RENDRA ADHITYARANO, 020610082 (2010) PERBANDINGAN KEDALAMAN ANESTESI ANTARA ARTIKAIN 4% - EPINEFRIN 1:100.000 DAN LIDOKAIN 2% - EPINEFRIN 1:80.000 PADA ANESTESI BLOK MANDIBULA PADA ODONTEKTOMI GIGI MOLAR KETIGA RAHANG BAWAH. Skripsi thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Background. The authors compared perceived pain in depth of anesthesia between 4% articaine – ephinefrin 1:100.000 versus 2% lidocaine – ephinefrin 1:80.000, in truncal block of the inferior alveolar nerve during the surgical extraction of impacted lower third molars. Articaine is 4-methyl-3(2-[propylamino]propionamido)-2-thiophenecarboxylic acid, methyl ester hydrochloride with. It is the only amide local anesthetic that contains a thiophene ring. In addition, articaine is the only widely used amide local anesthetic that contains an additional ester ring. Biotransformation of articaine occurs in both the plasma (hydrolysis by plasma esterase) and the liver (hepatic microsomal enzymes). Degradation of articaine is initiated by hydrolysis of the carboxylic acid ester groups to give free carboxylic acid. Articaine has many of the physicochemical properties of the most commonly used local anesthetics (lidocaine, mepivacaine and prilocaine) with the exception of the aromatic ring and its degree of protein binding . Articaine effectively penetrates tissue and is highly diffusible. Its plasma protein binding of approximate is higher than that observed with many local anesthetics. Additionally, the thiophene ring of articaine increases its liposolubility. Methods. A total sampling was conducted of 30 patients programmed for the bilateral surgical extraction of symmetrical lower third molars. Following the obtainment of informed consent, two operators performed surgery on an extemporaneous basis, using as local anesthetic 4% articaine-epinephrine 1:100,000 or 2% lidocaine-epinephrine 1:80,000. The study variables for each anesthetic were depth of anasthesia. Scoring was used to assess pain during surgery, and thus subjectively evaluate the anesthetic efficacy of the two solutions. Result. The difference in depth of anesthesia between 4% articaine-epinephrine 1:100,000 or 2% lidocaine-epinephrine 1:80,000 was not statistically. Mean of perceived pain is similar between 4% articaine-epinephrine 1:100,000 or 2% lidocaine-epinephrine 1:80,000. Conclusions. The results obtained suggest that 4% articaine is similar as 2% lidocaine, particularly in terms depth of anesthesia. However, no statistically significant differences in anesthetic efficacy were recorded between the two solutions.

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