(6) Felypressin is a non-catecholamine vasoconstrictor and chemically is related to vasopressin, the posterior pituitary hormone.
The aim of this study was to compare the effectiveness of 2% lidocaine with epinephrine (1:100,000) and 3% prilocaine with felypressin (0.03 I.U.
If the patient was in lidocaine or prilocaine regimen, buccal infiltration injection was administrated by inserting a short needle at the depth of the sulcus and advanced 4-7mm in order to deposit the anesthetic solution (1.4ml lidocaine 2% with epinephrine 1:100,000 or prilocaine 3% felypressin [0.03 I.U.
George et al (10) reported that 2% lidocaine with 1:100,000 epinephrine was superior to 3% prilocaine with 0.03 IU felypressin when surgical procedures were performed, the outcome of this study revealed that both prilocaine and lidocaine possess a similar potency and onset time of action.
Adrenaline is considered as strong vasoconstrictor when it is compared with felypressin. (5,11) The advantage of using the adrenaline in the local anesthetic agents is to minimize blood flow in the injection site, holding the local anesthetic in place, and reducing the rate of plasma uptake and potential toxicity.
(12) Their study investigated the effects of lidocaine 2% with epinephrine 1: 80,000, prilocaine 3% with Felypressin 0.03 IU/ml, and mepivacaine 3% plain on hypertensive patients during dental extraction.
Felypressin is less vasoconstrictive than adrenaline and constricts venous outflow.
This study provided strong evidences for using prilocaine with felypressin as a substitute local anesthetic for patients who have contraindication to the use of local anesthesia with adrenaline.
After local anesthesia with 0.45 ml of 3% prilocaine with 0.03 IU/ml felypressin, the nodule was excised and sent for histopathologic evaluation.
In their study, 63 patients received dental treatment after complaints of toothache or masticatory disorder during hospitalization, under local anesthesia with 3% prilocaine with 0.03 IU/ml felypressin, in a maximum period of 30 minutes.
In the present case, prilocaine with felypressin was the choice , and acetaminophen was prescribed for avoiding postoperative pain.