Articaine and mepivacaine efficacy in postoperative analgesia for lower third molar removal: a double-blind, randomized, crossover study

Objective: Comparison of the clinical efficacy of 4% articaine in relation to 2% mepivacaine, both with 1:100,000 epinephrine, in the prevention of postoperative pain after lower third molar removal. Study design: Twenty patients underwent removal of bilateral lower third molars under local anesthesia (articaine or mepivacaine) in 2 separate appointments, in a double-blind, randomized, and crossed manner. Objective and subjective parameters were recorded for paired comparison of postoperative courses. Results: Duration of analgesia provided by articaine and mepivacaine was 198.00 ± 25.86, and 125.40 ± 13.96 min, respectively (P = .02), whereas the duration of anesthesia was 273.80 ± 15.94 and 216.85 ± 20.15 min, respectively (P = .06). Both solutions exerted no important effects upon arterial pressure, heart rate, or oxygen saturation (P > .05). Conclusions: Articaine provides a longer period of analgesic effect and a tendency for a longer period of anesthesia as compared to mepivacaine. The presence of a vasoconstrictor agent in local anesthetic solutions does not seem to influence hemodynamic parameters during lower third molar removal in healthy subjects. © 2006 Mosby, Inc. All rights reserved.

Development of hydrophilic nanocarriers for the charged form of the local anesthetic articaine

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Factorial design and characterization studies for articaine hydrochloride loaded alginate/chitosan nanoparticles

Nowadays, articaine hydrochloride (ATC) is a local anesthetic widely used in dental procedures, but its side effects include paresthesia and nerve injury. Alginate/chitosan nanoparticles (AG/CSnano) can be used as carrier for drugs, overcoming the problems. The aim of this work was to evaluate the factors (Calcium/alginate [Ca2+:AG] and Chitosan/alginate [CS:AG] mass ratios) influence on the average size, polydispersity index, zeta potential and encapsulation efficiency of ATC. AG/CSnano containing ATC were prepared by ionic pregelation method. A three-level factorial design was carried out and the factors varied were Ca2+/AG mass ratio and CS/AG mass ratio. There were obtained nanoparticles with size range of 340–550 nm and polydispersity index between 0.2 and 0.5, zeta potential range –19 and –22 mV and encapsulation efficiency of ATC in AG/Csnano between 22 and 45%. According to the results, the average size, polydispersity index and encapsulation efficiency were significantly affected to the variation of Ca2+/AG and CS/AG mass ratio, but the zeta potential didn't change significantly with factor variations. The factorial design showed it was possible to identify formulations that presented better results for the parameters measured. The factor chosen for the suitable formulations was the encapsulation efficiency. Through this parameter, one formulation was chosen with highest encapsulation efficiency of ATC and presented good colloidal stability parameters aiming future clinical applications.

Screening of Conditions for the Preparation of Poly( -Caprolactone) Nanocapsules Containing the Local Anesthetic Articaine

The local anesthetic articaine (ATC) is widely used in dentistry; however, its side effects can include paresthesia and nerve injury. Polymeric nanocapsules (PN) can be used as carriers for drugs, and help to reduce undesirable symptoms. The objective of this study was to evaluate the influence of different factors on the average size, polydispersion, and encapsulation efficiency of PN containing ATC. Poly(ε-caprolactone) (PCL) nanocapsules containing ATC were prepared by the oil-in-water emulsion/solvent evaporation method. The final ATC concentration was 2%. The preparation conditions were optimized using a central composite blocked cube-star design to investigate the influence of two variables at five levels, with 22 factorial points (–1 and +1), two replicates of the central point, 2×2 axial points (–1.414 and +1.414), and an orthogonal distribution, resulting in 10 experiments. The factors varied were the PVA concentration and the sonication time. The nanocapsules showed a satisfactory size range, a polydispersivity index less than 0.2, and high encapsulation efficiency. The values of the factors had no significant influence on either average size or polydispersion, although the encapsulation efficiency was significantly influenced by the sonication time. Improved formulations were identified using the central composite design, which revealed that the main consideration in selecting a suitable formulation was the encapsulation efficiency. Two of the formulations showed both high encapsulation efficiency and colloidal characteristics appropriate for the route of administration.

Comparative analysis of tissue reactions to anesthetic solutions: histological analysis in subcutaneous tissue of rats.

Postanesthetic pain is a relatively common complication after local anesthesia. This complication may be caused by the anesthetic technique or by the anesthetic solution used. Tissue reactions induced by the anesthetic solutions may be one of the factors resulting in pain after anesthesia. The objective of this study was to comparatively analyze tissue reactions induced by different anesthetic solutions in the subcutaneous tissue of rats. The following solutions were utilized: 2% lidocaine without vasoconstrictor; a 0.5% bupivacaine solution with 1:200,000 adrenaline; a 4% articaine solution and 2% mepivacaine, both with 1:100,000 adrenaline; and a 0.9% sodium chloride solution as a control. Sterilized absorbent paper cones packed inside polyethylene tubes were soaked in the solutions and implanted in the subcutaneous region. The sacrifice periods were 1, 2, 5, and 10 days after surgery. The specimens were prepared and stained with hematoxylin and eosin for histological analysis. The results showed that there is a difference in tissue irritability produced by the local anesthetic solutions. The results also showed that there is no relation between the concentration of the drug and the inflammatory intensity, that the mepivacaine and articaine solutions promoted less inflammatory reaction than the bupivacaine, and that the lidocaine solution produced the least intense inflammation.