Introduction: For years, dentistry has had great strides in reducing pain during dental procedures, to have an accurate diagnosis must be made a good history, knowing that alternative pain management techniques with local anesthesia for the benefit ofpatients. Case Report: We present a 22-year-old with acute pain, acute irreversible pulpitis 46. performed inferior alveolar nerve block to start the continuous pulpectomy pain and proceeds to perform the technique of intraosseous anesthesia. Pain relief is noted. Looks for changes in heart rate before, during and after anesthesia intraosseous. Discussion: In this case demonstrates a successful outcome of the technique of intraosseous anesthesia as reinforcement to the inferior alveolar nerve block confirms the effectiveness of many studies reporting intraosseous anesthesia, there was also no significant changes in heart rate at perform the technique of intraosseous anesthesia with prilocaine 3% with Felypressin.