Lidocaine shot during dental treatment may have led to heart attack

An interesting article titled “Acute Myocardial Infarction After a Local Anesthetic Procedure in a Middle-Aged Patient” written by Lei Xiao and et al. appears in the American Journal of Medical sciences (2022). The article discusses how an injection of lidocaine into a 50 year old man during dental treatment possibly induced coronary artery spasm and led to acute myocardial infarction (AMI). In the article the authors discuss how a 50-year old man was admitted to a hospital complaining of chest distress, chest pain, and shortness of breath for the past four hours in March 2020. What had happened four hours earlier, was that the man with no history of high blood pressure, diabetes, atrial fibrillation, or high cholesterol visited a dentist and had a dental work performed. The man was not a smoker and had no known drug or food … Read more

Articaine versus Bupivacaine Anesthetic Effectiveness for Lower Teeth Extraction

An interesting article titled “A Comparative Evaluation of Anesthetic Effectiveness of 4% Articaine vs 0.5% Bupivacaine for Lower Molar Tooth Extraction” appears in Cureus in December 16, 2022, written by Tenglikar P, Manas A, Sahoo A, et al. (vol. 14, no. 12, pp. e32611). The article discusses the differences in the effectiveness of two common local anesthesia agents used in dentistry to control pain. The authors set out to explore the the effectiveness of 0.5% bupivacaine with 4% articaine in lower tooth extraction based on duration of anesthesia, onset, and pain perception along with observing blood pressure and heart rate. Today lidocaine (lignocaine) is extensively used as a local anesthestic agent in dentistry to control pain. Other anesthestic agents exists including bupivacaine and articaine. The authors conducted a randomized controlled study of patients having lower teeth extracted from June 2017 to October … Read more

Comparison of Bupivacaine and Lidocaine for Wisdom Teeth Surgery

An interesting article titled “Comparison of anaesthetic regime in patients undergoing third molar extraction” written by McCarthy et al. appears in Oral Surgery in 2018 (vol. 11, pp. 33-40). The article seeks to explore the use of lidocaine and bupivacaine which are two different anesthetic agents for wisdom teeth removal to see if there is any difference on patient pain, preference, and satisfaction. The authors state that using local anesthesia for removing wisdom teeth when also using general anesthesia is still controversial. They thus designed a double blind split-mouth randomized clinical trial where both an anesthetic and control were used on a patient at the same time. The authors conducted the study in two parts. In the first part 52 patients were given 2% lidocaine with 1: 80,000 epinepherine on one side and nothing given on the other side. In … Read more

FDA Issues Alert to Prevent Lidocaine 2 Percent Solution to Not be Used for Teething Pain for Children

On June 26, 2014, the FDA issued an alert warning health professionals and providers that “…prescription oral viscous lidocaine 2% solution should not be used to treat infants and children with teething pain.” The FDA says that topical pain relievers and other medications that are rubbed on the gums are not useful for infants because they wash out of the mouth within minutes. Furthermore, when too much viscous lidocaine is given to children and is swallowed it can result in brain injury, seizures, heart problems, and even death. The FDA alert is located over at http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm402790.htm. In the background information it states “In 2014, FDA reviewed 22 case reports of serious adverse reactions, including deaths, in infants and young children 5 months to 3.5 years of age who were given oral viscous lidocaine 2 percent solution for the treatment of … Read more