Phentolamine: What is it & how to use it?

CDA Oasis

6 years ago

Dr. John O’Keefe explored the use of Phetolamine with Dr. Joonyoung Ji, dental anesthesia specialist in Ottawa, ON.

Indications

Dental procedure – Adults – Reversal of local anesthesia, Soft-tissue and pulp tissue: 0.2 mg for every 1/2 cartridge of 1:100,000 epinephrine containing local anesthetic administered, 0.4 mg for every 1 cartridge of 1:100,000 epinephrine containing local anesthetic administered, and 0.8 mg for 2 cartridges of 1:100,000 epinephrine containing local anesthetic administered; location(s) and technique(s) (infiltration or block injection) should be the same as used for the local anesthetic/vasoconstrictor.

Dental procedure – Pediatric – Reversal of local anesthesia, Soft-tissue and pulp tissue: (6 yr and older or weighing 15 kg or more) MAX dose is 0.2 mg in children weighing 15 to 30 kg. 0.2 mg for 1/2 cartridge of 1:100,000 epinephrine containing local anesthetic administered, 0.4 mg for 1 cartridge of 1:100,000 epinephrine containing local anesthetic administered, and 0.8 mg for 2 cartridges of 1:100,000 epinephrine containing local anesthetic administered; location(s) and technique(s) (infiltration or block injection) should be the same as used for the local anesthetic/vasoconstrictor;
Phentolamine is a non-selective alpha-adrenergic antagonist. Phentolamine mesylate accelerates reversal of soft-tissue and pulpal anesthesia and associated functional deficits resulting from an intraoral submucosal injection of a vasoconstrictor-containing local anesthetic. With its short duration of alpha-adrenergic blocking activity, phentolamine mesylate results in vasodilatation when applied to vascular smooth muscle .
Phentolamine mesylate is an antihypertensive agent, with direct but less marked positive inotropic and chronotropic effects on heart muscle and vasodilator effects on vascular smooth muscle. It possesses a short duration of alpha-adrenergic blocking activity.