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EFFECT OF MANNITOL ON DENTAL ANESTHESIA

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drmithila's picture
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 Mannitol can increase the success of local anesthetics in the inferior alveolar nerve block.

The most common local anesthetic injection is the inferior alveolar nerve block but it has a failure rate of anywhere from 10 to 39 percent.

This issue is analyzed in the current issue of the journal Anesthesia Progress.

To explain this research, 40 adults were part of a study and each received an IAN block on three occasions at least a week apart. The study looked at the ineffectiveness of a standard anesthetic, like lidocaine or epinephrine, and compared it to the ability of the combination of lidocaine with epinephrine and 0.5 M of mannitol. Mannitol is a sugar alcohol present in fruits and vegetables and can be excreted quickly by the kidneys.

Mannitol has been proven to impact the opening of the perineurial membrane. In situations where there is IAN block failure, the perineurial barrier doesn’t permit full diffusion of the anesthetics. Mannitol helps because it increases permeability in these cases.

After people were injected with IAN block solutions, their pain levels were measured with a test of their mandibular teeth in four-minute intervals during a one-hour period. According to the study, it’s evident that when mannitol is added to lidocaine with epinephrine, there is a much higher chance of success for the anesthesia.

 

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EFFECT OF MANNITOL ON DENTAL ANESTHESIA

How to Increase Effectiveness Of Dental Nerve Block Anesthesia?

Mannitol has the positive effect of opening the perineurial membrane. It is believed that, in cases of IAN block failure (10-39%), the perineurial barrier around the nerve does not allow complete diffusion of the anesthetic into the nerve trunk. The addition of mannitol apparently allows enhanced permeability, increasing the success of an IAN block when administered concurrently.

After injections of the IAN block solutions, subjects’ pain levels were measured by an electric pulp test of their mandibular teeth at 4-minute intervals for 60 minutes. The study concluded that the addition of mannitol to lidocaine with epinephrine significantly increased the effectiveness of the anesthesia.

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EFFECT OF MANNITOL ON DENTAL ANESTHESIA

Allowing a patient to be comfortable and pain-free during surgical and restorative dental procedures is an essential part of the process. The most commonly used local anesthetic injection for lower teeth is the inferior alveolar nerve (IAN) block. However, failure rates ranging from 10 to 39 percent have been reported.

The current issue of the journal Anesthesia Progress presents a study testing the efficacy of adding a solution of mannitol to the anesthetic typically used in IAN blocks. Forty adult subjects participated in the study, receiving an IAN block at each of three separate appointments at least one week apart.

The study compared the effectiveness of the standard anesthetic, lidocaine with epinephrine, to the effectiveness of two different volumes of lidocaine with epinephrine plus 0.5 M mannitol. Mannitol is a sugar alcohol that occurs naturally in fruits and vegetables. It is rapidly excreted by the kidneys.

Though its impact is short-lived, mannitol has the positive effect of opening the perineurial membrane. It is believed that, in cases of IAN block failure, the perineurial barrier around the nerve does not allow complete diffusion of the anesthetic into the nerve trunk. The addition of mannitol apparently allows enhanced permeability, increasing the success of an IAN block when administered concurrently.

After injections of the IAN block solutions, subjects' pain levels were measured by an electric pulp test of their mandibular teeth at 4-minute intervals for 60 minutes. The study concluded that the addition of mannitol to lidocaine with epinephrine significantly increased the effectiveness of the anesthesia.

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