Pharmacology · patient case question
The mother asks whether anything can shorten the numbness after future appointments. Which agent reverses soft tissue anaesthesia?
Patient case: Child with lower lip swelling the day after a stainless steel crown
Patient: Child, 7 years old
Chief complaint: Brought by his father with swelling of the lower lip.
Background: A stainless steel crown was placed the day before under local anaesthesia.
Current findings: Swelling of the lower lip at the level of the mandibular occlusal plane.
Show answer and explanation
Correct answer: C. Phentolamine mesylate
- A. Naloxone reverses OPIOIDS.
- B. Atropine is an antimuscarinic used for bradycardia and to reduce secretions.
- C. CORRECT. PHENTOLAMINE MESYLATE (OraVerse®) is an alpha-adrenergic ANTAGONIST. Injected into the same site, it reverses the vasoconstriction produced by the epinephrine in the anaesthetic, increasing local blood flow and accelerating clearance of the anaesthetic — roughly halving the duration of soft tissue numbness. It directly reduces the risk of exactly the self-inflicted lip trauma this child sustained.
- D. Flumazenil reverses BENZODIAZEPINES.
Note: Learn the reversal set: phentolamine for soft tissue anaesthesia, flumazenil for benzodiazepines, naloxone for opioids.