Local Anesthetic Efficacy in Marijuana Users and Nonusers: A Pilot Study

Area of Science:

• Dental Anesthesiology
• Pharmacology
• Clinical Dentistry

Background:

• Limited literature exists on local anesthetic efficacy in patients with a history of drug use.
• A common clinical impression suggests these patients may be challenging to anesthetize.
• This study addresses the gap in understanding marijuana use and its impact on dental anesthesia.

Purpose of the Study:

• To assess local anesthetic efficacy in chronic marijuana users versus nonusers for dental treatment.
• To determine if marijuana use affects the success, onset, or duration of local anesthesia.
• To provide preliminary data for future, larger investigations.

Main Methods:

• A pilot study involving healthy adult male and female chronic marijuana users and nonusers.
• Subjects had asymptomatic, vital maxillary lateral incisors tested with electric pulp testing (EPT).
• Standard maxillary infiltration with 1.7 mL 2% lidocaine with 1:100,000 epinephrine was administered, with EPT at 3-minute intervals.

Main Results:

• 88% of nonusers and 61% of marijuana users achieved successful anesthesia (onset within 10 min, duration ≥ 15 min).
• The difference in successful anesthesia rates between groups was not statistically significant (P = .073).
• No significant differences in onset or duration of anesthesia were observed between users and nonusers for those successfully anesthetized.

Conclusions:

• No significant differences in local anesthetic efficacy were found between chronic marijuana users and nonusers.
• Findings suggest marijuana use may not significantly impact the success, onset, or duration of standard dental local anesthesia.
• Larger studies are recommended to provide more definitive evidence on this topic.