Abstract
Introduction
There is a decrease in the anesthetic efficacy of inferior alveolar nerve blocks in
patients with irreversible pulpitis. It was hypothesized that the increasing the volume
of anesthetic solution may improve the success rates of dental pulp anesthesia in
patients with pulpal pain.
Methods
Fifty-five adult volunteers, actively experiencing pain, participated in this prospective,
randomized, single-blind study. The patients were divided into 2 groups on a random
basis and received an inferior alveolar nerve block with either 1.8 mL or 3.6 mL of
2% lidocaine with 1:200,000 epinephrine. Endodontic access preparation was initiated
after 15 minutes of the initial IANB. Pain during treatment was recorded using the
Heft-Parker visual analog scale (HP VAS). The primary outcome measure, and the definition
of “success,” was the ability to undertake pulp access and canal instrumentation with
no or mild pain (HP VAS score <55 mm). Statistical analysis was performed using the
chi-square test.
Results
All patients included in the final analysis had profound lip anesthesia. There were
no significant differences in sex, age, or preoperative pain scores of the experimental
groups. IANBs of 1.8 mL lidocaine with epinephrine had a success rate of 26%, whereas
the administration of 3.6 mL had a 54% success rate. The difference was statistically
significant.
Conclusions
Increasing the volume of 2% lidocaine to 3.6 mL improved the success rate as compared
with 1.8 mL but did not give a clinical success rates of 100%.
Key Words
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Article info
Publication history
Published online: March 05, 2012
Identification
Copyright
© 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
