PDF: Role of 0.5 M mannitol as an adjuvant with lidocaine with or without epinephrine for inferior alveolar nerve block: A randomized control trial

Since the beginning of time surgeons have been searching for the substances that can be used to make procedures painless.

Such substances are the anesthetics. The most commonly used local anesthetic in dentistry is lidocaine.


An ideal solution is where profound anesthesia is achieved and maintained throughout the procedure and followed by early and complete recovery of sensation. 

For decades, mannitol is the most widely used agent in the management of raised intracranial pressure, as a renal protective agent in patient with high risk of developing renal failure, and as prophylaxis against acute renal failure surgeries.

A hyperosmolar solution can cause a transient and artificial opening of perineurium; this enhances the permeability for macromolecules and /or ions. 

The hyperosmolar solution of mannitol did not induce an inflammatory cell infiltrate when the tissue was examined histologically. 

There is paucity of literature mentioned use of mannitol with local anesthetic solution. Our study focuses on this aspect of combination of mannitol with local anesthesia and its possible use in oral and maxillofacial surgery.

The aims and objectives of the study were to assess whether 0.5 M of mannitol could increase the efficacy of lidocaine with or without epinephrine in inferior alveolar nerve block. 

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