The Anesthetic Efficacy of 3% Mepivacaine Plus 2% Lidocaine With 1:100,000 Epinephrine for Lower Jaw Dental Injections



Status:Completed
Conditions:Chronic Pain
Therapuetic Areas:Musculoskeletal
Healthy:No
Age Range:18 - 65
Updated:10/14/2017
Start Date:May 2012
End Date:May 2013

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A Prospective, Randomized, Double-blind Study of the Anesthetic Efficacy of 3% Mepivacaine Plus 2% Lidocaine With 1:100,000 Epinephrine for Inferior Alveolar Nerve Blocks.

The inferior alveolar nerve block (shot) is the most frequently used injection technique for
achieving local anesthesia (numbness) for the teeth in the lower jaw. However, this injection
does not always result in successful pulpal (tooth) anesthesia (patient felt pain). No study
has combined mepivacaine and lidocaine anesthetics (numbing solutions) for this type of
injection (shot). The investigators propose to compare an injection of mepivacaine followed
by lidocaine to an injection of lidocaine followed by lidocaine to determine if there is a
difference in effectiveness.

One hundred adult male and female subjects will randomly receive two sets of inferior
alveolar block injections (shots) consisting of an injection of 1.8 mL of 3% mepivacaine
followed by 1.8 mL of 2% lidocaine with 1:100,000 epinephrine, and an injection of 1.8 mL of
2% lidocaine with 1:100,000 epinephrine followed by 1.8 mL of 2% lidocaine with 1:100,000
epinephrine, at two separate appointments spaced at least two weeks apart, in a crossover
design. Whether the subject receives the mepivacaine or the lidocaine for the first injection
will be determined randomly. The doctor will not know whether the subject receives
mepivacaine or lidocaine for the first injection. The subject will not know which anesthetics
he/she receives. A pulp tester will be used to test the lower jaw teeth (molars, premolars,
and incisors) for anesthesia (numbness) in 4-minute time cycles for 60 minutes. The pain of
the IAN block injections will also be recorded. The data will be statistically analyzed.

Inclusion Criteria:

- between the ages of 18 and 65 years

- good health (ASA classification I or II)

- able to provide informed consent

Exclusion Criteria:

- allergy to lidocaine or mepivacaine

- history of significant medical problem (ASA classification III or greater)

- depression

- have taken CNS depressants (including alcohol or any analgesic medications) within the
last 48 hours

- lactating or pregnant

- inability to give informed consent
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