A Comparative Study of Effectiveness of Two Anesthetic Agent by Intrapulpal Injection

Abstract

Background: The intrapulpal injection is commonly used when conventional anesthetic techniques fail during endodontic procedures. To compare the level of intrapulpal anesthesia achieved by lidocaine along with adrenaline and normal saline solution 0.9% w/v sodium chloride of intrapulpal injections.  

Materials and methods: The study was conducted at the Department of Conservative Dentistry and Endodontics, Bangladesh Medical University, Dhaka between January 2007 to December 2007. The study populations were patients seeking treatment for the condition which required full anesthesia but could not be profoundly anaesthetized with conventional anesthesia. Based on  sensitization test, a total of 99 patients were consecutively  included in the study. The patients were randomly allocated into two groups– one group receiving injection lidocaine along with adrenaline (Group-A) and normal saline group (Group-B). Lack of profound pulpal anesthesia was determined if the patient experienced pain during chamber access or pulp extirpation. Anesthesia was determined to be effective when the patient could tolerate continuation of the treatment.   

Results: The mean age of the subjects was 31.14 ± 7.74 years with a male to female ratio of roughly 2:1. Pain was invariably precipitated by cold and hot stimuli. Exaggerated responses were elicited as vitality test was evoked by heat (65.2%) and cold (98.5%). Test cavity preparation was also found positive. Based on these tests, majority (87.9%) of the cases was diagnosed as acute open pulpitis. Procedure using bars also elicited pain response in about 47% of the cases. The Group-A achieved profound anesthesia in 100% cases and the group-B in 62.5% cases.

Conclusion: This result suggesting that combined lidocaine and adrenaline is the best than normal saline. It concluded that achieving profound anesthesia for pulpal extirpation is of utmost importance which can be obtained using lidocaine with adrenaline.

JCMCTA 2026 ; 37 (1) : 187-191