Éxito anestésico de 1,8ml de Lidocaína 2% en exodoncia de dientes mandibulares. Estudio piloto.
Abstract
Objetivo: Determinar el efecto anestésico de un cartucho de 1,8ml de anestesia lidocaína al 2% con epinefrina 1:100.000 en la técnica troncular al nervio alveolar inferior (NAI) para la exodoncia de dientes mandibulares. Material y método: Estudio piloto de carácter analítico. Participaron pacientes voluntarios del servicio Urgencia Dental de Valdivia-Chile con indicación de exodoncia en dientes mandibulares entre Mayo y Julio del año 2010. La técnica anestésica fue realizada por un solo dentista usando sólo un cartucho de anestesia al NAI. Luego de 15 minutos, se evaluó el efecto considerándose efectiva cuando no fue necesario el refuerzo anestésico durante la exodoncia de los dientes. Se analizó la relación entre el éxito anestésico con el sexo, edad, tipo y diagnóstico del diente y el nivel de dolor observado (chi-cuadrado y regresión logística; p< 0,05). Resultados: 62 pacientes fueron seleccionados, de los cuales solo en 47 (75,8%) se logró el éxito anestésico. No hubo asociación estadística con el sexo, edad, tipo ni diagnóstico dental y dolor percibido. Conclusión: El uso de un cartucho de 1,8ml de anestesia resultó efectiva en tres de cada cuatro pacientes atendidos por exodoncia de dientes mandibulares. Se sugiere nuevas investigaciones clínicas en relación a la efectividad de otros anestésicos con la misma dosis en el bloqueo del NAI.
Palabras claves: anestesia local, lidocaína, nervio alveolar inferior, exodoncia, estudio piloto.
Aim: To determine the anesthetic effect of a 1.8 ml cartridge of anesthetic lidocaine 2% with epinephrine 1:100,000 in inferior alveolar nerve block (NAI) for the extraction in mandibular teeth. Material and methods: A pilot study with analitic design. Participating patients of Dental Emergency Service volunteers from Valdivia-Chile for mandibular teeth extractions attending between May and July of 2010. The anesthetic technique was performed by a dentist using only one cartridge of anesthetic to the NAI. After 15 minutes, the effect was considered effective when anesthetic not require reinforcement with additional anesthesia during extraction of teeth. We analyzed the relationship between success anesthetic effect with sex, age, diagnosis of tooth and type and level of pain observed (chi-square and logistic regression, p <0,05). Results: 62 patients were selected, of which only 47 (75,8%) was achieved anesthetic success. There was no statistical association with sex, age, type or dental diagnosis and perceived pain. Conclusion: Using a 1,8 ml cartridge of anesthesia was effective in three of four patients treated by extraction of mandibular teeth. It suggests further research in relation to the clinical effectiveness of other anesthetics with the same dose in NAI.
Key words: "Anesthesia, Dental"[Mesh], Lidocaine, "Mandibular Nerve"[Mesh]; "Tooth Extraction"[Mesh]; Pilot study.
References
2. Reed KL, Malamed SF, Fonner AM. Local anesthesia part 2: technical considerations. Anesth Prog. 2012; 59(3): 127-36
3. Tima, M. En: Anestésicos Locales: Uso en Odontología. Concepción, Ediciones Universidad de Concepción, 1995. Capitulo 3. Página 138.
4. Dreven LJ, Reader A, Beck M, Meyers WJ, Weaver J. An evaluation of an electric pulp tester as a measure of analgesia in human vital teeth. J Endod. 1987; 13(5): 233-8.
5. Lai TN, Lin CP, Kok SH, Yang PJ, Kuo YS, Lan WH, Chang HH. Evaluation of mandibular block using a standardized method. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102(4): 462-8.
6. Raspall, Guillermo. Cirugía Oral e implantología. 2da edición. Buenos Aires, Madrid; editorial Médica Panamericana 2006. Capítulo 4, pág 69.
7. Botero JE, Bedoya E. Determinantes del diagnóstico periodontal. Rev. Clin. Periodoncia Implantol. Rehabil. Oral. 2010; 3(2): 94-99.
8. Glickman GN. AAE Consensus Conference on Diagnostic Terminology: background and perspectives. J Endod. 2009; 35(12): 1619-20.
9. Prohić S, Sulejmanagić H, Secić S. The efficacy of supplemental intraosseous anesthesia after insufficient mandibular block. Bosn J Basic Med Sci. 2005; 5(1): 57-60.
