Articaine

[epidural man]

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How come we don't use articaine for diagnostic medial branch blocks (or other injections)?

My dentist explained to me that articaine has a much more superior penetration of ligaments and bone. I then looked some things up - it is because of the thiophene ring.

Anyway, the MAL ligament may prevent a good medial branch block on occasion.

Safety profile is on par with lidocaine and earlier reports of neurotoxicity have been debunked.

 

[lobelsteve]

How come we don't use articaine for diagnostic medial branch blocks (or other injections)?

My dentist explained to me that articaine has a much more superior penetration of ligaments and bone. I then looked some things up - it is because of the thiophene ring.

Anyway, the MAL ligament may prevent a good medial branch block on occasion.

Safety profile is on par with lidocaine and earlier reports of neurotoxicity have been debunked.

Has anyone ever reported MAL preventing a good block?

 

[epidural man]

Has anyone ever reported MAL preventing a good block?

good question - just guessing it might.

 

[Laryngospasm]

I doubt in reality there would be any benefit.. duration of bupiv longer.. almost certainly cheaper and also studied more.

 

[Orin]

It makes sense in dentistry where you just need to get the block to do your job, but if you're using it as a diagnostic tool, I would suspect false positives would be higher.

How deep into the bone do you think your medial branch RFA can chase?

 

[powermd]

All the Articaine I see on Henry Schein contains epi.

 

[Ducttape]

yes,

and i could only find the injection syringes of 1.7 ml. maybe someone else can find 10 ml bottles of the stuff.

from what i see on a couple of review articles, it takes a few min more to kick in, it may be slightly less toxic but is otherwise no different than lidocaine.