UNASSIGNED: To investigate the comparative effects of local anesthesia using lidocaine with adrenaline vs. articaine with adrenaline in endoscopic endonasal dacryocystorhinostomy (EN-DCR).
UNASSIGNED: This retrospective study included a total of 180 patients. These patients were categorized into two groups: the lidocaine group, which received 2% lidocaine (1:100,000 adrenaline), and the articaine group, which received 4% articaine (1:100,000 adrenaline) for local anesthesia. The study compared anesthesia efficacy, intraoperative pain levels, intraoperative bleeding, as well as differences in heart rate and blood pressure between the two groups.
UNASSIGNED: The articaine group demonstrated a significantly lower visual analog scale (VAS) pain score when compared to the lidocaine group, measuring at 4.4 ± 0.6 cm vs. 5.0 ± 1.0 cm, respectively (P < 0.0001). Additionally, the articaine group exhibited a higher anesthesia efficacy compared to the lidocaine group (89.0% vs. 76.6%, p = 0.0487). Notably, the articaine group experienced less nasal mucosal bleeding during the surgery in contrast to the lidocaine group (p = 0.004). However, there were no statistically significant differences in changes in blood pressure and heart rate between the two groups (p > 0.05).
UNASSIGNED: This study demonstrated that 4% articaine (1:100,000 adrenaline) has superior clinical effectiveness in comparison to 2% lidocaine (1:100,000 adrenaline) in EN-DCR.

Introduction Oxidative stress, an imbalance between reactive oxygen species (ROS) production and antioxidant defenses, plays an important role in various dental diseases. Local anesthetics are frequently used in dentistry. The potential antioxidant activity of dental local anesthetics can contribute to dental practice. Therefore, this study aimed to investigate the ROS-scavenging activities of three commonly used dental local anesthetics, lidocaine, prilocaine, and articaine, focusing on their effects on hydroxyl radicals (HO•) and superoxide anions (O2 •-). Materials and methods The electron spin resonance (ESR) spin-trapping technique was employed to specifically measure the ROS-scavenging activities of these local anesthetics at varying concentrations. Results Lidocaine, prilocaine, and articaine exhibited concentration-dependent HO•-scavenging activities, with IC50 values of 0.029%, 0.019%, and 0.014%, respectively. Lidocaine and prilocaine showed concentration-dependent O2 •--scavenging activity, with IC50 values of 0.033% and 0.057%, respectively. However, articaine did not scavenge O2 •-. Conclusions The proactive use of dental local anesthetics may mitigate oxidative injury and inflammatory damage through direct ROS scavenging. However, further research is needed to elucidate the specific mechanisms underlying the antioxidant effects of these dental local anesthetics and their potential impact on the dental diseases associated with oxidative stress.

UNASSIGNED: The aim of this study was to compare the anesthetic efficacy of 4% articaine, 0.5% bupivacaine and 0.5% ropivacaine (with 1:200,000 adrenaline) during surgical removal of impacted mandibular third molars.
UNASSIGNED: The study included 75 patients randomly divided into three equal groups of 25 patients each. The study variables were: onset of anesthetic action, duration of surgery and anesthesia and postoperative analgesia. A visual analog scale was used to assess pain at different time intervals. Statistical analysis revealed insignificant difference among groups in terms of volume of anesthetic solution used, quality of anesthesia, surgical difficulty and duration of surgery.
UNASSIGNED: The mean onset time was significantly (P < 0.001) shorter for articaine (1.14 min) than ropivacaine (2.18 min) and bupivacaine (2.33 min). However, the duration of anesthesia as well as analgesia was significantly (P < 0.001) longer for bupivacaine (483.6 min and 464 min) and ropivacaine (426.6 min and 459 min) as compared to articaine (232.8 min and 191.4 min), respectively. Also, on comparing three groups pain scores at 6th postoperative hour were significant (P < 0.01).
UNASSIGNED: Ropivacaine and bupivacaine can be safely used in patients where longer duration of surgery is anticipated.

OBJECTIVE: This trial aimed to study the efficacy of articaine in pain management during endodontic procedures in pediatric patients.
METHODS: Ninety-eight children who received endodontic painless treatment were collected and randomly divided into the control group and observation group, with 49 cases in each group. The control group received infiltration anesthesia with lidocaine, and the observation group received infiltration anesthesia with articaine. Anesthesia effect, anesthesia onset time, sensory recovery time, duration of anesthesia, pain intensity, blood pressure, heart rate, and adverse reactions were compared.
RESULTS: The effective rate of anesthesia in the observation group was higher than that in the control group. The anesthesia onset time and sensory recovery time were shorter, the duration of anesthesia was longer, and the VAS score and facial expression score were lower in the observation group than in the control group. The heart rate of the observation group was lower, and diastolic blood pressure was higher than those of the control group. The total incidence of adverse reactions in the observation group was lower than that in the control group.
CONCLUSIONS: In the treatment of dental pulp diseases in children, the use of articaine can achieve better anesthesia effect and rapid onset of anesthesia and has less impact on the patient\'s blood pressure and heart rate, but it also can relieve pain and has good safety after the use of medication. It is worthy of clinical application.