10. Parirokh M, Satvati SA, Sharifi R, Rekabi AR, Gorjestani H, Nakhaee N, Abbott PV. Efficacy of combining a buccal infiltration with an inferior alveolar nerve block for mandibular molars with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(3): 468-73.
11. Claffey E, Reader A, Nusstein J, Beck M, Weaver J. Anesthetic efficacy of articaine for inferior alveolar nerve blocks in patients with irreversible pulpitis. J Endod. 2004; 30(8): 568-71.
12. Aggarwal V, Singla M, Miglani S, Kohli S, Singh S. Comparative evaluation of 1.8 mL and 3.6 mL of 2% lidocaine with 1:200,000 epinephrine for inferior alveolar nerve block in patients with irreversible pulpitis: a prospective, randomized single-blind study. J Endod. 2012; 38(6): 753-6.
13. Prasanna N, Subbarao CV, Gutmann JL. The efficacy of pre-operative oral medication of lornoxicam and diclofenac potassium on the success of inferior alveolar nerve block in patients with irreversible pulpitis: a double-blind, randomised controlled clinical trial. Int Endod J. 2011; 44(4): 330-6.
14. Aggarwal V, Singla M, Kabi D. Comparative evaluation of effect of preoperative oral medication of ibuprofen and ketorolac on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial. J Endod. 2010; 36(3): 375-8.
15. Aggarwal V, Singla M, Kabi D. Comparative evaluation of anesthetic efficacy of Gow-Gates mandibular conduction anesthesia, Vazirani-Akinosi technique, buccal-plus-lingual infiltrations, and conventional inferior alveolar nerve anesthesia in patients with irreversible pulpitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(2): 303-8.
16. Aggarwal V, Singla M, Rizvi A, Miglani S. Comparative evaluation of local infiltration of articaine, articaine plus ketorolac, and dexamethasone on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis. J Endod. 2011; 37(4): 445-9.
17. Sierra Rebolledo A, Delgado Molina E, Berini Aytís L, Gay Escoda C. Comparative study of the anesthetic efficacy of 4% articaine versus 2% lidocaine in inferior alveolar nerve block during surgical extraction of impacted lower third molars. Med Oral Patol Oral Cir Bucal. 2007; 12(2): E139-44.
18. Gamonal J, Mendoza C, Espinoza I, Muñoz A, Urzúa I, Aranda W, Carvajal P, Arteaga O. Clinical attachment loss in Chilean adult population: First Chilean National Dental Examination Survey. J Periodontol. 2010; 81(10): 1403-10.
19. Ministerio de Salud de Chile. Guía Clínica Urgencias Odontológicas Ambulatorias. Santiago: Minsal, 2011 . Revisado el 14 de abril de 2013. Disponible en: http://www.minsal.gob.cl/portal/url/item/7222b6448161ecb1e04001011f013f94.pdf.
20. Gutiérrez MF. , Hernández J.P. , Juarez I. , Aravena, P. 2013. Necesidad de Tratamiento Periodontal en adultos diabéticos controlados y no controlados en una población chilena. Estudio de corte transversal. Rev Clin Periodoncia Implantol Rehabil Oral. 2013 6(2). En Prensa.
21. Lai TN, Lin CP, Kok SH, Yang PJ, Kuo YS, Lan WH, Chang HH. Evaluation of mandibular block using a standardized method. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102(4): 462-8.
22. Colombini BL, Modena KC, Calvo AM, Sakai VT, Giglio FP, Dionísio TJ, Trindade AS Jr, Lauris JR, Santos CF. Articaine and mepivacaine efficacy in postoperative analgesia for lower third molar removal: a double-blind, randomized, crossover study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102(2): 169-74.
23. Isik K, Unsal A, Kalayci A, Durmus E. Comparison of three pain scales after impacted third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 112(6): 715-8.
24. Camarda AJ, Hochman MN, Franco L, Naseri L. A prospective clinical patient study evaluating the effect of increasing anesthetic volume on inferior alveolar nerve block success rate. Quintessence Int. 2007; 38(8): e521-6
25. Brandt M, Loyola G, Escobar P & Aravena P. Frecuencia del foramen retromolar y su importancia en anestesia local: Revisión de la literatura. J Oral Res 2012; 1(1): 35-38.
26. Yonchak T, Reader A, Beck M, Meyers WJ. Anesthetic efficacy of unilateral and bilateral inferior alveolar nerve blocks to determine cross innervation in anterior teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92(2): 132-5.
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