Infiltrated lidocaine 2% with epinephrine 1:80,000 causes more postoperative pain than lidocaine 2% after oral soft tissue surgery.
A controlled, randomized, double-blind, within-patient, crossover study was made with 50 patients (28 women and 22 men) of mean age 47 years (range, 32-69 years) who were subjected to identical bilateral gingivectomies. On one occasion, lidocaine 2% was infiltrated as the local anesthetic. On the other occasion, lidocaine 2% with epinephrine 1:80,000 was given. Postoperative pain intensity was recorded by the patients on a 100-mm visual analogue scale every hour during an 11-hour observation period. The mean pain intensity was numerically higher after lidocaine 2% at 0 hours and 1 hour postoperatively. Then the mean pain intensity after lidocaine 2% was lower than that after lidocaine 2% with epinephrine 1:80,000 throughout the remaining observation period. The difference in pain intensity was statistically significant (P < .05) at 2, 4, 5, 6, and 7 hours after surgery. Mean sum (SEM) pain intensity over the 11-hour observation period was lower (P = .03) after lidocaine 2%, 66.5 (13.4) mm than after lidocaine 2% with epinephrine 1:80,000, 92.6 (15.4) mm. The study shows that high epinephrine concentration (1:80,000) increases the postoperative pain after dental soft tissue surgery with mild pain.
Jorkjend
L
L
Section of Dental Pharmacology and Pharmacotherapy, University of Oslo, Norway.
Skoglund
L A
LA
D000328:Adult; D000368:Aged; D000766:Anesthesia, Dental / Q000009:adverse effects* / Q000379:methods; D000772:Anesthesia, Local / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects*; D004837:Epinephrine / Q000009:adverse effects*; D005260:Female; D005890:Gingivectomy / Q000379:methods*; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine