J P Lustig1, S P Zusman. 1. Department of Oral and Maxillofacial Surgery, Gabriela and Maurice Goldshleger School of Dental Medicine, Tel Aviv University, Ramat-Aviv, Israel.
Abstract
BACKGROUND: Probably the most common procedure in dentistry is the administration of local anesthetic, or LA. Immediate complications of LA administration include positive blood aspiration, blanching of the tissue and burning sensation on impingement of the nerve. Because studies about the immediate complications of LA administration were conducted before 1980, more recent data regarding this procedure are needed. MATERIALS AND METHODS: In this prospective study, an experienced dentist administered, 2,528 LA injections to 1,007 consecutive patients with 1-inch 27-gauge needles, using a solution of 2 percent lidocaine and 1:100,000 nordefrine hydrochloride. RESULTS: The authors observed positive blood aspiration in 73 injections (2.9 percent) without any further complications. The most severe immediate complication-syncope-occurred only in one case. In 63 injections (2.5 percent), the dentist touched the nerve, and the patient reported feeling an electric current sensation (40 times with inferior alveolar nerve blocks, 18 times with lingual nerve blocks, four times with mental nerve blocks and one time with a second injection to the same site) without any further complications. CONCLUSIONS: The results confirm that LA injections that are properly carried out appear to be safer today than they were in the past. CLINICAL IMPLICATIONS: LA is a safe procedure when the appropriate technique is used. It is even safer when an inferior alveolar nerve block is administered.
BACKGROUND: Probably the most common procedure in dentistry is the administration of local anesthetic, or LA. Immediate complications of LA administration include positive blood aspiration, blanching of the tissue and burning sensation on impingement of the nerve. Because studies about the immediate complications of LA administration were conducted before 1980, more recent data regarding this procedure are needed. MATERIALS AND METHODS: In this prospective study, an experienced dentist administered, 2,528 LA injections to 1,007 consecutive patients with 1-inch 27-gauge needles, using a solution of 2 percent lidocaine and 1:100,000 nordefrine hydrochloride. RESULTS: The authors observed positive blood aspiration in 73 injections (2.9 percent) without any further complications. The most severe immediate complication-syncope-occurred only in one case. In 63 injections (2.5 percent), the dentist touched the nerve, and the patient reported feeling an electric current sensation (40 times with inferior alveolar nerve blocks, 18 times with lingual nerve blocks, four times with mental nerve blocks and one time with a second injection to the same site) without any further complications. CONCLUSIONS: The results confirm that LA injections that are properly carried out appear to be safer today than they were in the past. CLINICAL IMPLICATIONS: LA is a safe procedure when the appropriate technique is used. It is even safer when an inferior alveolar nerve block is administered.
Authors: Pedro Christian Aravena; Camila Valeria; Nicolás Nuñez; Francisco Perez-Rojas; Cesar Coronado Journal: Dent Res J (Isfahan) Date: 2016 Nov-Dec