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Effectiveness of 2% Articaine as an anesthetic agent in children: randomized controlled trial

  • Neeraja Ramadurai
  • Deepa Gurunathan
  • A. Victor Samuel
  • Emg Subramanian
  • Steven J L Rodrigues
Original Article
  • 36 Downloads

Abstract

Aim

The aim of this study was to compare the effectiveness of 2% articaine and 2% lignocaine in achieving adequate anesthesia in children between the age group of 6–13 years using inferior alveolar nerve block.

Methods

A triple blinded randomized controlled trial was conducted in 180 participants (90 patients- 2% articaine, 90 patients-2% lignocaine). Effectiveness of the anesthetic agent was determined at 3 points determined by subjective evaluation of pain using pain scales (FPS-R). Paired sample t-test and chi square test were performed for statistical significance.

Result

Anesthetic success for 2% articaine were 64.4%, 42.2% and 81.8% respectively. The anesthetic success of 2% lignocaine was 66.7%, 48.9% and 85.7% at point one, point two and point three respectively (p > 0.05).

Conclusion

This study concludes that 2% articaine in 1:2,00,000 did not demonstrate superior clinical effectiveness in comparison to 2% lignocaine.

Clinical significance

Lignocaine has always been considered the gold standard. With its unique chemical structure and increased potency, Articaine has been gaining popularity. Its efficacy in 2% concentration had not been compared to 2% lignocaine. 2% articaine did not show clinical superiority but its comparable effectiveness with lignocaine can encourage further research in using articaine in reduced concentrations to improve effectiveness.

Keywords

Randomized controlled trial Articaine Children 

Notes

Funding

No funding was received.

Compliance with ethical standard

Conflict of interest

Dr. Neeraja Ramadurai declares that she has no conflict of interest.

Dr. Deepa Gurunathan declares that she has no conflict of interest.

Dr. EMG Subramanian declares that he has no conflict of interest.

Dr. Victor Samuel declares that he has no conflict of interest.

Dr. Steven Rodrigues declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

784_2018_2775_MOESM1_ESM.pdf (691 kb)
ESM 1 (PDF 691 kb)

References

  1. 1.
    Malamed S (2004) Clinical action of specific agents. In: Malamed S (ed) Handbook of local anesthesia. 5 e. Mosby, St. LouisGoogle Scholar
  2. 2.
    Oertal R, Rahn R, Kirch W (1997) Clinical pharmacokinetics of articaine. Clin Pharmacokinet 33:417–425CrossRefGoogle Scholar
  3. 3.
    Garisto GA, Gaffen AS, Lawrence HP, Tenenbaum HC (2010) Haas DA. Occurrence of paresthesia after dental local anesthetic administration in the United States. J am dent Assoc 1939. Jul 141(7):836–844Google Scholar
  4. 4.
    Haas DA, Lennnon D (1995) A 21 year retrospective study of reports of paresthesia following local anesthetic administration. J Can Dent Assoc 61:319–330PubMedGoogle Scholar
  5. 5.
    Hintze A, Paessler L (2006) Comparative investigations on the efficacy of articaine 4% (epinephrine 1:200,000) and articaine 2% (epinephrine 1:200,000) in local infiltration anaesthesia in dentistry – a randomized double blind study. Clin Oral Investig 10:145–150CrossRefGoogle Scholar
  6. 6.
    Knoll-Köhler E (1991) Local anesthesia in dentistry. Zahnärztliche Mitteilungen 81(23):2370–2375PubMedGoogle Scholar
  7. 7.
    Winther JE, Patirupanusara B (1974) Evaluation of carticaine - a new local analgesic. Int J Oral Surg 3(6):422–427CrossRefGoogle Scholar
  8. 8.
    Malamed SF, Gagnon S, Leblanc D (2000) A comparison between Articaine HCl and lidocaine HCl in pediatric dental patients. Pediatr Dent 22(4):307–311PubMedGoogle Scholar
  9. 9.
    Yapp KE, Hopcraft MS, Parashos P (2011) Articaine: a review of the literature. Br Dent J 210:323–329CrossRefGoogle Scholar
  10. 10.
    Arrow P (2012) A comparison of articaine 4% and lignocaine 2% in block and infiltration analgesia in children. Aust Dent J 57(3):325–333CrossRefGoogle Scholar
  11. 11.
    Hicks CL, von Baeyer CL, Spafford PA, van Korlaar I, Goodenough B (2001) The faces pain scale-revised: toward a common metric in pediatric pain measurement. Pain 93(2):173–183CrossRefGoogle Scholar
  12. 12.
    Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S (1997) The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 23(3):293–297PubMedGoogle Scholar
  13. 13.
    Tomlinson D, von Baeyer CL, Stinson JN, Sung LA (2010) Systematic review of faces scales for the self-report of pain intensity in children. Pediatrics 126(5):e1168–e1198CrossRefGoogle Scholar
  14. 14.
    De Amici D, Klersy C, Ramajoli F, Brustia L, Politi P (2000) Impact of the Hawthorne effect in a longitudinal clinical study: the case of anesthesia. Control Clin Trials 21(2):103–114CrossRefGoogle Scholar
  15. 15.
    Chambers CT (2002) Johnston C. developmental differences in children’s use of rating scales. J Pediatr Psychol 27(1):27–36CrossRefGoogle Scholar
  16. 16.
    St-Laurent-Gagnon T, Bernard-Bonnin AC, Villeneuve E (1992) Pain evaluation in preschool children and by their parents. Acta Paediatr 88(4):422–427CrossRefGoogle Scholar
  17. 17.
    Shih AR, von Baeyer CL (1994) Preschool children’s seriation of pain faces and happy faces in the affective facial scale. Psychol Rep 74(2):659–665CrossRefGoogle Scholar
  18. 18.
    Von Baeyer CL. Children’s self-reports of pain intensity: scale selection, limitations and interpretation. Pain Res Manag J Can Pain Soc 2006;11(3):157–162Google Scholar
  19. 19.
    Katyal V (2010) The efficacy and safety of articaine versus lignocaine in dental treatments: a meta-analysis. J Dent 2010(38):307–317Google Scholar
  20. 20.
    Jakobs W, Ladwig B, Cichon P, Oertal R, Kirch W (1995) Serum levels of articaine 2% and 4% in children. Anesth Prog 42:113–115PubMedPubMedCentralGoogle Scholar
  21. 21.
    Dower JS (2003) A review of paresthesia. Dent Today 22:64–69PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Neeraja Ramadurai
    • 1
  • Deepa Gurunathan
    • 1
  • A. Victor Samuel
    • 2
  • Emg Subramanian
    • 1
  • Steven J L Rodrigues
    • 3
  1. 1.Department of Pediatric and Preventive DentistrySaveetha Dental College and HospitalsChennaiIndia
  2. 2.Department of Pediatric DentistrySRM Kattankulathur Dental College, SRM Institute of Science and TechnologyChennaiIndia
  3. 3.Department of Pediatric dentistryGoa Dental CollegeBambolimIndia

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