title: Speed of injection influences efficacy of inferior alveolar nerve blocks: a double-blind randomized controlled trial in volunteers.
abstract: This randomized double-blind crossover trial investigated the efficacy and discomfort associated with slow (60 seconds) and rapid (15 seconds) inferior alveolar nerve blocks (IANB) using 2.0 ml of 2% lidocaine with 1:80,000 epinephrine in securing mandibular first molar, premolar and lateral incisor pulp anesthesia in 38 healthy adult volunteers. Episodes of maximal stimulation (80 microA) without sensation on electronic pulp testing were recorded. Injection discomfort was self-recorded by volunteers on 100 mm visual analogue scales. Data were analyzed by McNemar, Friedman, Wilcoxon Signed Ranks, and paired t tests. Slow IANB produced more episodes of no response to maximal pulp stimulation than rapid IANB in molars (220 episodes versus 159, p < 0.001), premolars (253 episodes versus 216, p = 0.003) and lateral incisors (119 episodes versus 99, p = 0.049). Slow IANB was more comfortable than rapid IANB (p = 0.021).
authors.affiliation: School of Dental Sciences, University of Newcastle upon Tyne, Framlington Place, Newcastle upon Tyne, England, UK.
authors.forename: Mohammad Dib
authors.initials: MD
authors.lastname: Kanaa
authors.forename: John Gerard
authors.initials: JG
authors.lastname: Meechan
authors.forename: Ian Porter
authors.initials: IP
authors.lastname: Corbett
authors.forename: John Martin
authors.initials: JM
authors.lastname: Whitworth
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D001641:Bicuspid / Q000294:innervation; D018592:Cross-Over Studies; D003782:Dental Pulp / Q000294:innervation; D003791:Dental Pulp Test; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007180:Incisor / Q000294:innervation; D007267:Injections / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008340:Mandibular Nerve; D008963:Molar / Q000294:innervation; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D012677:Sensation / Q000187:drug effects; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine