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Background <p>In dentistry operations, addition 0.5&#xa0;M mannitol to lidocaine-epinephrine improves anesthesia efficacy. However, its effect on hemodynamic parameters and post-operative outcomes have not been evaluated. This study aimed to compare the efficacy, hemodynamic parameters, and post-operative outcomes of 2% lidocaine and 1:200,000 epinephrine, with or without 0.5&#xa0;M mannitol, in intra-oral nerve blocks.</p> Materials and methods <p>This prospective, randomized, controlled, triple-blind, split-mouth study included 25 patients who required intra-oral block for elective extraction of lower erupted teeth. The Test side (<i>n</i> = 25) received lidocaine-epinephrine-mannitol, while the Control side (<i>n</i> = 25) received lidocaine-epinephrine. The primary outcome measures were evaluated were onset and duration of anesthesia. The secondary outcome measures were pain (assessed with visual analogue scale [VAS] on day 0–3, and 7); hemodynamic parameters (including heart rate, systolic blood pressure [SBP], diastolic blood pressure [DBP], and oxygen saturation, assessed pre-, intra-, and post-operatively); and post-operative complications (swelling and trismus assessed on day 7).</p> Results <p>The Test side had a significantly early onset of action (<i>p</i> = 0.006) and delayed return of sensation (<i>p</i> = 0.001). On day 0, VAS score was significantly lower in the Test side (<i>p</i> = 0.017), with no difference at other intervals (<i>p</i> &gt; 0.05). Post-operatively, mouth opening was significantly greater on the test side (<i>p</i> = 0.023), with no difference in post-operative swelling (<i>p</i> = 0.317). The control side had a significantly higher intra- (<i>p</i> = 0.018) and post-operative (<i>p</i> = 0.006) heart rate, with comparable SBP, DBP, and oxygen saturation.</p> Conclusion <p>Lidocaine-epinephrine-mannitol formulation showed improved anesthetic efficacy, reduced pain on the day of procedure, stable hemodynamic parameters, and increased post-operative mouth opening.</p> Trial registration <p><a href="https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=NzQxMDU=%26Enc=%26userName=">CTRI/2022/10/046921</a> [Registered on: 31/10/2022].</p>

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Efficacy of 0.5M mannitol as an adjuvant to lidocaine and epinephrine for intra-oral nerve blocks - a split-mouth, randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Radhika Singh,
  • Anupam Singh,
  • Mehul Saha,
  • Adarsh Kudva,
  • Srikanth Gadicherla,
  • Kalyana C. Pentapati,
  • A. Chitra,
  • Dharnappa Poojary,
  • Sreea Roy

摘要

Background

In dentistry operations, addition 0.5 M mannitol to lidocaine-epinephrine improves anesthesia efficacy. However, its effect on hemodynamic parameters and post-operative outcomes have not been evaluated. This study aimed to compare the efficacy, hemodynamic parameters, and post-operative outcomes of 2% lidocaine and 1:200,000 epinephrine, with or without 0.5 M mannitol, in intra-oral nerve blocks.

Materials and methods

This prospective, randomized, controlled, triple-blind, split-mouth study included 25 patients who required intra-oral block for elective extraction of lower erupted teeth. The Test side (n = 25) received lidocaine-epinephrine-mannitol, while the Control side (n = 25) received lidocaine-epinephrine. The primary outcome measures were evaluated were onset and duration of anesthesia. The secondary outcome measures were pain (assessed with visual analogue scale [VAS] on day 0–3, and 7); hemodynamic parameters (including heart rate, systolic blood pressure [SBP], diastolic blood pressure [DBP], and oxygen saturation, assessed pre-, intra-, and post-operatively); and post-operative complications (swelling and trismus assessed on day 7).

Results

The Test side had a significantly early onset of action (p = 0.006) and delayed return of sensation (p = 0.001). On day 0, VAS score was significantly lower in the Test side (p = 0.017), with no difference at other intervals (p > 0.05). Post-operatively, mouth opening was significantly greater on the test side (p = 0.023), with no difference in post-operative swelling (p = 0.317). The control side had a significantly higher intra- (p = 0.018) and post-operative (p = 0.006) heart rate, with comparable SBP, DBP, and oxygen saturation.

Conclusion

Lidocaine-epinephrine-mannitol formulation showed improved anesthetic efficacy, reduced pain on the day of procedure, stable hemodynamic parameters, and increased post-operative mouth opening.

Trial registration

CTRI/2022/10/046921 [Registered on: 31/10/2022].