Pharmacodynamic responses of exogenous epinephrine during mandibular third molar surgery

Abstract

Background:The systemic effects attributable to the injection of dental local anesthetic solutions have been the subject of discussion for many years.Aim and Objective:The aim of the present study was to investigate the biochemical and hemodynamic effects of adrenaline in lignocaine local anesthetic solutions when used in clinical doses in patients undergoing third molar surgery under general anesthesia.Materials and Methods:Of the total 30 patients, 15 were given local anesthetic solution containing adrenaline and the other 15 were given the same without adrenaline. Hemodynamic and biochemical parameters were recorded at considerable intervals. The changes from the pre-local anesthetic (baseline) values with each treatment were compared by analysis of variance and Student's t-test. The changes within each treatment were compared by the paired t-test.Results and Conclusion:This study shows that exogenous adrenaline administration in clinical doses produces systemic effects even in conditions where the endogenous release of the catecholamines would be expected to be considerable.

Epinephrine-induced lactic acidosis in orthognathic surgery: a report of two cases

“…Epinephrine is the main vasoconstrictor used in dental practice today123. In commonly used dental cartridges, the concentration of epinephrine varies from 1:50,000 (20 µg/mL) to 1:200,000 (5 µg/mL)2.…”

“…Epinephrine delays the absorption of local anesthetics, which have vasodilating properties and rapid diffusing action. It also controls bleeding at incision sites and produces preemptive analgesia1237.…”

“…The use of a local anesthetic in conjunction with a vasoconstrictor is the most effective means of reducing blood loss in these procedures. Epinephrine is the most commonly used vasoconstrictor123. This drug not only provides hemostasis, but also improves the depth and duration of anesthesia along with a reduction of systemic toxic effects in local infiltration anesthesia2.…”

Análise da variabilidade da frequência cardíaca (VFC), cortisol e alfa amilase em cirurgias de exodontia de terceiros molares inferiores

“…O estudo de Liau et al (2008) (Sivanmalai et al, 2012). Alguns autores sugerem que o aumento na FC e alterações na PA durante procedimentos odontológicos resultariam da liberação de catecolaminas endógenas do estresse emocional (Hondrum, 1985;Meyer, 1987); outros, entretanto, consideraram a resposta cardiovascular apresentada ser influenciada pela ação farmacológica do anestésico local (Tolas et al,1982;Meechan et al, 2002).…”