Being a hygienist in NJ, I administer blocks with local anesthesia. I was told by the dentist I work with not to use it for mandibular blocks, so I don’t. However, I never was told that in my anesthesia classes and while doing research, there doesn’t seem to he concrete evidence of septocaine causing parasthesia
I have recently been to two separate seminars where the speakers said there is no current evidence of the Septocaine/parasthesia worry. I have been using it for 3 years now without an issue.
All the dentist at my office believes that septocaine does aid in parasthesia for mand blocks, however when I took the local anesthesia course the Dentist teaching did not strongly believe that septocaine was increasing any chances. I am afraid we will have no real conclusion on this issue. I practice in New York. Hygienist do not block here only infiltrate anyway.
I agree that there is not a standard conclusion on this issue so you need to use your judgement. Our office almost always uses Septocaine for mandibluar blocks but I can understand why someone might not be comfortable using it.
I was taught not to use it for an IA in hygiene school. It is safer to use in cardiac patients (septocaine 1:200k)and it provides more profound anesthesia than carbocaine. I have used it for IA but only when lidocaine is contraindicated.
I have read some of the research around this issue. We decided to stop using septocaine for lower blocks. However, we don’t see as good of results with it so we have been going back to using septocaine more.
Malamed say do not use the 4% mandibular blocks. My school teachers and follows those recommendations. Lidocaine works fine for IA’s and if that doesn’t seem to be working I would try a Gow Gates.
I use septo 4% for mandibular block anesthesia with no problem. If you look at the probability of long term parasthesia with ANzy type of anesthetic, it is very low to begin with. It is only POSSIBLY slightly higher with Septo, and I don’t know if they ever have proven that it was the Septo being used that caused the problem. I’m not worried about it, it’s a great anesthetic.
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