Influence of Vasoconstrictors on the Toxicity of Procaine Anesthetic Solutions

Tainter, M. L.; Throndson, A.H.

doi:10.14219/jada.archive.1938.0146

Cited by 8 publications

(4 citation statements)

References 2 publications

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“…Vasoconstrictors. It is common knowledge that vasoconstrictors retard and prolong the duration of action of local anesthetics used perineurally or intrathecally.5, 19,25 It is assumed that they exert the same effect topically. However, our findings are at variance with existing clinical impressions.…”

Section: Potentiating Effect Of Nonanesthetic Substancesmentioning

confidence: 99%

The comparative potency and effectiveness of topical anesthetics in man

Adriani

Zepernick

Arens

et al. 1964

Clin Pharma and Therapeutics

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Comparative data concerning the effects of topical anesthetics in man are not available. A technique with the use of electrical stimulation which permitted such a study was developed by the authors. The tip of the tongue is the most sensitive area in the body to this type of stimulation. Over 40 drugs with topical activity were studied with the tip of the tongue as the test site. The most potent and effective compounds are tetracaine, cocaine, dibucaine, lidocaine, and dyclonine. With the exception of dyclonine, these are toxic systemically if used in excess. The addition of vasoconstrictors, detergents, demulcents, cations, hyaluronidase, and other often suggested potentiating agents, does extend the period of activity. Need for a controlled studyNo wholly satisfactory technique has been available for studying topical anesthesia in man. Therefore, clinically significant data of a comparative nature are sparse. The efficacy of topical anesthetics is usually established by observing their ability to suppress the corneal or laryngeal reflexes. 6 , 8 The effects on the laryngeal reflex have been used as a basis for study in man. However, this technique has drawbacks because the responsiveness is variable and the reflex is obtunded after repeated stimulation. The need for a better method of study was obvious. After a num-

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Section: Potentiating Effect Of Nonanesthetic Substancesmentioning

confidence: 99%

The comparative potency and effectiveness of topical anesthetics in man

Adriani

Zepernick

Arens

et al. 1964

Clin Pharma and Therapeutics

View full text Add to dashboard Cite

show abstract

“…The reasons for using LA agents perioperatively are both to block peripheral nociceptive excitation after tissue damage and to prevent the sensitization of the central nervous system [ 6 ]. LAs generally can be used as a preparation together with adrenaline, which has a very strong vasoconstrictor effect: (a) the addition of the LA to the blood is prevented, the LA remains in the surgical site, and the LA effect is maintained better [ 7 ]; (b) the risk of a toxic effect is decreased by preventing its entry into systemic circulation [ 8 ]; (c) bleeding in the surgical site is decreased because of the vasoconstrictor effect of adrenaline [ 9 ]; and (d) the vasodilator effect of the LA is decreased [ 10 ]. However, there are also some randomized controlled studies that show the ineffectiveness of LA during tonsillectomy [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Perioperative and Postoperative Effects of Levobupivacaine and of Levobupivacaine + Adrenaline in Pediatric Tonsillectomy: A Double-Blind Randomized Study

Çiçekci

Sizer

Atici

et al. 2017

Pain Research and Management

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Objectives We aimed to assess the effects of levobupivacaine and of levobupivacaine + adrenaline administered during pediatric tonsillectomy on the postoperative period. Methods A total of 90 patients between the ages of five and twelve were divided randomly into two groups before tonsillectomy: levobupivacaine only (0.5%) 0.4 mg·kg−1 or levobupivacaine (0.5%) 0.4 mg·kg−1 + adrenaline (1 : 200.000) administered by means of peritonsillar infiltration. Primary outcomes were postoperative pain scores recorded at various intervals until 24 hours postoperatively. Secondary outcomes included postoperative nausea and vomiting (PONV), time to first oral intake, time to the first administration of analgesics and total consumption of analgesics, and the amount of bleeding for all children. Results In both groups, patients had the same postoperative pain scores and PONV rates, and equal amounts of analgesics were consumed up to 24 hours postoperatively. The two groups also had the same time until first oral intake, recovery time and time to the first analgesic request, and amount of bleeding. Conclusions Perioperative levobupivacaine infiltration on its own is a valid alternative to the combination of levobupivacaine + adrenaline for perioperative and postoperative effectiveness in pediatric tonsillectomy. This trial is registered with Australian New Zealand Clinical Trial Registry ACTRN: ACTRN12617001167358.

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“…of 2 per cent solution containing epinephrine 1:50,000 was required to obtain adequate clinical dental anesthesia. Out of the 344 cases examined in this study, 21 per cent showed inadequate depth of anesthesia even with this rather large drug amount and volume. Winter and Tainter5 reported a clinical comparison of 2 and 3 per cent procaine solutions, both containing epinephrine 1:50,000.…”

Section: Discussionmentioning

confidence: 61%

“…This has been rather thoroughly studied,13-16 as has been the influence of added vasoconstrictors on these factors. [17][18][19][20][21][22] The other element is depth or completeness of anesthesia. Since neither time of onset nor duration of action necessarily parallel the depth of local anesthesia, it was decided to attempt to measure this latter variable.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Depth of Anesthesia and Toxicity of two and four Per Cent Procaine Hydrochloride Solution

Everett

1949

J Dent Res

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Influence of Vasoconstrictors on the Toxicity of Procaine Anesthetic Solutions

Cited by 8 publications

References 2 publications

The comparative potency and effectiveness of topical anesthetics in man

The comparative potency and effectiveness of topical anesthetics in man

Comparison of the Perioperative and Postoperative Effects of Levobupivacaine and of Levobupivacaine + Adrenaline in Pediatric Tonsillectomy: A Double-Blind Randomized Study

A Comparison of Depth of Anesthesia and Toxicity of two and four Per Cent Procaine Hydrochloride Solution

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