Are local anesthetics still controversial for patients taking oral anticoagulants?
This summary is based on the article published in the British Journal of Oral and Maxillofacial Surgery: Safety of local anaesthesia in dental patients taking oral anticoagulants: is it still controversial? (January 2012)
Purpose of the Study
To investigate the safety of local infiltration techniques and the inferior alveolar nerve block (IANB) in dental patients taking oral anticoagulants.
- Bleeding as a result of the use of local anaesthesia in patients with therapeutic INR is unlikely, provided that the IANB is done correctly.
- IANB in patients with INR within therapeutic range is safe. Haemorrhagic complications after local anaesthesia, including the IANB (possibly even other nerve blocks), are not likely, and if they do happen they resolve uneventfully.
- It is advisable to use intraligamentary or intraseptal techniques of local anaesthesia in these patients, as they are safer in that they are less likely to provoke haemorrhagic complications.
- To lessen the possibility of them happening with IANB, needles with smaller diameter should be used, and the needle should be advanced slowly as the anaesthetic solution is injected.
- The anaesthetic with vasoconstrictor should be used, together with the IANB technique with which the dentist is familiar.
Do you have any particular question on this topic? Do you have any comments or suggestions? Email us at firstname.lastname@example.org
You are invited to comment on this post and provide further insights by posting in the comment box which you will find by clicking on “Post a reply” below. You are welcome to remain anonymous and your email address will not be posted.