Handbook of Local Anesthesia

428 Pages·2012·17.82 MB·English

by  Stanley F. Malamed

TABLE 4-4  TABLE 4-17 
Maximum Recommended Dosages (MRDs) of Local  Duration of Pulpal and Soft Tissue Anesthesia for 
Anesthetics Available in North America Available Local Anesthetics
MANUFACTURER’S AND FDA (MRD) DURATION
(APPROXIMATE MINUTES)
Local Anesthetic mg/kg mg/lb MRD, mg m
Drug Formulation Pulpal Soft Tissue
Articaine
With vasoconstrictor 7.0 3.2 None listed Mepivacaine 3% (infiltration) 5-10 90-120
Bupivacaine Prilocaine 4% (infiltration) 10-15 o60-120
With vasoconstrictor None listed None listed 90 Prilocaine 4% (nerve block) 40-60 120-240
With vasoconstrictor 2.0 0.9 90 Articaine 4% + epinephrine 45-60 180-240
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(Canada) 1 : 200,000
Lidocaine Lidocaine 2% + epinephrine .60 180-300
With vasoconstrictor 7.0 3.2 500 1 : 50,000 t
Mepivacaine Lidocaine 2% + epinephrine 60 180-300
o
No vasoconstrictor 6.6 3.0 400 1 : 100,000
With vasoconstrictor 6.6 3.0 400 Mepivacaine 2% + 60 180-300
Prilocaine levonordefrin 1 : 20,000p
No vasoconstrictor 8.0 3.6 600 Articaine 4% + epinephrine 60-75 180-300
With vasoconstrictor 8.0 3.6 600 1 : 100,000 s
Prilocaine 4% + epinephrine 60-90 180-480
g
CALCULATION OF MILLIGRAMS OF 1 : 200,000
LOCAL ANESTHETIC PER DENTAL Bupivacaine 0.5% + >90 240-720
o
CARTRIDGE (1.8 mL CARTRIDGE) epinephrine 1 : 200,000
Local Percent × 1.8 mL =
l
Anesthetic Concentration mg/mL mg/Cartridge
b
Articaine 4 40 72*
Bupivacaine 0.5 5 9
.
Lidocaine 2 20 36
y
Mepivacaine 2 20 36
3 30 r54
Prilocaine 4 40 72
a
MRD, Maximum recommended dose.
*Cartridges of some drugs in the United States reard, “1.7 mL. each.” The
actual volume of all local anesthetic cartridges is approximately 1.76 mL.
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Stanley F. Malamed, DDS
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Professor of Anesthesia and Medicine
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l School of Dentistry
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University of Southern California
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with 441 illustrations
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To Beverly, Heather, Jennifer, and Jeremy,
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and the next generation: Matthew, Rachel, Gabriella,
Ashley, Rebecca, Elijah, and Ethan .
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Contributors
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Daniel L. Orr II, BS, DDS, MS (Anesthesiology), Mark N. Hochman, DDS
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PhD, JD, MD Private Practice Limited to Periodontics
Professor and Director Orthodontics and Implant Dentistry
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Oral and Maxillofacial Surgery and Advanced Pain Control Specialized Dentistry of New York
University of Nevada Las Vegas School of Dental Medicine New York City, New York .
Las Vegas, Nevada Clinical Associate Professor t
Clinical Professor New York University o
Oral and Maxillofacial Surgery College of Dentistry
University of Nevada School of Medicine New York City, New Yoprk
Las Vegas, Nevada Clinical Consultant
Milestone Scientisfic, Inc.
Livingston, New Jersey
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