A clinical study of anesthetic efficacy of alkalinizing lidocaine in inferior alveolar nerve blocks

Kim, Tae Hwan; Kim, Kyung Wook; Kim, Chul Hwan

Abstract

Inferior alveolar nerve block using lidocaine is the most frequent local anesthetic method in the dental treatment, but clinically it is not always successful. The 2% lidocaine cartridge has been used commonly in dental anesthesia. It contains vasoconstrictor and antioxidant, which presents low pH which provides chemical stability and longer shelf life. But alkalinized local anesthetics has less tissue trauma, easier dissociation of the non-ionized base which penetrates nerve sheath, rapid onset and more intensity. In this study, in inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate (experimental group) is compared with plain lidocaine (control group) about injection pain, anesthetic onset, duration and postinjection discomfort. In inferior alveolar nerve block, alkalinized lidocaine using sodium bicarbonate showed lower injection pain. There was significant difference statistically from plain lidocaine (p=0.019). Comparing with plain lidocaine, alkalinized lidocaine produced more rapid onset (lip and pulp anesthetic onset), there was no significant difference (p>0.05). but there was boundary significance (0.050.05). These results suggest that addition of sodium bicarbonate to 2% lidocaine (1:100,000 epinephrine) for inferior alveolar nerve block is more effective for reduction of injection pain and onset time.