BACTEREMIA FOLLOWING LOCAL-ANESTHETIC INJECTIONS IN CHILDREN

Objectives To estimate odontogenic bacteraemia following three differe nt types of local anaesthetic injections, namely: buccal infiltration analgesia (BIA), conventional intraligamental analgesia (CIA), and mod ified intraligamental analgesia (MIA). Patients and meth ods The bacte raemia-producing potential of three methods of injecting local analges ic solution was determined by taking blood samples, using aseptic tech nique, from 143 children, aged 1 year 11 months to 19 years 4 months, undergoing general anaesthesia for dental extractions. Of these 143 ch ildren, a subgroup of 50 had blood taken before any dentogingival mani pulative procedures to provide a baseline level of bacteraemia. The in jection methods were buccal infiltration, conventional intraligamental , and a modified intraligamental. The blood samples were taken 30 seco nds after injection and cultured in aerobic and anaerobic broth cultur es (Bactec) and from lysis filtration vials (Isolator). Results The pe rcentage prevalence of bacteraemia was: baseline level 8%; buccal infi ltration analgesia 16%; modified intraligamental analgesia 50%; and co nventional intraligamental analgesia 97%. These values were statistica lly significantly different using the chi-squared test (P < 0.001). Th e mean value for colony forming units per millilitre (Isolator system) was 252 (sd = 646) for the intraligamental technique but zero for bas eline, infiltration and modified intraligamental techniques. Conclusio ns All local anaesthetic techniques studied were associated with bacte raemia which may have implications for antibiotic prophylaxis for dent al treatment. The intraligamental techniques had statistically signifi cantly greater percentage prevalence of bacteraemia compared with base line. The modified intraligamental technique causes significantly less bacteraemia than the conventional intraligamental technique.