Magnesium sulfate, when added to lidocaine, acts as an adjuvant in inferior alveolar nerve block (IANB) and elicits favorable improvements in duration, onset, and anesthetic efficacy, as elucidated from a systematic review. The purpose of this study was to explore efficacy of magnesium sulfate as an add-on therapy to the local anesthetic lidocaine for IANB.

Using the MeSH keywords-Magnesium sulphate, Adjuvant, Lidocaine, Inferior Alveolar Nerve Block, a literature search was done using PubMed, Google Scholar, Elsevier science direct, Ovid Medline, Lilacs, Scopus, Cochrane, and Wiley online library. Thirteen full-text papers were filtered out of 45 total articles, and three were included in the qualitative assessment. This review was conducted under PRISMA principles. Overall, three randomized control studies were incorporated.

Magnesium, which has antinociceptive, anesthetic, and neuroprotective effects, can be utilized as a lidocaine adjuvant. When magnesium sulphate was added to lidocaine and compared to regular local anesthetic solutions, the magnesium sulphate group demonstrated a profound difference from the other groups (P<0.05) in all three trials.

When utilized as an adjuvant, the analgesic properties of magnesium also improves the efficacy of established analgesic agents. Hence, magnesium sulfate can be used as an adjuvant to achieve substantial pulpal anesthesia in difficult instances.