title: Bacteraemia following local anaesthetic injections in children.
abstract: OBJECTIVE
  To estimate odontogenic bacteraemia following three different types of local anaesthetic injections, namely: buccal infiltration analgesia (BIA), conventional intraligamental analgesia (CIA), and modified intraligamental analgesia (MIA).
  
  
  METHODS
  The bacteraemia-producing potential of three methods of injecting local analgesic solution was determined by taking blood samples, using aseptic technique, from 143 children, aged 1 year 11 months to 19 years 4 months, undergoing general anaesthesia for dental extractions. Of these 143 children, a subgroup of 50 had blood taken before any dentogingival manipulative procedures to provide a baseline level of bacteraemia. The injection methods were buccal infiltration, conventional intraligamental, and a modified intraligamental. The blood samples were taken 30 seconds after injection and cultured in aerobic and anaerobic broth cultures (Bactec) and from lysis filtration vials (Isolator).
  
  
  RESULTS
  The percentage prevalence of bacteraemia was: baseline level 8%; buccal infiltration analgesia 16%; modified intraligamental analgesia 50%; and conventional intraligamental analgesia 97%. These values were statistically significantly different using the chi-squared test (P < 0.001). The mean value for colony forming units per millilitre (Isolator system) was 252 (sd = 646) for the intraligamental technique but zero for baseline, infiltration and modified intraligamental techniques.
  
  
  CONCLUSIONS
  All local anaesthetic techniques studied were associated with bacteraemia which may have implications for antibiotic prophylaxis for dental treatment. The intraligamental techniques had statistically significantly greater percentage prevalence of bacteraemia compared with baseline. The modified intraligamental technique causes significantly less bacteraemia than the conventional intraligamental technique.
authors.affiliation: Department of Paediatric Dentistry, Eastman Dental Institute, University of London.
authors.forename: G J
authors.initials: GJ
authors.lastname: Roberts
authors.forename: N B
authors.initials: NB
authors.lastname: Simmons
authors.forename: P
authors.initials: P
authors.lastname: Longhurst
authors.forename: P B
authors.initials: PB
authors.lastname: Hewitt
mesh_terms: D000278:Administration, Buccal; D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000009:adverse effects*; D000772:Anesthesia, Local / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data; D016470:Bacteremia / Q000209:etiology* / Q000382:microbiology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D019140:Dental Care for Children; D006801:Humans; D007223:Infant; D007267:Injections / Q000009:adverse effects; D008012:Lidocaine / Q000009:adverse effects*; D010513:Periodontal Ligament
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine