Local Anaesthesia in Elderly Patients. An Experimental Study of Oral Infiltration Anaesthesia

The proportion of elderly people is increasing. Normal ageing causes a reduced physiological capacity and ability to meet challenges. In future more elderly people will have functioning natural dentitions and undergo routine dental procedures for which local anaesthesia is required. In this experimental investigation the effect of infiltration anaesthesia from 3 commonly used agents was compared in healthy elderly and young subjects. The subjects comprised 40 volunteers and the anaesthetic agents tested were lidocaine (20 mg/ml) with epinephrine (12.5 micrograms/ml), prilocaine (30 mg/ml) with felypressin (0.54 microgram/ml) and mepivacaine (30 mg/ml). The elderly subjects had a highly significantly shorter onset time compared to the young group. There was no statistically significant difference in duration of tooth anaesthesia between lidocaine with epinephrine and prilocaine with felypressin. Because elderly people have lower drug tolerance, prilocaine with felypressin is therefore recommended for routine dentistry.