Effect of intraosseous anesthesia on control of hemostasis in pigs.
BACKGROUND
Intraosseous anesthesia is used to deliver anesthetic into cancellous bone adjacent to the root apices. No study has assessed the effect of this anesthetic technique on hemostasis. The purpose of this study was to compare the amount of bleeding from soft tissue and bone in pig jaws after preoperative intraosseous or infiltration anesthesia with 2% lidocaine containing 1:50,000 epinephrine.


METHODS
Twelve pigs were divided into 3 groups. The first group received infiltration anesthesia on one half of the jaw and no anesthesia on the other half. The second group received intraosseous anesthesia on one half of the jaw and no anesthesia on the other half. The third group received infiltration anesthesia on one half of the jaw and intraosseous anesthesia on the second half. Blood was collected during flap reflection to measure the volume of soft tissue bleeding. Osteotomies were then prepared with blood collected from the surgical site to measure the volume of osseous bleeding.


RESULTS
The median soft tissue blood loss observed in animals receiving infiltration anesthesia (1.14 mL) was significantly less as compared with animals that received no anesthesia (4.49 mL) or intraosseous anesthesia (2.45 mL). Compared with median hard tissue blood loss observed in animals without anesthesia (1.51 mL), significantly less blood loss was observed in animals receiving either infiltration anesthesia (0.67 mL) or intraosseous anesthesia (0.76 mL).


CONCLUSIONS
Infiltration anesthesia resulted in significantly less soft tissue bleeding (p = .004) as compared with no anesthesia. Infiltration and intraosseous anesthesia resulted in significantly less osseous bleeding than the use of no anesthetic (p < .001). The volume of blood loss for each animal was shown to be below the maximum safe volume of blood loss for a single procedure.
Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California 92534, USA. tybakes@hotmail.com
Tyler F
TF
Baker
Mahmoud
M
Torabinejad
Stephen F
SF
Schwartz
David
D
Wolf
D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000818:Animals; D016063:Blood Loss, Surgical; D004837:Epinephrine / Q000008:administration & dosage; D006487:Hemostasis / Q000187:drug effects*; D007267:Injections; D007568:Jaw / Q000187:drug effects*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000601:surgery; D006472:Oral Hemorrhage / Q000209:etiology; D010027:Osteotomy; D010519:Periodontium / Q000601:surgery; D011897:Random Allocation; D013524:Surgical Flaps; D013552:Swine; D019227:Tooth Apex / Q000187:drug effects*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine