Nizhny Novgorod, Nizhny Novgorod, Russian Federation
employee
Moscow, Russian Federation
employee
Moscow, Moscow, Russian Federation
graduate student
Moscow, Moscow, Russian Federation
Moscow, Moscow, Russian Federation
Rostov-on-Don, Rostov-on-Don, Russian Federation
Rostov-on-Don, Rostov-on-Don, Russian Federation
UDC 616.31
Study Subject: The study focuses on the anesthetic efficacy of 2 ml of 20 mg/ml (2%) articaine solution (Joint-stock company «Binergia») compared with 2 ml of 20 mg/ml (2%) lidocaine hydrochloride solution. Objective: To perform a comparative assessment of the effectiveness of conduction anesthesia of the third branch of the trigeminal nerve using articaine- and lidocaine-based local anesthetics. Methodology: Patients were randomly assigned to two equal groups of 20 each. The first group received 2 ml injections of 20 mg/ml articaine hydrochloride solution, while the second group was administered 2 ml of 20 mg/ml lidocaine hydrochloride solution. The primary indication for local anesthesia was ICD-10 code K10.2: Inflammatory diseases of the jaws (periostitis). Local anesthetic dosages did not exceed half the maximum allowable dose for each patient, considering individual body weight. The main efficacy endpoints included • Level of analgesia measured by the Visual Analog Scale (VAS) within 10 minutes of anesthetic administration; • Onset time of anesthesia, defined as the moment of loss of pain sensitivity within the area of innervation; • Duration of analgesia, measured from the onset of anesthesia to the return of sensitivity. Results: The study demonstrated the clinical effectiveness of both local anesthetic solutions—20 mg/ml (2%) lidocaine and 20 mg/ml (2%) articaine — for conduction anesthesia in patients with purulent-inflammatory diseases of the maxillofacial region. For deep inflammatory foci, 20 mg/ml (2%) articaine is preferable. For short-term procedures, especially in patients with specific risk factors, utilization of 20 mg/ml (2%) lidocaine may be appropriate. Conclusions: 1. Administration of 20 mg/ml (2%) lidocaine solution for local anesthesia in the presence of inflammation provides a moderate reduction in VAS scores, likely due to its anti-inflammatory properties. 2. The use of 20 mg/ml (2%) lidocaine hydrochloride solution offers reliable anesthesia and assists in inflammation control, thus improving postoperative outcomes as observed during the postoperative period. 3. It was found that 20 mg/ml (2%) lidocaine hydrochloride has a shorter duration of action (125 ± 14 min) compared to 20 mg/ml (2%) articaine hydrochloride (175 ± 23 min), which is an important consideration when planning postoperative care.
anesthesia, lidocaine, 2% articaine, inflammation, dentistry, jaw, pain
1. Stirrup P., Crean S. Does articaine, rather than lidocaine, increase the risk of nerve damage when administered for inferior alveolar nerve blocks in patients undergoing local anaesthesia for dental treatment? A mini systematic review of the literature. British dental journal. 2019;226(3):213-223. https://doi.org/10.1038/sj.bdj.2019.98
2. Vasil'ev Yu.L., Kuzin A.N. Osobennosti innervacii i obezbolivaniya frontal'nogo otdela nizhney chelyusti u pozhilyh pacientov. Endodontiya Today. 2013;(1):15-19. [Vasiliev Yu.L., Kuzin A.N. Features of local anesthesia and innervation of the chin region on the mandible in elderly patients. Endodontics Today. 2013;(1):15-19. (In Russ.)]. https://elibrary.ru/item.asp?id=20469342
3. Yuan T., Li Z., Li X., Yu G., Wang N., Yang X. Lidocaine attenuates lipopolysaccharide-induced inflammatory responses in microglia. The Journal of surgical research. 2014;192(1):150-162. https://doi.org/10.1016/j.jss.2014.05.023
4. Seok Han B., Ko S., Seok Park M., Ji Lee Y., Eun Kim S., Lee P. et al. Lidocaine combined with general anesthetics impedes metastasis of breast cancer cells via inhibition of tgf-beta/smad-mediated emt signaling by reprogramming tumor-associated macrophages. Int Immunopharmacol. 2024;142(Pt B):113207. https://doi.org/10.1016/j.intimp.2024.113207
5. Sato Y., Matsumoto S., Ogata K., Bacal K., Nakatake M., Kitano T. et al. The dose-response relationships of the direct scavenging activity of amide-based local anesthetics against multiple free radicals. Journal of clinical biochemistry and nutrition. 2023;73(1):16-23. https://doi.org/10.3164/jcbn.22-131
6. Matveev A.V., Krasheninnikov A.E., Egorova E.A., Matveeva E.A. Analiz effektivnosti i bezopasnosti lidokaina (obzor literatury). Sibirskiy nauchnyy medicinskiy zhurnal. 2020;40(6):12-22. [Matveev A.V., Krasheninnikov A.E., Egorova E.A., Matveeva E.A. Effectiveness and safety of lidocaine use (review). Siberian Scientific Medical Journal. 2020;40(6):12-22. (In Russ.)]. https://www.elibrary.ru/item.asp?id=44400759
7. Gulenko O.V., Vasil'ev Yu.L. Mestnoe obezbolivanie u detey do 4 let v stomatologii: sostoyanie voprosa. Stomatologiya. 2021;100(4):117-122. [Gulenko OV, Vasil’ev YuL. Local anesthesia in children younger than 4 years in dentistry: state of the question. Stomatology. 2021;100(4):117‑122. (In Russ.)]. https://doi.org/10.17116/stomat2021100041117
8. Matveev A.V., Konyaeva E.I., Egorova E.A., Beytullaev A.M. Retrospektivnyy analiz spontannyh soobscheniy o nezhelatel'nyh reakciyah pri primenenii lidokaina, privedshih k letal'nomu ishodu. Bezopasnost' i risk farmakoterapii. 2024;12(1):35-44. [Matveev A.V., Konyaeva E.I., Egorova E.A., Beitullaev A.M. Retrospective Analysis of Spontaneous Reports of Fatal Adverse Reactions Associated with Lidocaine. Safety and Risk of Pharmacotherapy. 2024;12(1):35-44. (In Russ.)]. https://doi.org/10.30895/2312-7821-2023-395
9. Velichko E.V., Lobaeva T.A., Rabinovich S.A., Vasil'ev Yu.L., Mazov Ya.A., Lobanova Yu.N. Himiko-analiticheskiy podhod k ocenke effektivnosti mestnyh anestetikov. Rossiyskiy zhurnal boli. 2023;21(3):35‑42. [Velichko E.V., Lobaeva T.A., Rabinovich S.A., Vasil’ev Yu.L., Mazov Ya.A., Lobanova Yu.N. Chemical-analytical approach to evaluating the effectiveness of local anesthetics. Russian Journal of Pain. 2023;21(3):35‑42. (In Russ.)]. https://doi.org/10.17116/pain20232103135
10. Kuznetsov A., Kazumova A., Ivanova N., Vasil’ev Y.L. Assessment of the potentially toxic effect of 2% and 4% Articaine on the patients’ cardiovascular system during tooth extraction. Bulletin of Stomatology and Maxillofacial Surgery. 2025;21(3):303-312. https://doi.org/10.58240/1829006X-2025.3-303
11. Dhake P., Nagpal D., Chaudhari P., Lamba G., Hotwani K., Singh P. Buffered articaine infiltration for primary maxillary molar extractions: a randomized controlled study. Journal of dental anesthesia and pain medicine. 2022;22(5):387-394. https://doi.org/10.17245/jdapm.2022.22.5.387
12. Rabinowitz Y., Williams S., Triana R.R., Khan M.T.F., Hooker K.J., Dubey A. et al. Assessing the efficacy of buffered versus nonbuffered lidocaine in dental extractions: a double-blinded randomized controlled trial. Journal of oral and maxillofacial surgery. 2024;82(6):684-691. https://doi.org/10.1016/j.joms.2024.03.008
13. Warren V.T., Fisher A.G., Rivera E.M., Saha P.T., Turner B., Reside G. et al. Buffered 1% lidocaine with epinephrine is as effective as non-buffered 2% lidocaine with epinephrine for mandibular nerve block. Journal of oral and maxillofacial surgery. 2017;75(7):1363-1366. https://doi.org/10.1016/j.joms.2016.12.045
14. Rabinovich S.A., Vasil'ev Yu.L., Zavodilenko L.A., Kobiyasova I.V, Gos'kov I.A. Obezbolivanie v stomatologii u detey i vzroslyh. Moskva: GEOTAR-Media; 2022. 336 c. [Rabinovich S.A., Vasiliev Yu.L., Zavodilenko L.A., Kobiyasova I.V., Gos'kov I.A. Anesthesia in dentistry in children and adults. Moscow: GEOTAR-Media; 2022. 336 p. (In Russ.)]. https://doi.org/10.33029/9704-6954-5-PRD-2022-1-336
15. Rabinovich S.A., Vasil'ev Yu.L., Velichko E.V., Daraushe H.M.S. Mestnoe obezbolivanie v stomatologii: obrazovatel'nye, klinicheskie i yuridicheskie aspekty. Moskva: Libri plyus; 2023. 123 c. [Rabinovich S.A., Vasiliev Yu.L., Velichko E.V., Daraushe H.M.S. Local anesthesia in dentistry: educational, clinical and legal aspects. Moscow: Libri plus; 2023. 123 p. (In Russ.)]. https://rusmed.rucml.ru/ffind?iddb=17&ID=RUCML-BIBL-0001648778
16. Anisimova E.N., Anisimova N.Yu., Kovylina O.S., Eliseev D.A., Hodnenko O.V., Kravchenko I.A. Primenenie 2% rastvora artikaina bez vazokonstriktora i s epinefrinom v koncentracii 1 : 200 000 na detskom ambulatornom stomatologicheskom prieme. Institut stomatologii. 2021;(3):53-55. [Anisimova E.N., Anisimova N.Yu., Kovilina O.S., Eliseev D.A., Hodnenko O.V., Kravchenko I.A. Using of a 2% solution of articaine with epinephrine 1 : 200 000 in the pediatric dentistry. Institut stomatologii. 2021;(3):53-55. (In Russ.)]. https://elibrary.ru/item.asp?id=46652200
17. Ramadurai N., Gurunathan D., Samuel A.V., Subramanian E., Rodrigues S.J.L. Effectiveness of 2% Articaine as an anesthetic agent in children: randomized controlled trial. Clinical oral investigations. 2019;23(9):3543-3550. https://doi.org/10.1007/s00784-018-2775-5
18. Anisimova N.Yu., Anisimova E.N., Ryazancev N.A., Kravchenko I.A. Sravnitel'nyy analiz primeneniya 2% i 4% rastvora artikaina pri in'ekcionnoy mestnoy anestezii. Stomatologiya. 2021;100(5):25-29. [Anisimova N.Y., Anisimova E.N., Ryazantcev N.A., Kravchenko I.A. Comparative analysis of 2% and 4% articaine solution efficacy and safety for the local anesthesia. Stomatology. 2021;100(5):25‑29. (In Russ.)]. https://doi.org/10.17116/stomat202110005125
19. Kämmerer P.W., Schneider D., Palarie V., Schiegnitz E., Daubländer M. Comparison of anesthetic efficacy of 2 and 4% articaine in inferior alveolar nerve block for tooth extraction — a double-blinded randomized clinical trial. Clinical oral investigations. 2017;21(1):397-403. https://doi.org/10.1007/s00784-016-1804-5
20. Tan Y.Z., Shi R.J., Ke B.W., Tang Y.L., Liang X.H. Paresthesia in dentistry: The ignored neurotoxicity of local anesthetics. Heliyon. 2023;9(7):e18031. https://doi.org/10.1016/j.heliyon.2023.e18031



