DOSAGE AND ADMINISTRATION
As with all local anesthetics, the dose varies and depends upon the area to be anesthetized, the vascularity of the tissues, individual tolerance and the technique of anesthesia. The lowest dose needed to provide effective anesthesia should be administered. For specific techniques and procedures, refer to standard dental manuals and textbooks.
For infiltration and block injections in the upper or lower jaw, the average dose of 1 cartridge will usually suffice.
Each cartridge contains 1.8 mL (36 mg of 2% or 54 mg of 3%).
Five cartridges (180 mg of the 2% solution or 270 mg of the 3% solution) are usually adequate to affect anesthesia of the entire oral cavity. Whenever a larger dose seems to be necessary for an extensive procedure, the maximum dose should be calculated according to that patient's weight. A dose of up to 3 mg per pound of body weight may be administered. At any single dental sitting the total dose for all injected sites should not exceed 400 mg in adults.
The maximum pediatric dose should be carefully calculated as follows.
Maximum Dose for Children =
Child's Weight (lbs) × Maximum recommended Dose
150 for Adults (400 mg)
The following table, approximating these calculations, may also be used as a guide. This table is based upon a recommended maximum for larger children of 5 cartridges (the maximum recommended adult dose) during any single dental sitting, regardless of the child's weight or (for 2% mepivacaine) calculated maximum amount of drug:
| | Maximum Allowable Dosage |
|---|
| | 3% Mepivacaine
(Plain) | 2% Mepivacaine with
1:20,000 Levonordefrin |
|---|
| | 3 mg/lb
(270 mg max) | 3 mg/lb
(180 mg max) |
|---|
Weight
(lb) | mg | Number of
Cartridges | mg | Number of
Cartridges |
|---|
| 20 | 60 | 1.1 | 60 | 1.6 |
| 30 | 90 | 1.7 | 90 | 2.5 |
| 40 | 120 | 2.2 | 120 | 3.3 |
| 50 | 150 | 2.8 | 150 | 4.2 |
| 60 | 180 | 3.3 | 180 | 5.0 |
| 80 | 240 | 4.4 | 180 | 5.0 |
| 100 | 270 | 5.0 | 180 | 5.0 |
| 120 | 270 | 5.0 | 180 | 5.0 |
Adapted from Malamed, Stanley F: Handbook of medical emergencies in the dental office, ed. 2, St. Louis, 1982. The C.V. Mosby Co.
When using Polocaine Dental for infiltration or regional block anesthesia, injection should always be made slowly and with frequent aspiration.
Any unused portion of a cartridge should be discarded.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.
DISINFECTION OF CARTRIDGES
As in the case of any cartridge, the diaphragm should be disinfected before needle puncture. The diaphragm should be thoroughly swabbed with either pure 91% isopropyl alcohol or 70% ethyl alcohol, USP, just prior to use. Many commercially available alcohol solutions contain ingredients which are injurious to container components, and therefore, should not be used. Cartridges should not be immersed in any solution.
|
