title: Heart rate effects of intraosseous injections using slow and fast rates of anesthetic solution deposition.
abstract: The authors, using a crossover design, randomly administered, in a single-blind manner, 3 primary intraosseous injections to 61 subjects using: the Wand local anesthetic system at a deposition rate of 45 seconds (fast injection); the Wand local anesthetic system at a deposition rate of 4 minutes and 45 seconds (slow injection); a conventional syringe injection at a deposition rate of 4 minutes and 45 seconds (slow injection), in 3 separate appointments spaced at least 3 weeks apart. A pulse oximeter measured heart rate (pulse). The results demonstrated the mean maximum heart rate was statistically higher with the fast intraosseous injection (average 21 to 28 beats/min increase) than either of the 2 slow intraosseous injections (average 10 to 12 beats/min increase). There was no statistically significant difference between the 2 slow injections. We concluded that an intraosseous injection of 1.4 mL of 2% lidocaine with 1 : 100,000 epinephrine with the Wand at a 45-second rate of anesthetic deposition resulted in a significantly higher heart rate when compared with a 4-minute and 45-second anesthetic solution deposition using either the Wand or traditional syringe.
authors.affiliation: Former graduate student in endodontics, The Ohio State University, Columbus, Ohio, 43210, USA.
authors.forename: Louis
authors.initials: L
authors.lastname: Susi
authors.forename: Al
authors.initials: A
authors.lastname: Reader
authors.forename: John
authors.initials: J
authors.lastname: Nusstein
authors.forename: Mike
authors.initials: M
authors.lastname: Beck
authors.forename: Joel
authors.initials: J
authors.lastname: Weaver
authors.forename: Melissa
authors.initials: M
authors.lastname: Drum
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000295:instrumentation / Q000379:methods*; D000772:Anesthesia, Local / Q000295:instrumentation / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007267:Injections / Q000295:instrumentation; D007568:Jaw; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D010092:Oximetry; D011446:Prospective Studies; D016037:Single-Blind Method; D013594:Syringes; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine