Unintentional hypotension from lidocaine infiltration during orthognathic surgery and general anaesthesia

Abstract

Lidocaine induced dose-dependent arterial hypotension when combined with a defined level of general anaesthesia. The causative mechanism is unclear.

Local anesthesia for functional endoscopic sinus surgery employing small volumes of epinephrine‐containing solutions of lidocaine produces profound hypotension

“…Enlund et al have reported lidocaine combined with epinephrine might induce dose‐dependent hypotension when combined with a defined level of general anesthesia, but they attributed the reason to the effect of lidocaine (10). However, we believe the infiltration of low‐dose epinephrine elicits hypotension, which was also reported by Anderhuber et al (11) during FESS.…”

Marked Hypotension Induced by Adrenaline Contained in Local Anesthetic

“…Local anesthetics are known to produce vasodilation in concentrations used clinically by their direct effect on the smooth muscles of vessel walls, with cocaine being the only exception 15,16 . Enlund et al 17 have reported that lidocaine may induce dose‐dependent arterial hypotension when combined with a defined level of general anesthesia. However, only 40 mg lignocaine was used in our study, and it affected BP only to a small degree.…”

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

“…In a study with higher doses of lidocaine and epinephrine, we also noted unintentional hypotension after submucosal infiltration in conjunction with deep general anesthesia (2). However, the blood pressure reaction was less pronounced, and our conclusion was that the hypotensive reaction was due to lidocaine.…”