title: Prospective, randomized single-blind study of the anesthetic efficacy of 1.8 and 3.6 milliliters of 2% lidocaine with 1:50,000 epinephrine for inferior alveolar nerve block.
abstract: BACKGROUND
  The purpose of this prospective, randomized study was to compare the degree of pulpal anesthesia obtained in vital, asymptomatic teeth by using 1.8 mL and 3.6 mL of 2% lidocaine with 1:50,000 epinephrine compared with 1.8 mL of 2% lidocaine with 1:100,000 epinephrine for inferior alveolar nerve (IAN) block.
  
  
  METHODS
  Thirty adult subjects randomly received IAN blocks of 1.8 mL and 3.6 mL of 2% lidocaine with 1:50,000 epinephrine and 1.8 mL of 2% lidocaine with 1:100,000 epinephrine at 3 separate appointments in a crossover design. An electric pulp tester was used to test for anesthesia in 3-minute cycles for 60 minutes of the first molars, first premolars, and lateral incisors. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes, and the 80 reading was continuously sustained through the 60th minute.
  
  
  RESULTS
  By using 1.8 mL of 2% lidocaine with 1:50,000 epinephrine, successful pulpal anesthesia ranged from 33%-50%, and when using 3.6 mL of 2% lidocaine with 1:50,000 epinephrine, success ranged from 40%-60%. When using 1.8 mL of 2% lidocaine with 1:100,000 epinephrine, success ranged from 40%-60%, with no significant difference among the 3 anesthetic formulations.
  
  
  CONCLUSIONS
  Increasing the epinephrine concentration to 1:50,000 epinephrine or increasing the volume to 3.6 mL of 2% lidocaine with 1:50,000 epinephrine did not result in more successful pulpal anesthesia when compared with 1.8 mL of 2% lidocaine with 1:100,000 epinephrine by using the IAN block.
authors: Division of Endodontics, The Ohio State University, Columbus, Ohio 43210, USA.
authors: Maji
authors: M
authors: Wali
authors: Melissa
authors: M
authors: Drum
authors: Al
authors: A
authors: Reader
authors: John
authors: J
authors: Nusstein
mesh_terms: D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D018592:Cross-Over Studies; D003782:Dental Pulp / Q000187:drug effects / Q000294:innervation; D003791:Dental Pulp Test; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008334:Mandible; D008340:Mandibular Nerve / Q000187:drug effects*; D009407:Nerve Block / Q000379:methods*; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine