Chumpitaz-Cerrate V, Caldas-Cueva V, Franco-Quino CI, Chávez-Rimache LK

Language: Spanish
References: 26
Page: 1-12
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ABSTRACT

Introduction: The alkalinization of lidocaine has been successful in blocking the inferior dental nerve; however, there are contradictory results regarding its clinical efficacy.
Objective: To determine the effect of 2% lidocaine with 1: 80,000 adrenaline alkalinized with 8.4% sodium bicarbonate on inferior dental nerve block.
Material and methods: Experimental, prospective and longitudinal study that comprised 50 patients from the Dental School of the National University of San Marcos. The following solutions were administered for inferior dental nerve block: 2% lidocaine with epinephrine 1: 80,000 alkalinized with 8.4% sodium bicarbonate and 2% lidocaine with 1: 80,000 adrenaline not alkalinized. Pain intensity was evaluated by injection, hemodynamic parameters and anesthetic periods (time of onset of action and duration of the anesthetic effect).
Results: There was a lower pain intensity due to injection in the alkalized lidocaine group (19.16 ± 2.7) compared to the non-alkalinized lidocaine group (22.88 ± 4.2); p=0.02. Likewise, the onset time of action was lower in the alkalized lidocaine group (105.72 ± 9.7) compared to the non-alkalinized lidocaine group (157.52 ± 12.1); p=0.002. However, no significant differences were found in the hemodynamic parameters (p>0.05) and the duration of the anesthetic effect (p=0.114).
Conclusions: Lidocaine 2% with adrenaline 1: 80,000 alkalized with sodium bicarbonate at 8.4% on the block of the inferior dental nerve produces a decrease in pain intensity due to injection and the time of onset of action, compared to the non-alkalinized formulation. However, there are no differences in relation to the hemodynamic parameters or the duration of the anesthetic effect.

REFERENCES

1. Pereira LAP, Groppo FC, Bergamaschi C de C, Meechan JG, Ramacciato JC, Motta RHL, et al. Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in intraosseous injections in symptomatic irreversible pulpitis of mandibular molars: anesthetic efficacy and cardiovascular effects. Oral Surg Oral Med Oral Pathol Oral Radiol [Internet]. 2013 Aug [Citado 19/02/2020];116(2):e85-91. Disponible en: Disponible en: http://doi.org.10.1016/j.oooo.2011.10.045

2. Khatri A, Kalra N, Tyagi R, Khandelwal D. Pain perception and efficacy of local analgesia using 2% lignocaine, buffered lignocaine, and 4% articaine in pediatric dental procedures. J Dent Anesth Pain Med [Internet]. 2019 [Citado 19/02/2020];19(2):101. Disponible en: Disponible en: http://doi.org.10.17245/jdapm.2019.19.2.101

3. Phero JA, Nelson B, Davis B, Dunlop N, Phillips C, Reside G, et al. Buffered versus non-buffered lidocaine with epinephrine for mandibular nerve block: clinical outcomes. J Oral Maxil Surg [Internet]. 2017 Apr [Citado 19/02/2020];75(4):688-93. Disponible en: Disponible en: http://doi.org.10.1016/j.joms.2016.09.055

4. Malamed SF, Tavana S, Falkel M. Faster onset and more comfortable injection with alkalinized 2% lidocaine with epinephrine 1:100,000. Compend Contin Educ Dent . 2013;34(1):10-20.

5. Gadve VR, Shenoi R, Vats V, Shrivastava A. Evaluation of anxiety, pain, and hemodynamic changes during surgical removal of lower third molar under local anesthesia. Ann Maxillofac Surg [Internet]. 2018 Jul-Dec [Citado 19/02/2020];8(2):247-53. Disponible en: Disponible en: http://doi.org.10.4103/ams.ams_216_18

6. De Souza Melo MR, Sabey MJS, Lima CJ, de Almeida Souza LM, Groppo FC. The effect of 2 injection speeds on local anesthetic discomfort during inferior alveolar nerve blocks. Anesth Prog [Internet]. 2015 [Citado 19/02/2020];62(3):106-9. Disponible en: Disponible en: http://doi.org.10.2344/11-00037.1

7. Schellenberg J, Drum M, Reader A, Nusstein J, Fowler S, Beck M. Effect of buffered 4% lidocaine on the success of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: A prospective, randomized, double-blind study. J Endod [Internet]. 2015 Jun [Citado 19/02/2020];41(6):791-6. Disponible en: Disponible en: http://doi.org.10.1016/j.joen.2015.02.022

8. Vasan A, Baker JA, Shelby RA, Soo MSC. Impact of sodium bicarbonate-buffered lidocaine on patient pain during image-guided breast biopsy. J Am Coll Radiol [Internet]. 2017 Sep [Citado 19/02/2020];14(9):1194-201. Disponible en: Disponible en: http://doi.org.10.1016/j.jacr.2017.03.026

9. Balasco M, Drum M, Reader A, Beck M. Buffered lidocaine for incision and drainage: a prospective, randomized double blind study. J Endod . 2013; 39(11):1329-34.

10. Nambiar AK, Younis A, Khan ZA, Hildrup I, Emery SJ, Lucas MG. Alkalinized lidocaine versus lidocaine gel as local anesthesia prior to intra-vesical botulinum toxin (BoNTA) injections: A prospective, single center, randomized, double-blind, parallel group trial of efficacy and morbidity: Local Anesthetics for Intra-Vescial BotoxTM: An RCT. Neurourol Urodyn [Internet]. 2016 Apr [Citado 19/02/2020];35(4):522-7. Disponible en: Disponible en: http://doi.org.10.1002/nau.22750

11. Comerci AW, Maller SC, Townsend RD, Teepe JD, Vandewalle KS. Effect of a new local anesthetic buffering device on pain reduction during nerve block injections. Gen Dent. 2015 Dec;63(6):74-8.

12. Saatchi M, Khademi A, Baghaei B, Noormohammadi H. Effect of sodium bicarbonate-buffered lidocaine on the success of inferior alveolar nerve block for teeth with symptomatic irreversible pulpitis: a prospective, randomized double-blind study. J Endod [Internet]. 2015 Jan [Citado 19/02/2020];41(1):33-5. Disponible en: Disponible en: http://doi.org.10.1016/j.joen.2014.09.011

13. Hobeich P, Simon S, Schneiderman E, He J. A prospective, randomized, double-blind comparison of the injection pain and anesthetic onset of 2% lidocaine with 1:100,000 epinephrine buffered with 5% and 10% sodium bicarbonate in maxillary infiltrations. J Endod [Internet]. 2013 [Citado 19/02/2020];39(5):597-9. Disponible en: Disponible en: http://doi.org.10.1016/j.joen.2013.01.008

14. General Assembly of the World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Coll Dent. 2014;81(3):14-8.

15. Sawang K, Chaiyasamut T, Kiattavornchareon S, Pairuchvej V, Bhattarai BP, Wongsirichat N. Double versus single cartridge of 4% articaine infiltration into the retro-molar area for lower third molar surgery. J Dent Anesth Pain Med [Internet]. 2017 Jun [Citado 19/02/2020];17(2):121-7. Disponible en: Disponible en: http://doi.org.10.17245/jdapm.2017.17.2.121

16. Saccň M, Meschi M, Regolisti G, Detrenis S, Bianchi L, Bertorelli M, et al. The relationship between blood pressure and pain. J Clin Hypertens [Internet]. 2013 Aug [Citado 19/02/2020];15(8):600-5. Disponible en: Disponible en: http://doi.org.10.1111/jch.12145

17. Raocharernporn S, Boonsiriseth K, Khanijou M, Wongsirichat N. Hemodynamic changes and pain perception-related anxiety after experiencing an impacted-tooth removal: clinical practice outcome. J Dent Anesth Pain Med [Internet]. 2017 Jun[Citado 19/02/2020];17(2):105-11. Disponible en: Disponible en: http://doi.org.10.17245/jdapm.2017.17.2.105

18. Cepeda MS, Tzortzopoulou A, Thackrey M, Hudcova J, Arora Gandhi P, Schumann R. Adjusting the pH of lidocaine for reducing pain on injection. Cochrane Database Syst Rev [Internet]. 2010 Dec [Citado 19/02/2020];(12):CD006581. Disponible en: Disponible en: http://doi.org.10.1002/14651858.CD006581.pub2

19. Guo J, Yin K, Roges R, Enciso R. Efficacy of sodium bicarbonate buffered versus non-buffered lidocaine with epinephrine in inferior alveolar nerve block: A meta-analysis. J Dent Anesth Pain Med [Internet]. 2018 Jun [Citado 19/02/2020];18(3):129-42. Disponible en: Disponible en: http://doi.org.10.17245/jdapm.2018.18.3.129

20. Kashyap VM, Desai R, Reddy PB, Menon S. Effect of alkalinisation of lignocaine for intraoral nerve block on pain during injection, and speed of onset of anaesthesia. Br J Oral Maxillofac Surg [Internet]. 2011 [Citado 19/02/2020];49(8):e72-75. Disponible en: Disponible en: http://doi.org.10.1016/j.bjoms.2011.04.068

21. Warren VT, Fisher AG, Rivera EM, Saha PT, Turner B, Reside G, et al. Buffered 1% lidocaine with epinephrine is as effective as non-buffered 2% lidocaine with epinephrine for mandibular nerve block. J Oral Maxil Surg [Internet]. 2017 Jul [Citado 19/02/2020];75(7):1363-6. Disponible en: Disponible en: http://doi.org.10.1016/j.joms.2016.12.045

22. Whitcomb M, Drum M, Reader A, Nusstein J, Beck M. A prospective, randomized, double-blind study of the anesthetic efficacy of sodium bicarbonate buffered 2% lidocaine with 1:100,000 epinephrine in inferior alveolar nerve blocks. Anesth Prog [Internet]. 2010 [Citado 19/02/2020];57(2):59-66. Disponible en: Disponible en: http://doi.org.10.2344/0003-3006-57.2.59

23. Aulestia Viera PV, Braga MM, Borsatti MA. The effect of adjusting the pH of local anaesthetics in dentistry: a systematic review and meta-analysis. Int Endod J [Internet]. 2018 Aug [Citado 19/02/2020];51(8):862-76. Disponible en: Disponible en: http://doi.org.10.1111/iej.12899

24. Goranović T, Pirkl I, Parazajder D, Gudelj G, Zdilar B, Vučković B, et al. The effect of injection speed on haemodynamic changes immediate after lidocaine/adrenaline infiltration of nasal submucosa under general anaesthesia. Period boil. 2011;113(2):217-21.

25. De Morais HHA, de Santana Santos T, Araújo FA da C, Vajgel A, de Holanda Vasconcellos RJ. Hemodynamic changes comparing lidocaine HCl with epinephrine and articaine HCl with epinephrine. J Craniofac Surg [Internet]. 2012 Nov [Citado 19/02/2020];23(6):1703-8. Disponible en: Disponible en: http://doi.org.10.1097/SCS.0b013e31826bec3b

26. Ledowski T, Reimer M, Chavez V, Kapoor V, Wenk M. Effects of acute postoperative pain on catecholamine plasma levels, hemodynamic parameters, and cardiac autonomic control. Pain [Internet]. 2012 Apr [Citado 19/02/2020];153(4):759-64. Disponible en: Disponible en: http://doi.org.10.1016/j.pain.2011.11.002