Dose‐dependent hypotension from epinephrine, or lidocaine, or both?

Enlund, Mats

doi:10.1111/j.1399-6576.2006.01070.x

Cited by 3 publications

(2 citation statements)

References 2 publications

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“…Second, we did not measure serum concentrations of articaine or catecholamines to investigate whether there was a relationship between these and cardiovascular response, as has been suggested in previous reports. 11 Third, we excluded patients who required administration of a vasopressor from further analysis. This resulted in the data from 3 patients not being included in recovery period after the hypotensive episode.…”

Section: Discussionmentioning

confidence: 99%

The Pathophysiology of Early Hypotension Following Epinephrine-containing Local Anesthetic Infiltration of the Nasal Mucosa in Patients Undergoing Endoscopic Transsphenoidal Hypophysectomy: A Prospective, Observational Study

Wiles

Sanders²,

Sinha³

et al. 2017

Journal of Neurosurgical Anesthesiology

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In patients undergoing endoscopic transsphenoidal hypophysectomy, the nasal mucosa is often infiltrated with local anesthetic solutions that contain epinephrine to aid hemostasis. This may, however, result in hemodynamic changes, especially hypotension. We characterized the cardiovascular changes using a LiDCOrapid monitor in 13 patients after the infiltration of 4% articaine containing 1:200,000 epinephrine. Nine (69%) had a >20% decrease in mean arterial pressure at a median time of 116 seconds after the infiltration of articaine with epinephrine. Analysis of the cardiac output data revealed that this was caused by a sustained reduction in systemic vascular resistance. The arterial blood pressure normalized over a period of 60 to 90 seconds secondary to increases in stroke volume and heart rate producing an elevation in cardiac output. Transient hypotension following the infiltration of epinephrine-containing local anesthetics may be caused by epinephrine stimulation of β2-adrenoceptors producing vasodilation.

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Section: Discussionmentioning

confidence: 99%

The Pathophysiology of Early Hypotension Following Epinephrine-containing Local Anesthetic Infiltration of the Nasal Mucosa in Patients Undergoing Endoscopic Transsphenoidal Hypophysectomy: A Prospective, Observational Study

Wiles

Sanders²,

Sinha³

et al. 2017

Journal of Neurosurgical Anesthesiology

View full text Add to dashboard Cite

show abstract

“…We read with great interest the letter by Dr Enlund (1), in which he described an insightful analysis of the disparate results of two articles with regard to unintentional hypotension episodes after local infiltration of epinephrine‐containing lidocaine (2, 3). Dr Enlund successfully drew an integrative conclusion that a combination of relatively small doses of lidocaine and epinephrine results in profound hypotension, mainly due to an adrenergic β 2 effect.…”

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confidence: 99%