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Does the volume of supplemental intraligamentary injections affect the anaesthetic success rate after a failed primary inferior alveolar nerve block? A randomized‐double blind clinical trial
Author(s) -
Aggarwal V.,
Singla M.,
Miglani S.,
Kohli S.,
Sharma V.,
Bhasin S. S.
Publication year - 2018
Publication title -
international endodontic journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.988
H-Index - 119
eISSN - 1365-2591
pISSN - 0143-2885
DOI - 10.1111/iej.12773
Subject(s) - medicine , lidocaine , inferior alveolar nerve , visual analogue scale , anesthesia , root canal , heart rate , surgery , dentistry , blood pressure , molar
Aim To investigate the efficacy of 0.2 mL vs. 0.6 mL of 2% lidocaine when given as a supplementary intraligamentary injection after a failed inferior alveolar nerve block (IANB). Methodology Ninety‐seven adult patients with symptomatic irreversible pulpits received an IANB and root canal treatment was initiated. Pain during treatment was recorded using a visual analogue scale (Heft‐Parker VAS ). Patients with unsuccessful anaesthesia ( n = 78) randomly received intraligamentary injection of either 0.2 mL or 0.6 mL of 2% lidocaine with 1 : 80 000 epinephrine. Root canal treatment was reinitiated. Success after primary injection or supplementary injection was defined as no or mild pain ( HP VAS score ≤54 mm) during access preparation and root canal instrumentation. Heart rate was monitored using a finger pulse oximeter. The anaesthetic success rates were analysed with Pearson chi‐square test at 5% significance levels. The heart rate changes were analysed using t ‐tests. Results The intraligamentary injections with 0.2 mL solution gave an anaesthetic success rate of 64%, whilst the 0.6 mL was successful in 84% of cases with failed primary IANB . (χ 2 = 4.3, P = 0.03). There was no significant effect of the volume of intraligamentary injection on the change in heart rate. Conclusions Increasing the volume of intraligamentary injection improved the success rates after a failed primary anaesthetic injection.