Lidocaine Concentration in Mandibular Bone After Subperiosteal Infiltration Anesthesia Decreases With Elevation of Periosteal Flap and Irrigation With Saline

• Published in: Anesthesia progress Vol. 61; no. 2; pp. 53 - 62
• Main Authors: Ogawa, Sachie, Watanabe, Masahiro, Kawaai, Hiroyoshi, Tada, Hitoshi, Yamazaki, Shinya
• Format: Journal Article
• Language: English
• Published: United States Allen Press Inc 2014; American Dental Society of Anesthisiology
• Subjects: Anesthesia, Local - methods; Anesthetics, Local - administration & dosage; Anesthetics, Local - analysis; Animals; Bone Density - physiology; Chromatography, High Pressure Liquid; Imaging, Three-Dimensional - methods; Injections; Lidocaine - administration & dosage; Lidocaine - analysis; Male; Mandible - chemistry; Periosteum - surgery; Rabbits; Scientific Reports; Sodium Chloride - administration & dosage; Surgical Flaps - surgery; Therapeutic Irrigation - methods; Time Factors; X-Ray Microtomography - methods; Jawbone; Lidocaine concentration; Periosteal flap; Infiltration anesthesia
• ISSN: 0003-3006; 1878-7177
• DOI: 10.2344/0003-3006-61.2.53

It has been reported that the action of infiltration anesthesia on the jawbone is attenuated significantly by elevation of the periosteal flap with saline irrigation in clinical studies; however, the reason is unclear. Therefore, the lidocaine concentration in mandibular bone after subperiosteal infiltration anesthesia was measured under several surgical conditions. The subjects were 48 rabbits. Infiltration anesthesia by 0.5 mL of 2% lidocaine with 1 : 80,000 epinephrine (adrenaline) was injected into the right mandibular angle and left mandibular body, respectively. Under several surgical conditions (presence or absence of periosteal flap, and presence or absence of saline irrigation), both mandibular bone samples were removed at a fixed time after subperiosteal infiltration anesthesia. The lidocaine concentration in each mandibular bone sample was measured by high-performance liquid chromatography. As a result, elevation of the periosteal flap with saline irrigation significantly decreased the lidocaine concentration in the mandibular bone. It is suggested that the anesthetic in the bone was washed out by saline irrigation. Therefore, supplemental conduction and/or general anesthesia should be utilized for long operations that include elevation of the periosteal flap with saline irrigation.