1:200,000 에피네프린 리도카인의 소개
Efficacy and safety of 2% lidocaine HCl with 1:200,000 epinephrine
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INTRODUCTION The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. METHODS Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in two separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial. Visual analogue scale pain scores obtained immediately after surgical extraction were primarily evaluated for the two groups receiving different epinephrine concentrations. Visual analogue scale pain scores obtained 2, 4, and 6 h after administering an anesthetic, onset and duration of analgesia, onset of pain, intraoperative bleeding, operator’s and participant’s overall satisfaction, drug dosage, and hemodynamic parameters were evaluated for the two groups. RESULTS There were no statistically significant differences between the two groups in any measurements except hemodynamic factors (P > .05). Changes in systolic blood pressure and heart rate following anesthetic administration were significantly greater in the group receiving 1:80,000 epinephrine than in that receiving 1:200,000 epinephrine (P 01). CONCLUSION The difference in epinephrine concentration between 1:80,000 and 1:200,000 in 2% lidocaine liquid does not affect the medical efficacy of the anesthetic. Furthermore, 2% lidocaine with 1:200,000 epinephrine has better safety with regard to hemodynamic parameters than 2% lidocaine with 1:80,000 epinephrine. Therefore, we suggest using 2% lidocaine with 1:200,000 epinephrine rather than 2% lidocaine with 1:80,000 epinephrine for surgical extraction of impacted mandibular third molars in hemodynamically unstable patients. Key words : Epinephrine; Hemodynamics; Lidocaine
Abstract
INTRODUCTION The most commonly impacted tooth is the third molar. An impacted third molar can ultimately cause acute pain, infection, tumors, cysts, caries, periodontal disease, and loss of adjacent teeth. Local anesthesia is employed for removing the third molar. This study aimed to evaluate the efficacy and safety of 2% lidocaine with 1:80,000 or 1:200,000 epinephrine for surgical extraction of bilateral impacted mandibular third molars. METHODS Sixty-five healthy participants underwent surgical extraction of bilateral impacted mandibular third molars in two separate visits while under local anesthesia with 2% lidocaine with different epinephrine concentration (1:80,000 or 1:200,000) in a double-blind, randomized, crossover trial. Visual analogue scale pain scores obtained immediately after surgical extraction were primarily evaluated for the two groups receiving different epinephrine concentrations. Visual analogue scale pain scores obtained 2, 4, and 6 h after administering an anesthetic, onset and duration of analgesia, onset of pain, intraoperative bleeding, operator’s and participant’s overall satisfaction, drug dosage, and hemodynamic parameters were evaluated for the two groups. RESULTS There were no statistically significant differences between the two groups in any measurements except hemodynamic factors (P > .05). Changes in systolic blood pressure and heart rate following anesthetic administration were significantly greater in the group receiving 1:80,000 epinephrine than in that receiving 1:200,000 epinephrine (P 01). CONCLUSION The difference in epinephrine concentration between 1:80,000 and 1:200,000 in 2% lidocaine liquid does not affect the medical efficacy of the anesthetic. Furthermore, 2% lidocaine with 1:200,000 epinephrine has better safety with regard to hemodynamic parameters than 2% lidocaine with 1:80,000 epinephrine. Therefore, we suggest using 2% lidocaine with 1:200,000 epinephrine rather than 2% lidocaine with 1:80,000 epinephrine for surgical extraction of impacted mandibular third molars in hemodynamically unstable patients. Key words : Epinephrine; Hemodynamics; Lidocaine
참고문헌 (17)
- Haas DA, "Local anesthetic use by dentists in Ontario", Journal (Canadian Dental Association), 61(4), pp.297~304 (1995)
- Becker DE, "Local anesthetics: review of pharmacological considerations", Anesthesia progress, 59(2), pp.90~101 (2012)
- Jastak JT, "Vasoconstrictors and local anesthesia: a review and rationale for use", Journal of the American Dental Association (1939), 107(4), pp.623~630 (1983)
- Sveen K., "Effect of the addition of a vasoconstrictor to local anesthetic solution on operative and postoperative bleeding, analgesia and wound healing", International journal of oral surgery, 8(4), pp.301~306 (1979)
- Bromage PR, "Concentrations of lignocaine in the blood after intravenous, intramuscular epidural and endotracheal administration", Anaesthesia, 16, pp.461~478 (1961)
- Wilkinson GR, "Bupivacaine levels in plasma and cerebrospinal fluid following peridural administration", Anesthesiology, 33(5), pp.482~486 (1970)
- Bushara Ping, "Hemodynamic changes associated with a novel concentration of lidocaine HCl for impacted lower third molar surgery", Journal of Dental Anesthesia and Pain Medicine, 15(3), pp.121~128 (2015), 대한치과마취과학회[DOI]
- Bushara Ping, "The efficacy of an elevated concentration of lidocaine HCl in impacted lower third molar surgery", Journal of Dental Anesthesia and Pain Medicine, 15(2), pp.69~76 (2015), 대한치과마취과학회[DOI]
- Aggarwal V, "Comparison of the anaesthetic efficacy of epinephrine concentrations (1 : 80 000 and 1 :200 000) in 2% lidocaine for inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a randomized, double-blind clinical trial", International endodontic journal, 47(4), pp.373~379 (2014)
- WHO, "World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects", Bull World Health Organ, 79(4), pp.373~374 (2001)
- Moore PA, "Local anesthetics:pharmacology and toxicity", Dental clinics of North America, 54(4), pp.587~599 (2010)
- Sisk AL, "Vasoconstrictors in local anesthesia for dentistry", Anesthesia progress, 39(6), pp.187~193 (1992)
- Murakawa T, "Two cases of circulatory failure after local infiltration of epinephrine during tonsillectomy", Masui. The Japanese journal of anesthesiology, 47(8), pp.955~962 (1998)
- Niwa H, "Cardiovascular response to epinephrine-containing local anesthesia in patients with cardiovascular disease", Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 92(6), pp.610~616 (2001)
- Haas DA, "An update on local anesthetics in dentistry", Journal (Canadian Dental Association), 68(9), pp.546~551 (2002)
- Troullos ES, "Plasma epinephrine levels and cardiovascular response to high administered doses of epinephrine contained in local anesthesia", Anesthesia progress, 34(1), pp.10~13 (1987)
- Hersh EV, "The pharmacokinetics and cardiovascular effects of high-dose articaine with 1:100,000 and 1:200,000epinephrine", Journal of the American Dental Association (1939), 137(11), pp.1562~1571 (2006)