Is Septocaine (Articaine) safe for block anesthesia?

Lots of people have asked me this. There have been reports of parathesia or even anesthesia after the administration of articaine for an inferior alveolar block. Possible reasons include the high concentration (4%) or increased tissue penetration.

Parethesia or anesthesia can occur after a block with any anesthetic preparation. Reasons include:

• Direct needle injury;
• Direct injury to the blood supply or the nerve;
• Swelling or bleeding around the nerve which causes compression.

Having said that, reports of anesthesia/parathesia appear to be higher with Articiane.

I personally use Articaine for infiltration only. I have no problem with "hitting" my blocks using Lidocaine or Carbocaine, and Articaine's improved penetration is most needed when I infiltrate. Articaine can be invaluable in certain situations such as:

• Obtaining palatal anesthesia wirhout a palatal injection (especially in kids);
• Penetrating an area of inflammation or infection
• Need for less needle insertions when infiltrating large areas of the mouth.

What do you think?

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