Local dental anaesthesia with lidocaine and adrenaline. Effects on plasma catecholamines, heart rate and blood pressure

Salonen, Markku; Forssell, Heli; Scheinin, Mika

doi:10.1016/s0901-5027(88)80071-7

Cited by 48 publications

(29 citation statements)

References 5 publications

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“…Peak value of plasma epinephrine concentration was obtained just after the administration of local anesthetic with epinephrine, while the peak value of plasma norepinephrine concentration was obtained during dental surgery (unpublished observations) . The time courses of plasma catecholamine concentrations were consistent with previous findings (13,14). These results suggest that epinephrine (1:80,000) administered in local anesthetic leaks into the systemic circulation.…”

Section: Discussionsupporting

confidence: 90%

Suppression of Cardiac Sympathetic Nervous System during Dental Surgery in Hypertensive Patients.

et al. 2000

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We determined the changes in blood pressure, pulse rate, and heart rate variability during dental surgery in hypertensive patients. The study included 18 essential hypertensives and 18 age and sex matched normotensive controls who underwent tooth extraction at our hospital. Holter electrocardiographic monitoring was used to determine the power spectrum of R-R variability before and during dental surgery. The low frequency (LF: 0.041 to 0.140 Hz), high frequency (HF: 0.140 to 0.500 Hz), and total spectral powers (TF:0.000 to 4.000 Hz) were calculated, and the ratio of LF to HF and the percentage of HF relative to TF (%HF:HF/TF X 100) were used as indexes of sympathetic and parasympathetic activities, respectively. The baseline blood pressure for hypertensive patients (149±4/85±2 mmHg) was significantly higher than that for normotensive patients (119 ± 3/71 ± 2 mmHg). The baseline pulse rates were similar between the two groups. Blood pressure increased during tooth extraction in both groups; however, changes in blood pressure did not differ between them. Administration of local anesthetic significantly decreased the %HF in normotensive patients (before vs. after anesthesia; 22.3 ± 2.4 vs. 13.8 ± 2.7%, p < 0.05). In contrast, the LF/HF significantly decreased during the local anesthesia and tooth extraction in hypertensive patients.These results suggest that pressor response induced by tooth extraction did not differ between normotensive and hypertensive patients, and that suppression of the cardiac sympathetic nervous system during dental surgery might attenuate the pressor response in patients with hypertension.

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Section: Discussionsupporting

confidence: 90%

Suppression of Cardiac Sympathetic Nervous System during Dental Surgery in Hypertensive Patients.

et al. 2000

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“…3). HR values varied significantly in a number of earlier studies (Salonen et al, 1998;Niwa et al, 2001;Vasconcellos et al), which was not the case in the present study or in other previous studies (Mestre Aspa et al; de Morais et al, 2012b), in which no alterations to HR were correlated with the use of anesthetic solutions (Fig. 4).…”

Section: Discussioncontrasting

confidence: 50%

Hemodynamic Behavior in Third Molar Surgeries Using Lidocaine or Articaine

Stella

Falci

Coelho

et al. 2018

Int. J. Odontostomat.

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STELLA, P. E. M.; FALCI, S. G. M.; COELHO, V. S. & DOS SANTOS, C. R. R.Hemodynamic behavior in third molar surgeries using lidocaine or articaine. Int. J. Odontostomat., 12(1):76-85, 2018. SUMMARY:The aim of this research was to assess the hemodynamic variations during the extraction of impacted lower third molars using lidocaine 2 % or articaine 4 %, as local anesthetics. Fourteen patients with a mean age of 22.4 (SD=3.25), were submitted to the bilateral extraction of lower third molars, with an interval of three to four weeks between the two extractions. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate and oxygen saturation in the blood were assessed at seven specific time points: baseline; anesthetic puncture; two minutes after anesthesia; osteotomy; suture and five minutes after the procedure had been completed. The statistical analysis involved descriptive analysis, the Shapiro-Wilk test, the Mann-Whitney test, the t-test and the repeated measurements test. No significant differences were found for any of the hemodynamic behavior variables when comparing lidocaine 2 % and articaine 4 %. Significant differences were found between the time points assessed within each group, particularly in relation to the variable heart rate. In the articaine group, systolic blood pressure exhibited a significant decrease five minutes after the procedure. There were no significant variations in hemodynamic behavior between the two different anesthetic groups (articaine 4 % and lidocaine 2 %).

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“…Although some reports state that plasma norepinephrine concentration dropped 14,16 or was stable [17][18][19] after epinephrine injection, most agree that it rose. 10,20-23 Significant increases in plasma norepinephrine concentrations were recognized 15 min and 20 min after injection in our group V. Catecholamines develop their effect by combining with a postsynaptic receptor.…”

Section: Discussionmentioning

confidence: 99%

“…In Reports regarding the influence of epinephrine on circulatory dynamics agree with each other in showing an increase in heart rate and a decrease in diastolic blood pressure. 10,14,19 On the other hand, regarding changes in systolic blood pressure, there are different opinions, stating that it is stable 10,16,18,20,26 or that it rises. 19,27 In the present study, in regard to changes in the circulatory hemodynamics, we observed a decrease in systolic blood pressure at 4 and 5 min after the injection in group II, and a decrease in the diastolic blood pressure at 5 min after the injection in group IV, and a decrease at 2, 3, 4, and 5 min after the injection in group V. Heart rate, on the other hand revealed no significant differences from baseline or among the groups.…”

Section: Discussionmentioning

confidence: 99%

The effects of epinephrine in local anesthetics on plasma catecholamine and hemodynamic responses

et al. 2005

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In order to clarify the influence of epinephrine in local anesthetics on endogenous epinephrine, we examined the concentration of plasma catecholamines (epinephrine and norepinephrine) and hemodynamics by administering 4 ml of 2% lidocaine containing different concentrations of epinephrine. Forty-three healthy adult male volunteers were divided into five groups according to epinephrine concentration: 0-microg (group I), 10-microg (group II), 20-microg (group III), 40-microg (group IV), and 50-microg (group V). The parameters were examined immediately, and at 1, 2, 3, 4, 5, 10, 15, and 20 min after the injection. In groups II, III, IV, and V, the plasma epinephrine concentration was elevated to peak at 5 min after the injection, after which it started to decline. The amount of increase in the plasma epinephrine concentration at 5 min showed a highly positive correlation with the amount of epinephrine added to the local anesthetic in groups II, III, and IV. In group V the plasma epinephrine concentration showed a marked increase as compared to the baseline level. Plasma norepinephrine concentrations were found to be significantly elevated at 15 and 20 min in group V. A decrease in systolic blood pressure was observed at 4 and 5 min in group II. A decrease in diastolic blood pressure was observed at 5 min in group II; at 3, 4, and 5 min in group IV; and at 2, 3, 4, and 5 min in group V. Heart rate revealed no significant differences from baseline level in any of the groups and there were no significant differences among the groups. It is suggested that exogenous epinephrine added to a local anesthetic may stimulate the presynaptic beta2 receptors on sympathetic nerve endings and on the adrenomedulla, and accelerate the release of endogenous epinephrine.

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Local dental anaesthesia with lidocaine and adrenaline. Effects on plasma catecholamines, heart rate and blood pressure

Cited by 48 publications

References 5 publications

Suppression of Cardiac Sympathetic Nervous System during Dental Surgery in Hypertensive Patients.

Suppression of Cardiac Sympathetic Nervous System during Dental Surgery in Hypertensive Patients.

Hemodynamic Behavior in Third Molar Surgeries Using Lidocaine or Articaine

The effects of epinephrine in local anesthetics on plasma catecholamine and hemodynamic responses

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