A Double-Blind Randomized Multifactorial Clinical Study Comparing The Efficacy Of 2% Lidocaine With Adrenaline To That Of 4% Prilocaine With Felypressin

Abstract

Introduction: Lidocaine with Adrenaline and Prilocaine with Felypressin both formulations are available in Ministry of health Saudi Arabia. Although both formulations are well documented and found to be clinically safe in numerous clinical studies. This study focused on comparing these two formulations based on which one is more convenient in use as local anesthetic agents for Dental Extractions in completely healthy ASA class1 patients.

Material and Methods:

Total of 460 Patients (all ASA type 1) between age group 18 to 60 were divided in two main groups as group 1(lidocaine 2%) and group 2 (prilocaine 4%). These Two main groups were further divided in two subgroups as Mg1 (Maxillary group) and Mg2 (mandibular group). The patients were randomized and equally distributed by assisting nurse whereas the administrating physician and the patients were blind regarding the choice of anesthetic agent. In the Mg1 group the local anesthesia technique used was buccal and palatal infiltration, whereas in Mg2 group inferior alveolar nerve block and buccal infiltration was used.

The comparison criteria's were:

1)      Latency or Onset of anesthesia,

2)      The amount of anesthetic agent used,

3)      Need to re-anaesthetize the surgical zone (number of times),

4)      Pain perception during procedure on the visual scale of 1 to 10,

The results of each group were collected and tabulated and subjected to statistical analysis

Results: The results showed that the onset of local anesthesia in buccal infiltration was better with Prilocaine 4% at 0.95 minutes, but time (anesthesia) required for achieving the full effect of local anesthesia was almost similar in both groups. Significant difference was found in amount of anesthetic solution required to achieve full anesthesia. As Prilocaine 4%was required in much higher quantity compared to Lidocaine 2%.

Conclusion: In our study we wanted to compare success of anesthesia (absence of pain) in both groups. We found that Lidocaine with adrenaline was found to be more superior to prilocaine with felypressin for dental extractions. The amount of Anesthetic solution required to achieve full

Anesthesia was significantly higher in Prilocaine 4%. The more number of injections causes discomfort to the patient so we recommend using Lidocaine 2% in healthy ASA class1 patients.