Abstract
Although pain control remains the cornerstone of any oral and dental procedure, prolonged local anesthetic effects may be undesirable in many instances in maxillofacial clinical practice. There remains a risk of trauma to the patient’s lips, cheeks and tongue due to this residual effect of the local anesthetic by patients biting on their own tissue or inadvertent burns caused by hot drinks or food which may be consumed. The Food and Drug Administration (FDA) in May 2009 has approved phentolamine mesylate, a nonspecific alpha-adrenergic antagonist, for the reversal of soft tissue anesthesia and the associated functional deficits resulting from a local dental anesthetic. This paper reviews the indications, recommended dosage, mechanism of action, pharmacokinetics, clinical studies, complications and adverse effects of phentolamine mesylate for the reversal of soft-tissue anesthesia resulting from an intraoral sub-mucosal injection of a local anesthetic containing a vasoconstrictor.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ogle OE, Mahjoubi G. Advances in local anaesthesia in dentistry. Dent Clin North Am. 2011;55(3):481–99.
http://www.oraverse.com/dental-professionals/about-oraverse/pharmacologydentalProfessionals. Accessed 15 Nov 2011.
Malamed S. What’s new in local anaesthesia? SAAD Dig. 2009;25:4–14.
http://www.google.com/patents?id=XqNYAAAAEBAJ&zoom=4&pg=PA1#v=onepage&q&f=false. Accessed 15 Nov 2011.
Urech E, Marxer A, Miescher K. 2-Aminoalkyl-imidazoline. Helvetica Chim Acta. 1950;33:1386–1407. doi:10.1002/hlca.19500330539.
Tuncel M, Ram VC. Hypertensive emergencies. Etiology and management. Am J Cardiovasc Drugs. 2003;3(1):21–31.
Chan GM, Sharma R, Price D, Hoffman RS, Nelson LS. Phentolamine therapy for cocaine-associated acute coronary syndrome (CAACS). J Med Toxicol. 2006;2(3):108–11.
Bella AJ, Brock GB. Intracavernous pharmacotherapy for erectile dysfunction. Endocrine. 2004;23:149–55.
Rowbotham MC. Pharmacologic management of complex regional pain syndrome. Clin J Pain. 2006;22(5):425–9.
Hersh EV, Lindemeyer RG. Phentolamine mesylate for accelerating recovery from lip and tongue anesthesia. Dent Clin North Am. 2010;54(4):631–42.
Prescribing information.http://www.oraverse.com/assets/pdf/OraVerse-PI.pdf. Accessed 17 Nov 2011.
Hersh EV, Moore PA, Papas AS, Goodson JM, Navalta LA, Rogy S, et al. Soft tissue anesthesia recovery group. Reversal of soft-tissue local anesthesia with phentolamine mesylate in adolescents and adults. J Am Dent Assoc. 2008;139(8):1080–93.
Tavares M, Goodson JM, Studen-Pavlovich D, Yagiela JA, Navalta LA, Rogy S, et al. Soft tissue anesthesia reversal group. Reversal of soft-tissue local anesthesia with phentolamine mesylate in pediatric patients. J Am Dent Assoc. 2008;139(8):1095–104.
Moore PA, Hersh EV, Papas AS, Goodson JM, Yagiela JA, Rutherford B, et al. Pharmacokinetics of lidocaine with epinephrine following local anesthesia reversal with phentolamine mesylate. Anesth Prog. 2008;55(2):40–8.
Laviola M, McGavin SK, Freer GA, Plancich G, Woodbury SC, Marinkovich S, et al. Randomized study of phentolamine mesylate for reversal of local anesthesia. J Dent Res. 2008;87(7):635–9.
Saunders TR, Psaltis G, Weston JF, Yanase RR, Rogy SS, Ghalie RG. In-practice evaluation of OraVerse for the reversal of soft-tissue anesthesia after dental procedures. Compend Contin Educ Dent. 2011;32(5):58–62.
http://www.drugs.com/sfx/oraverse-side-effects.html. Accessed 14 Nov 2011.
Conflict of interest
The authors declare that there is no actual or potential conflict of interest in relation to this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bhargava, D. Phentolamine mesylate. J. Stomat. Occ. Med. 5, 53–56 (2012). https://doi.org/10.1007/s12548-012-0038-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12548-012-0038-7