PARESTHESIAS WITH ARTICAINE (SEPTOCAINE®) AND PRILOCAINE (CITANEST®) LOCAL ANESTHETICS
An article1 that reanalyzed data from a Canadian study2 showed prilocaine to have a 15X greater frequency of paresthesias with mandibular block anesthesia compared with lidocaine.
The article1 that reanalyzed data from the Canadian study2 showed articaine to have a 20X greater frequency of paresthesias with mandibular block anesthesia compared with lidocaine.
Clinical Research Associates (CRA)3 had 2 paresthesias in 13,000 patient treatments with articaine. If mandibular block injections were given in half of the appointments (6,500) the paresthesia rate would be:
1 paresthesia per 3,250 mandibular block injections.
Septodont’s study4 submitted to the U.S. FDA reported 21 paresthesias in 882 patient treatments with articaine. If mandibular block injections were given in half of the appointments, the paresthesia rate would be:
1 paresthesia per 21 mandibular block injections.
Some of the patients with the paresthesias also have the pain of dysesthesia from the site of the paresthesia.
The article reporting these findings was published in the peer-reviewed section of the February, 2003 issue of Dentistry Today1 and can be accessed at DentistryToday.com. The article recommends that prilocaine and articaine not be used for mandibular block and lingual block anesthesia, and that informed consent be obtained if they are used for those injections.
1. Dower JS. A review of paresthesia in association with administration of
anesthesia. Dentistry Today 2003:22 (2):64-69. Quiz 69.
2. Haas DA, Lennon D. A 21 year retrospective study of reports of paresthesia following local anesthetic administration. J Can Dent Assoc 1995;61(4):319-330.
3. Clinical Research Associates (CRA) Newsletter 2001;25(6).
4. Septodont application to United States Food and Drug Administration for approval of articaine local anesthetic (NDA 20-971) 1998;256-259.
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