Background :
Vasoconstrictors in local anesthetic (LA) solutions lengthen the duration of anaesthesia, causing self-inflicted soft tissue injury (STI). Phentolamine Mesylate (PM) has been identified as a reliable LA reversal agent. The purpose of the systematic review was to assess the effectiveness of PM in shortening anesthetic duration, outcome measures, and the occurrence of adverse effects.
Data source: The authors searched published studies in MEDLINE, PubMed, EBSCO, Web of Science, Scopus, Science Direct, and the Cochrane Central Register of Controlled Trials between January 2008 and June 2022. The inclusion criteria were met by randomized controlled trials (RCT) utilizing PM. Using the selection criteria, two reviewers independently appraised the retrieved literature.
Study selection: After removing duplicates, 378 articles were found in the databases. Upon reading the abstract, 306 articles were disregarded. For 72 relevant studies, full texts for the papers were found. The final 11 studies were chosen based on the eligibility criteria. The Critical Appraisal Skills Programme tool and Cochrane Collaboration methodology were then used to independently evaluate the risk of bias within and across the studies respectively.
Conclusion: The evidence from the review was consistent with the therapeutic success of PM in combination with various LA agents, in which the time to recover from residual STA was significantly reduced in all the studies with a high degree of patient satisfaction. An awareness regarding PM utilized for LA reversal should be promoted to avoid the negative consequences of residual anesthesia.