The main objective in administering an intrapulpal anesthesia is to give it under pressure. Although it has been stated in the scientific literature that saline is as effective as 2% lidocaine with 1:100,000 epinephrine in providing anesthesia intrapulpally,28,29 it is recommended to use 2% lidocaine with 1:100,000 epinephrine. Empirically, the use of anesthetic with a vasoconstrictor will provide some vasoconstriction on the pulpal vascular system. This is important because most pulps with irreversible pulpitis can be hyperemic due to the body’s attempt to address the localized inflammation.
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