{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:21:16Z","timestamp":1783470076028,"version":"3.55.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":60,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Manipal Academy of Higher Education, Manipal"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In dentistry operations, addition 0.5\u00a0M mannitol to lidocaine-epinephrine improves anesthesia efficacy. However, its effect on hemodynamic parameters and post-operative outcomes have not been evaluated. This study aimed to compare the efficacy, hemodynamic parameters, and post-operative outcomes of 2% lidocaine and 1:200,000 epinephrine, with or without 0.5\u00a0M mannitol, in intra-oral nerve blocks.<\/jats:p>\n <\/jats:sec>\n \n Materials and methods<\/jats:title>\n \n This prospective, randomized, controlled, triple-blind, split-mouth study included 25 patients who required intra-oral block for elective extraction of lower erupted teeth. The Test side (\n n<\/jats:italic>\n \u2009=\u200925) received lidocaine-epinephrine-mannitol, while the Control side (\n n<\/jats:italic>\n \u2009=\u200925) received lidocaine-epinephrine. The primary outcome measures were evaluated were onset and duration of anesthesia. The secondary outcome measures were pain (assessed with visual analogue scale [VAS] on day 0\u20133, and 7); hemodynamic parameters (including heart rate, systolic blood pressure [SBP], diastolic blood pressure [DBP], and oxygen saturation, assessed pre-, intra-, and post-operatively); and post-operative complications (swelling and trismus assessed on day 7).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The Test side had a significantly early onset of action (\n p<\/jats:italic>\n \u2009=\u20090.006) and delayed return of sensation (\n p<\/jats:italic>\n \u2009=\u20090.001). On day 0, VAS score was significantly lower in the Test side (\n p<\/jats:italic>\n \u2009=\u20090.017), with no difference at other intervals (\n p<\/jats:italic>\n \u2009>\u20090.05). Post-operatively, mouth opening was significantly greater on the test side (\n p<\/jats:italic>\n \u2009=\u20090.023), with no difference in post-operative swelling (\n p<\/jats:italic>\n \u2009=\u20090.317). The control side had a significantly higher intra- (\n p<\/jats:italic>\n \u2009=\u20090.018) and post-operative (\n p<\/jats:italic>\n \u2009=\u20090.006) heart rate, with comparable SBP, DBP, and oxygen saturation.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Lidocaine-epinephrine-mannitol formulation showed improved anesthetic efficacy, reduced pain on the day of procedure, stable hemodynamic parameters, and increased post-operative mouth opening.<\/jats:p>\n <\/jats:sec>\n \n Trial registration<\/jats:title>\n \n CTRI\/2022\/10\/046921<\/jats:ext-link>\n [Registered on: 31\/10\/2022].\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1186\/s12903-026-08468-3","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T10:54:51Z","timestamp":1778324091000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of 0.5M mannitol as an adjuvant to lidocaine and epinephrine for intra-oral nerve blocks - a split-mouth, randomized controlled trial"],"prefix":"10.1186","volume":"26","author":[{"given":"Radhika","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehul","family":"Saha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adarsh","family":"Kudva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srikanth","family":"Gadicherla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalyana C.","family":"Pentapati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Chitra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharnappa","family":"Poojary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreea","family":"Roy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"issue":"1","key":"8468_CR1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.17245\/jdapm.2022.22.1.39","volume":"22","author":"M Singla","year":"2022","unstructured":"Singla M, Gugnani M, Grewal MS, Kumar U, Aggarwal V. 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