UNASSIGNED: The objective of this research was to conduct a comparison and evaluate the pain perception and time of onset of 2% lignocaine 1:80,000 epinephrine with 4% articaine 1:100,000 epinephrine in the pediatric population.
UNASSIGNED: A split-mouth randomized control trial was conducted on 50 children aged 9-14 years who required inferior alveolar nerve block (IANB) anesthesia for bilateral dental treatment in the mandibular arch. The time of onset was recorded when no sensation was reported even when maximum electrical stimulus was applied in an electric pulp testing (EPT). The pain perception was assessed using a visual analog scale (VAS) rated by the patient for subjective symptoms and face, legs, activity, cry, and consolability (FLACC) scale for objective pain rated by the operator.
UNASSIGNED: The mean onset of time, pain-VAS, and FLACC score decreased by 1.31, 12.07, and 18.39%, respectively in 4% articaine as compared to 2% lignocaine but the difference did not reach statistical significance (p > 0.05), that is, found to be statistically the same.In conclusion, it can be inferred that the utilization of 4% articaine is as potent as 2% lignocaine solution but showed slightly better onset of anesthesia and pain experience among the children although the findings were not statistically significant.
UNASSIGNED: Local anesthesia (LA) is one of the main methods of pain management in pediatric practice which makes it essential to choose an LA agent with a shorter time of onset and less pain on administration.
UNASSIGNED: Singh SS, Koul M. A Comparative Evaluation of Pain Experience and Time of Onset of 2% Lignocaine and 4% Articaine in Inferior Alveolar Nerve Block among Pediatric Population: A Clinical Study. Int J Clin Pediatr Dent 2024;17(1):67-71.

UNASSIGNED: The inability in achieving complete pulpal anesthesia with standard buccal infiltration especially in cases with SIP used for maxillary teeth. The study aimed to compare the anesthetic efficacy of buccal and buccal plus palatal infiltration technique using 2% lidocaine and 4% articaine in permanent maxillary first molars with the diagnosis of symptomatic irreversible pulpitis (SIP).
UNASSIGNED: One hundred and twenty-three patients with clinical diagnosis of SIP, aged 18-50 years were randomly allocated to three treatment groups (N = 41). Group 1(BIL): Buccal infiltration technique using 2% lidocaine with 1:80,000 adrenaline. Group 2(BPIL): combination of buccal plus palatal infiltration using 2% Lidocaine with 1:80,000 adrenaline. Group 3(BIA): Buccal infiltration using 4% articaine with 1:100,000 adrenaline. Pain intensity of patients were recorded before and after the administration of local anesthesia during endodontic procedure that is during caries removal, access preparation and pulp removal using Heft-Parker Visual Analog Scale (HP-VAS). Success was defined by \"no pain (0 mm)\" or \"mild pain (0-54 mm)\" during endodontic procedure. The anesthetic efficacy rates were analyzed using chi-square tests, age differences using one-way ANOVA.
UNASSIGNED: The final analysis included total of 117 patients. Higher success was observed in group II (85%) in comparison to group I (69%) and group III (74%), but the difference was statistically nonsignificant (p > 0.05). Our results demonstrated a nonsignificant difference between genders in all three groups (p > 0.05).
UNASSIGNED: The use of buccal plus palatal infiltration and 4% articaine can provide effective anesthesia as standard buccal infiltration and 2% lidocaine for patients with SIP in maxillary first molars.

OBJECTIVE: The absolute necessity of a palatal injection for the extraction of primary maxillary molars has never been explored, despite the fact that it is widely known that children do not tolerate local anesthetic injections into the palatal tissue well. The aim of this study was to compare separately the perception of pain in the absence of palatal injection after anesthesia and maxillary primary molar tooth extraction using different anesthetic solutions and different post-anesthetic waiting times.
METHODS: A single-blinded randomized controlled study was conducted in 78 participants (26 patients with palatal anesthesia (the control groups), and 26 patients with 5 min and 26 patients with 8 min post-anesthetic waiting time without palatal anesthesia (the study groups)). Subjective experiences of pain were evaluated separately after anesthesia and tooth extraction using the Visual Analog Scale (VAS) and the Wong-Baker Faces Pain Rating Scale (WBS).
RESULTS: In terms of VAS scores obtained following administration of anesthesia, there was a statistically significant difference between the groups (p<0.05). VAS pain scores were reported to be lower in the groups without palatal anesthesia than in the groups with palatal anesthesia. No statistically significant difference was observed in VAS and Wong-Baker scores after tooth extraction between the groups with and without palatal anesthesia (P>0.05).
CONCLUSIONS: While the pain reported following administration of anesthesia was found to be higher in the groups receiving palatal anesthesia, no difference was found between the groups in the pain reported after tooth extraction.
CONCLUSIONS: Extraction of maxillary primary molars is possible without palatal injection by injecting 4% articaine or 2% lidocaine into the buccal vestibule of the tooth with a waiting time of 5 or 8 min.

