Are local anesthetics safe for children?

When administered correctly, local anesthetics are safe for children. • Since the 1960s, dentists have begun using an aspirating syringe, which has a small internal harpoon that engages the rubber stopper of the local anesthetic carpule. This technique enables dentists to aspirate for blood, and see if the needle has inadvertently entered a blood vessel - before injecting the anesthetic solution.

• Local anesthetics have a low margin of safety between the effective dose and the toxic dose. The lethal dose for many local anesthetics is only 3 times that of the effective dose. • Deaths following local anesthetic administration are almost always a result of overdosage.

The maximum safe dose of lidocaine for a child is 4.5 mg/kg per dental appointment. • Bupivicaine (Marcaine) is an amide local anesthetic with a high toxic potential, and should not be used in children. The duration of anesthesia with bupivicaine can be as long as 24 hours.

• Lidocaine is less toxic than many other ... more.

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