J Dent Anesth Pain Med.  2015 Jun;15(2):63-68.

Advantages of anterior inferior alveolar nerve block with felypressin-propitocaine over conventional epinephrine-lidocaine: an efficacy and safety study

• Shinzaki H
• Sunada K

Abstract

BACKGROUND
Conventional anesthetic nerve block injections into the mandibular foramen risk causing nerve damage. This study aimed to compare the efficacy and safety of the anterior technique (AT) of inferior alveolar nerve block using felypressin-propitocaine with a conventional nerve block technique (CT) using epinephrine and lidocaine for anesthesia via the mandibular foramen.
METHODS
Forty healthy university students with no recent dental work were recruited as subjects and assigned to two groups: right side CT or right side AT. Anesthesia was evaluated in terms of success rate, duration of action, and injection pain. These parameters were assessed at the first incisor, premolar, and molar, 60 min after injection. Chi-square and unpaired t-tests were used for statistical comparisons, with a P value of < 0.05 designating significance.
RESULTS
The two nerve block techniques generated comparable success rates for the right mandible, with rates of 65% (CT) and 60% (AT) at both the first molar and premolar, and rates of 60% (CT) and 50% (AT) at the lateral incisor. The duration of anesthesia using the CT was 233 ± 37 min, which was approximately 40 min shorter than using the AT. This difference was statistically significant (P < 0.05). Injection pain using the AT was rated as milder compared with the CT. This difference was also statistically significant (P < 0.05).
CONCLUSIONS
The AT is no less successful than the CT for inducing anesthesia, and has the added benefits of a significantly longer duration of action and significantly less pain.

Keyword

Anterior technique for mandibular nerve block; Felypressin; Inferior alveolar nerve blocks

MeSH Terms

Anesthesia
Bicuspid
Epinephrine
Felypressin
Humans
Incisor
Lidocaine
Mandible
Mandibular Nerve*
Molar
Nerve Block
Epinephrine
Felypressin
Lidocaine

Figure

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  Fig. 1 Anesthetic effectiveness rate on the first molar. No significant differences were found between the conventional technique with epinephrine-lidocaine (EL) and the anterior technique using felypressin-propitocaine (FP).

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  Fig. 2 Anesthetic effectiveness rate on the first premolar. No significant differences were found between the conventional technique with epinephrine-lidocaine (EL) and the anterior technique using felypressin-propitocaine (FP).

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  Fig. 3 Anesthetic effectiveness rate on the right incisor. No significant differences were found between the conventional technique with epinephrine-lidocaine (EL) and the anterior technique using felypressin-propitocaine (FP).

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