• Journal of Yeungnam Medical Science
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• 제11권1호
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• pp.30-34
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• 1994

염산 lidocaine의 피하 주입시 발생되는 고통을 감소시키기 위하여 8.4% sodium bicarbonate로 중화시켜 사용해 보았다. 지원자를 대상으로한 실험군의 100%에서 예상된 효과를 얻을 수 있었다.

• International Journal of Oral Biology
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• 제32권2호
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• pp.45-49
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• 2007

In this study, the cytotoxicity of commonly used local anesthetics was evaluated on odontoblasts which are essential for pulpal homeostasis in vitro. Local anesthetics, such as articaine, bupivacaine, levobupivacaine, lidocaine, mepivacaine, prilocaine, and procaine, were tested on the odontoblast cell line, MDPC-23. The concentration-and time-dependent cytotoxic effects of local anesthetics on odontoblasts were measured by MTT assay. Among local anesthetics treated for 18 h, only bupivacaine significantly showed cell death in a concentration-($LC_{50}=1.2mM$) and time-dependent manner. To confirm cell death induced by bupivacaine, the observation of cell morphology and FACS using Annexin V and propidium iodide (PI) staining were performed. As a result of Annexin V and PI staining, as well as the morphological change, only bupivacaine induced apoptotic cell death on odontoblasts when compared with levobupivacaine and lidocaine. These results suggest that bupivacaine might affect normal pulpal integrity even after uneventful local anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권3호
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• pp.173-177
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• 2023

Local anesthetics are an essential part of pain control during dental treatment. Despite its effectiveness and safety, patients should constantly be aware of potential adverse effects, including allergic reactions. Allergic reactions to amide-type local anesthetics (LAs), such as lidocaine and mepivacaine, are rare compared to those to ester-type LAs. Herein, we report the case of a patient with a history of allergy to lidocaine and mepivacaine, with symptoms of itching, diffuse erythema of the wrists and hands, dizziness, and pectoralgia. This case report emphasizes the importance of collecting medical and dental histories of patients is necessary, and how an allergy test in the allergy and clinical immunology department helps select safe LAs for patients.

• 대한약리학회지
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• 제23권2호
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• pp.113-121
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• 1987

국소마취제가 mitochondria에서의 전자이동 및 superoxide라디칼의 생성 그리고 지질의 과산화에 따른 malondialdehyde생성에 미치는 영향을 관찰하였다. 국소마취제는 전자이동계 의 효소활성도에 영향을 나타내었다. NADH dehydrogenase, NADH oxidase와 NADH-ubiquinone oxidoreductase의 활성도는 lidocaine, procaine과 dibucaine에 의하여 효과적으로 억제되었고 cocaine에 의하여 약간 억제되었다. Succinate dehydrogenase, succinate cytochrome c oxidoreductase와 succinate-ubiquinone oxidoreductase 활성도는 lidocaine 과 dibucaine에 의하여 억제되었으나 succinate oxidase는 국소마취제에 의하여 활성화되었다. 국소마취제는 dihydroubiquinone-cytochrome c oxidoreducatse와 cytochrome c oxidase의 활성도를 억제하였다. 이와 같은 반응에서 국소마취제에 대한 complex I segment의 반응이 다른 complex segment보다 크게 나타났다. 국소마취제는 succinate 또는 NADH에 의한 superoxide 생성과 이에 대한 antimycin의 자극효과를 억제하였다. 또한 국소마취제는 산소라디칼에 의한 지질의 과산화를 억제하였다. 이상의 결과로부터 국소마취제는 mitochondria의 전자전달 과정 중 Complex I segment때 또는 인접한 부위에 작용하여 전자이동을 억제함으로써 superoxide 생성과 지질의 과산화를 억제할 것으로 시사되었다.

• The Korean Journal of Pain
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• 제9권1호
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• pp.46-56
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• 1996

Many surgeons and anesthesiologists prefer using vasoconstrictor mixed with local anesthetic agent to reduce the incidence of side effects and prolong the duration of analgesia because most local anesthetic agents, except cocaine, were believed to possess vasodilating effect. However, some investigators recently reported vasoconstricting effect of local anesthetic agents. There is still controversy on the vasoactive effect of local anesthetic agents. So this study is aimed to clarify the vasoactive effect of local anesthetics in the animal model resembling clinical settings. Rabbits were anesthesized with ketamine and haloghane, and respirations were controlled with Harvard animal ventilator. Lidocaine (0.5%, 1.0%, 1.5%) and bupivacaine (0.125%, 0.25% and 0.5%) with or without 1:100,000 epinephrine were subdermaly injected on the femoral bupivacaine of the femoral artery were measured with Doppler flow meter in vivo. The mean arterial pressure, pulse rate, arterial blood gases, pH and level of serum electrolytes were measured at every 2 minute interval for 30 minutes. Results were as follows: 1) There was no significant vasoconstriction with 0.5% lidocaine and 0.125% bupivacaine. 2) Statistically significant (p<0.05) vasodilations were observed with lidocaine (1.0~2.0%) and bupivacaine (0.25~0.5%). 3) There were no changes on the duration of vasodilation induced by local anesthetic agents of various concentrations. 4) Onset of vasodilation induced by local anesthetic agents of high concentration were faster than that of lower concentrations. 5) In the mixed injection group of epinephrine and local anesthetic agent, the vasoconstriction induced by epinephrine was completely reversed by local anesthetics, approximately 5 minutes later. In conclusion, local anesthetic agents at dose exceeding 1.0% lidocaine and 0.25% bupivacaine increase local blood flow significantly in animal study in vivo which is applicable in human clinical settings. The increase blood flow may be due to dilatation of blood vessel. Further study on the analysis of association between amount of absorbed local anesthetics in blood vessels and dilatation of blood vessels is needed.

