Equivalence Trial of Low Anesthesic Dose for Maxillary Nerve Block

Objectives: The aims of the study were twofold: (1) to evaluate the analgesic efficacy of low versus normal dose versus normal for maxillary nerve block anesthesia; and (2) to evaluate and compare any adverse effects between them. Methods: In this equivalence clinical trial, 82 patients underwent removal maxillary teeth were randomly assigned to receive low (1.2ml) or traditional (1.8ml) dose of 2% lidocaine-hydrochloride with 1:50,000 epinephrine for troncular maxillary nerve block anesthesia via the greater palatine canal. Visual Analogue Scale (VAS), patient declared pain, additional anesthesia required and any adverse effects were evaluated and significant differences with chi-square test were calculated (p<0.05). Results: The low-dose group (LDG) exhibited 2,9 mean VAS and 2.8 for traditional-group (TDG) (p=.15). Fifty-six percent of patients in LDG perceived no pain meanwhile 59.1% of TDG (p=.21). Five patients in LDG shows collateral effects andone in TDG (p=0.56). The most common collateral effect was transient diplopia.

Conclusion: There was no significant differences in anesthesic efficacy and percentage of collateral effects for for troncular maxillary nerve block anesthesia via the greater palatine canal with the use of low or traditional dose of 2% lidocaine withepinephrine. therefore, low dose of troncular anesthesia can be considered as effective as traditional dose for maxillary tooth extractions.