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The authors, using a crossover design, randomly administered, in a single-blind manner, inferior alveolar nerve blocks using 36 mg of lidocaine with 18 μg of epinephrine or a combination of 36 mg of lidocaine with 18 μg epinephrine plus 36 mg meperidine with 18 μg of epinephrine, at 2 separate appointments, to 52 subjects. An electric pulp tester was used to test for anesthesia, in 4-minute cycles for 60 minutes, of the molars, premolars, and central and lateral incisors. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes and the 80 reading was continuously sustained for 60 minutes. Using the lidocaine solution, successful pulpal anesthesia ranged from 8 to 58% from the central incisor to the second molar. Using the lidocaine/meperidine solution, successful pulpal anesthesia ranged from 0 to 17%. There was a significant difference (P < .05) between the lidocaine and lidocaine/meperidine solutions for the lateral incisors through the second molars. We conclude that the addition of meperidine to a standard lidocaine solution does not increase the success of the inferior alveolar nerve block.Abstract
Heft-Parker visual analog scale (VAS) used for assessment of pain. The millimeter demarcations were not shown on the patients' VAS.
Incidence of second molar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Incidence of first molar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Incidence of second premolar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Incidence of first premolar anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Incidence of lateral incisor anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
Incidence of central incisor anesthesia as determined by lack of response to electrical pulp testing at the maximum setting (percentage of 80/80s) at each postinjection time interval for the lidocaine and lidocaine/meperidine solutions. Significant differences (P < .05) between the 2 anesthetic solutions are marked with an asterisk (*).
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