Complications associated with posterior superior alveolar nerve block using articaine as a local anesthetic agent

Mandeep Sharma; Sandeep Sharma; Pooja Sharma; Sneha Kulkarni

Volume : VII, Issue : IX, September - 2018

Complications associated with posterior superior alveolar nerve block using articaine as a local anesthetic agent

Mandeep Sharma, Sandeep Sharma, Pooja Sharma, Sneha Kulkarni

Abstract :

Background & Objectives

Local anesthetics are frequently administered in dental field.Lignocaine is most commonly used local anesthetic solution for extracting tooth in oral surgery. The major source of drug–related complications in the dental office occur because of local anesthetics.Articaine contains a thiophene group, which increases its lipo–solubility. It has high diffusion properties so it can be used widely in the dentistry field. Posterior superior alveolar nerve block is commonly used in dentistry for extraction and other purposes. But due to the high diffusion properties its use in posterior superior alveolar nerve block is limited due to risk of complications. Objectives of the study was to evaluate the complications associated with the use of articaine in posterior alveolar nerve block.

Methodology: A randomized study was carried on 100 patients of age group 10–60 years who requiredprocedure in posterior maxillary arch, visitingthe Department of Oral and Maxillofacial surgery. They were included in the study after obtaining informed consent.Posterior superior alveolar nerve block of anesthetic solution was given randomly to 100 patients. Objective signs were checked after 2 minutes. Duration of anesthesia was measured.Patientsreceiving dental anesthesia were evaluated by questionnaire for risk factors, and complicationsassociated with the administration of the local anesthetic.

Results:The most frequently observed complications were dizziness, tachycardia,agitation, nausea, tremor which were transient in nature.23% had at least one risk factor in their medical histories out of which 13.04% (3 patients) showed complications. Overallincidence of complicationswasalso 4 %. Severe complications (seizure, onchospasm) did not occurred in any case. No paresthesia was noted in nerve. No ocular complications were present in any of the case. No hematoma occurred following administration of posterior superior alveolarnerve block.

Interpretation & Conclusion: No severe complications occurred with the use of articaine in PSA nerve block.The incidence of complications due to articaine as anesthetic agent inPSA nerve block can be reduced. Proper evaluation of patients should be done for risk factors with adequatemedical history prior to dental treatment.