afety of local anaesthesia in dental patients taking oral nticoagulants : is it still controversial ?

he aim of this study was to investigate the safety of local infiltration techniques and the inferior alveolar nerve block (IANB) in dental atients taking oral anticoagulants. A total of 352 patients were given a total of 560 injections of local anaesthetic (119 IANB and 441 others). he study group comprised 279 patients with therapeutic international normalised ratios (INRs), and the control group 73 patients who were aking oral anticoagulants but had subtherapeutic INR on the day of operation. Blood was aspirated 7 times (7.3%) during the IANB in the tudy group. However, there were no clinical signs of prolonged haemorrhage into the medial pterygoid muscle or pterygomandibular space fter 96 IANB, including those from whom blood had been aspirated. Only two minor haematomas developed after multiple infiltrations in the ingual sulci. The results suggest that bleeding as a result of the use of local anaesthesia in patients with therapeutic INR is unlikely, provided hat the IANB is done correctly. 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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