title: Hyaluronidase increases the duration of mepivacaine in inferior alveolar nerve blocks.
abstract: OBJECTIVE
  To evaluate the duration of the effect of mepivacaine when hyaluronidase is injected immediately prior to the end of pulpal anesthesia.
  
  
  METHODS
  Forty bilateral, symmetrical third molar surgeries were performed in 20 healthy patients. Inferior alveolar nerve block was induced using 2.8 mL 2% mepivacaine with epinephrine. Hyaluronidase (75 turbidity-reducing units) or a placebo was injected 40 minutes after the beginning of pulpar anesthesia (randomized and double-blind trial). The duration of effect in the pulpal and gingival tissues was evaluated by response to painful electrical stimuli applied to the adjacent premolar, and by mechanical stimuli (pin prick) to the vestibular gingiva, respectively.
  
  
  RESULTS
  In both tissues, the duration of anesthetic effect with hyaluronidase was longer (P < .01) than with the placebo.
  
  
  CONCLUSIONS
  Hyaluronidase increases the duration of mepivacaine in inferior alveolar nerve blocks.
authors.affiliation: Integrated Dental Clinic, Department of Estomatology, College of Dentistry, University of São Paulo, São Paulo, Brazil. acrth@usp.br
authors.forename: Anna Carolina Ratto
authors.initials: AC
authors.lastname: Tempestini Horliana
authors.forename: Mayara Aguilar Dias
authors.initials: MA
authors.lastname: de Brito
authors.forename: Flávio Eduardo Guillin
authors.initials: FE
authors.lastname: Perez
authors.forename: Maria Prazeres Barbalho
authors.initials: MP
authors.lastname: Simonetti
authors.forename: Rodney Garcia
authors.initials: RG
authors.lastname: Rocha
authors.forename: Maria Aparecida
authors.initials: MA
authors.lastname: Borsatti
mesh_terms: D000759:Adjuvants, Anesthesia / Q000494:pharmacology*; D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local; D003782:Dental Pulp / Q000187:drug effects; D003791:Dental Pulp Test / Q000379:methods; D004357:Drug Synergism; D004812:Epidemiologic Methods; D004837:Epinephrine; D005260:Female; D005881:Gingiva / Q000187:drug effects; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000494:pharmacology*; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects*; D008619:Mepivacaine; D008964:Molar, Third / Q000601:surgery; D009407:Nerve Block / Q000379:methods*; D013997:Time Factors
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D008619:Mepivacaine; D006821:Hyaluronoglucosaminidase; D004837:Epinephrine