This systematic review with meta-analysis was conducted to evaluate the effectiveness of local anesthetic administration into temporomandibular joint cavities in relieving pain and increasing mandibular mobility. Randomized controlled trials were included with no limitation on report publication dates. Final searches were performed on 15 October 2023, using engines provided by the US National Library, Bielefeld University, and Elsevier Publishing House. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Articular pain and mandible abduction values and their mean differences were summarized in tables and graphs. Eight studies on a total of 252 patients evaluating intra-articular administration of articaine, bupivacaine, lidocaine, and mepivacaine were included in the systematic review. None of the eligible studies presented a high risk of bias in any of the assessed domains. An analgesic effect of intra-articular bupivacaine was observed for up to 24 h. In the long-term follow-up, there were no statistically significant changes in quantified pain compared to both the baseline value and the placebo group, regardless of the anesthetic used (articaine, bupivacaine, and lidocaine). There is no scientific evidence on the effect of intra-articular administration of local anesthesia on the range of motion of the mandible. Therefore, in the current state of knowledge, the administration of local anesthetics into the temporomandibular joint cavities can only be considered as a short-term pain relief measure.

UNASSIGNED: Although most of the metabolism of local anesthetics (LAs) takes place in the liver, no study has investigated the effect of these anesthetics on the kidney function of single-kidney humans or animals. The present study was conducted to examine the effect of LAs on renal function in single-kidney rats.
UNASSIGNED: The present experimental animal study with two control groups was done in an animal laboratory. Forty-two rats were randomly assigned to seven groups of six rats, including two control groups and five experimental groups. The experimental groups underwent intraperitoneal anesthesia with 2% lidocaine, 2% lidocaine with 1:80,000 epinephrine, 4% articaine, 3% prilocaine with 0.03 IU Felypressin, and 3% mepivacaine, respectively. Unilateral nephrectomy was done. After 24 h, the rats\' blood urea nitrogen (BUN), serum creatinine (Cr), and blood specific gravity (BSG) were measured. A standard dose of anesthetics was injected into the peritoneum for 4 days afterward. Then, these indices were measured again 24 h after the last injection. Data were analyzed using IBM SPSS (version 21.0). One-way analysis of variance, Tukey\'s honestly significant difference post hoc, and paired t-tests were used for statistical analysis. P < 0.05 was considered statistically significant.
UNASSIGNED: The results indicated significant differences among groups in the rats\' BUN and serum Cr 24 h after nephrectomy (P < 0.05). However, there were no significant differences in BUN, BSG, and Cr among groups after the interventions.
UNASSIGNED: LAs did not affect renal function in single-kidney rats. Therefore, dentists can use the anesthetics in single-kidney people.

OBJECTIVE: This study was conducted to explore the preference and experience of paediatric dentists based in Switzerland regarding the use of articaine and other local and topical anaesthesia.
METHODS: An 18-question survey was developed, piloted, and distributed to the members of the Swiss association of paediatric dentistry (n = 460). The following information were collected: most used local anaesthetic in different age groups, time needed to inject a full ampule, frequency of observed local and systemic side effects, application of topical anaesthetic prior to injection, time waited between application and the injection, and perceived effectiveness of topical anaesthetic. The dentists\' responses were analysed with logistic regressions reporting odds ratios (OR) and 95% confidence intervals (CI) at 5%.
RESULTS: The response rate was 37% (n = 168) out of the 460 questionnaires sent, with the responders being predominantly female (67%) and 47-year-old on average. More than 80% of the dentists used articaine in all age groups. 45% of responders took longer than 60 s to inject a full ampule. Local and systemic side-effects were observed by 82% and 28% of respondents respectively, although the nature and the significance of those were not detailed due to the anonymous nature of the questionnaire. Significantly less local adverse effects were seen for older children (p = 0.04) and among dentists with more years of experience (p = 0.01). Most responders applied topical anaesthetic and half of them waited longer than 60 s before injection.
CONCLUSIONS: Articaine is a widely used local anaesthetic by the studied group of Swiss paediatric dentists regardless of patient\'s age. The use of topical anaesthetic before injection is a common practice with good perceived effectiveness.