An evaluation of volumes and concentrations of lidocaine in human inferior alveolar nerve block*,**

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The purpose of this study was to evaluate, with the electric pulp tester, the anesthetic efficacy of 1.8 ml of 2% lidocaine with 1:100,000 epinephrine, 3.6 ml of 2% lidocaine with 1:200,000 epinephrine, and 1.8 ml of 4% lidocaine with 1:100,000 epinephrine in human inferior alveolar nerve block. Thirty subjects randomly received each of the solutions at three successive appointments. The first molar, canine, lateral incisor, and contralateral canine were tested with the pulp tester at various time intervals up to 55 min. Complete anesthesia was defined as an 80/80 reading with the pulp tester. No significant differences in anesthetic success or failure were found among the three solutions. Potential anesthetic problems (failure, noncontinuous anesthesia, slow onset, and short duration) occurred in 43 to 57% of the molars, in 43 to 60% of the canines, and in 57 to 80% of the lateral incisors. Complete anesthesia in the mandible is a meaningful clinical problem.

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      2019, Journal of Endodontics
      Citation Excerpt :

      This finding is in corroboration with the previous reports of the suboptimal success rates of 13%–54% for IANB using 2% lidocaine as a primary injection9,40,64,96 or success rates of 13% for repeating IANB as a supplemental injection40,96. Moreover, consistent with previous clinical trials21,47,97–99, the subgroup analysis showed that increasing the anesthetic volume to more than 1 carpule (1.8 mL) does not improve the success of IANB when treating mandibular molars with symptomatic irreversible pulpitis. Hence, the clinical trend to repeat IANB when it fails may need to be reconsidered.

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    *

    This study was supported by research funding from the Ohio Association of Endodontists, J. David Brilliant Memorial Fund.

    **

    This article was adapted from a thesis submitted by Dr. Vreeland in partial fulfillment of the requirements for the MS degree at The Ohio State University, Columbus, OH. A portion of this article was presented at the 42nd Annual Session of the American Association of Endodontists, San Diego, CA, and was honored by a graduate student research award.

    1

    Dr. Vreeland is in private practice limited to endodontics, Manchester, MO. Dr. Reader is associate professor, Department of Endodontics, The Ohio State University, Columbus, OH. Dr. Beck is associate professor, Department of Diagnostic Services, The Ohio State University. Dr. Meyers is professor and chairman, Department of Endodontics, The Ohio State University. Dr. Weaver is associate professor, Department of Oral and Maxillofacial Surgery, The Ohio State University.

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