Computerized Method ◽  
Local Anesthetic Injection ◽  
Computerized System ◽  
Buccal Infiltration

Background: Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. Study design: The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. Study design: It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Results: Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. Conclusion: It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups

Sign in / Sign up

Export Citation Format

Share Document