• 대한소아치과학회지
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• 제44권3호
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• pp.365-369
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• 2017

국소마취제는 치과 영역에서 임상적으로 널리 사용되어 왔으나, 국소마취제로 인한 과민반응은 매우 드물게 나타난다. 그러나 낮은 발생률에도 불구하고, 국소마취제로 인한 과민반응 증례가 보고되어 왔다. 본 증례는 충차치료를 주소로 내원한 26개월 남환에서 관찰된 과민반응으로, 리도카인 국소마취 후 하순의 부종이 발생하였다. 항히스타민제와 스테로이드의 사용으로 증상이 경감되었다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권4호
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• pp.237-244
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• 2016

Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권3호
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• pp.209-212
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• 2016

Lidocaine, a local anesthetic commonly used in dental treatments, is capable of causing allergies or adverse effects similar to allergic reactions. However, the frequency of such occurrences in actual clinical settings is very rare, and even clinical tests on patients with known allergies to local anesthetics may often show negative results. When adverse effects, such as allergy to lidocaine, are involved, patients can be treated by testing other local anesthetics and choosing a local anesthetic without any adverse effects, or by performing dental treatment under general anesthesia in cases in which no local anesthetic without adverse effects is available. Along with a literature review, the authors of the present study report on two cases of patients who tested positive on allergy skin tests for lidocaine and bupivacaine and subsequently underwent successful dental treatments with either general anesthesia or a different local anesthetic.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.137-146
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• 2020

Background: Mandibular third molar removal is the most common surgical procedure encountered in oral and maxillofacial clinics. It also presents the greatest challenges and controversies for surgeons when surgical removal is considered. Furthermore, diverse anesthesia results and success rates are achieved after using the same concentrations of different solutions or the same amounts of local anesthetics. The purpose of this study was to examine the efficiency of using double-cartridge (3.4 ml) 4% lidocaine (high concentration) and 4% articaine with a 1:100000 epinephrine infiltration in the retromolar region for impacted lower third molar surgery. Methods: This double-blind study included 30 patients with symmetrically impacted lower third molars. The patients were randomly selected to receive 4% articaine on one side and 4% lidocaine on the other, as a local anesthetic for third molar surgery. The onset, duration of soft-tissue numbness, pulpal sensitivity, amount of additional local anesthetic needed, pain score during the surgical procedure, and duration of the operation were recorded. Results: The results of this research indicate that 86.7% of the operations in the 4% articaine group and 83.3% of those in the 4% lidocaine group were successful. Furthermore, the outcomes in both groups were not statistically significant (P > 0.05). Numbness onset occurred faster in the articaine group than it did in the lidocaine group. However, the duration of soft-tissue anesthesia and pain scores recorded immediately postoperatively were similar. Conclusion: It is concluded that 4% lidocaine and 4% articaine had a similar infiltration efficacy in the retromolar region and both local anesthetics are adequate for impacted lower third molar surgery. There were no statistically significant differences between the two local anesthetics regarding pain control and the duration of soft-tissue numbness during the procedure.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.56-60
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• 2020

Vocal fold injections are usually performed with a patient wake in an office under local anesthesia. For comfortable and safe office-based procedures, thorough anesthesia and premedication should be provided to the following three regions; nasal cavity, oropharynx, and larynx. Topical lidocaine is most widely used anesthetics on office based procedure. Lidocaine has a low to intermediate potency, 45 minutes to 60 minutes' duration of action, and onset of sufficient anesthesia within 90 seconds of topical administration. Tetracaine, prilocaine, ropivacaine, and bupivacaine also have been used in the office-based procedures. Nasal decongestant, oxymetazoline, is also used for widening nasal cavity by constriction of nasal mucosa. The amount of topical and local anesthetics used in vocal fold injection rarely exceeds toxic doses. The physician should know proper anesthesia techniques and must be familiar with the safe dose and complication of all anesthetics used.