**3. Local anesthetics**

The use of local anesthetic agents in pain management plays a vital role. It is the safest and most effective medications to prevent and manage pain during dental treatment [8]. Today's availability of a variety of local anesthetic agents allows dentists to choose an anesthetic with specific properties such as time of onset and duration, hemostatic control, and degree of cardiac side effects that are suited for each individual patient and dental operation [9]. 2 percent lignocaine (Xylotox, Adcock Ingram; Xylesthesin, 3 M) with 1:80000 adrenaline content, 3 percent mepivacaine (Carbocaine) without a vasoconstrictor and 4 percent articaine (Ubistesin 3 M) with either 1:100000 or 1:200000 adrenaline concentration is currently the most commonly used local anesthetic agents in general dentistry [10]. Each local anesthetic has its own maximum recommended dose (MDR) measured in mg/kg body weight. Unfortunately, the literature7 shows that the mg/kg MDR for each drug ranges from 4.4 mg/kg 8 to 6.6 mg/kg [11, 12].
