Epinephrine and local anesthesia revisited.

@article{Brown2005EpinephrineAL,
  title={Epinephrine and local anesthesia revisited.},
  author={Ronald S. Brown and Nelson L. Rhodus},
  journal={Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics},
  year={2005},
  volume={100 4},
  pages={
          401-8
        }
}
  • R. Brown, N. Rhodus
  • Published 2005
  • Medicine
  • Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics
The issue concerning how much and under what circumstances epinephrine vasoconstriction within dental local anesthesia is appropriate has been strenuously debated over the last 50 years. Because relevant human and animal studies are difficult to perform, there are, at present, insufficient data to answer many of our questions.Many of the previous conclusions regarding safety and efficacy were based upon incomplete understanding, bias, and limited scientific and clinical data. Well designed… Expand

Paper Mentions

Interventional Clinical Trial
Patients with cardiac channelopathies needing restorative dental treatment will be included in two sessions of the study, using local dental anesthetic: lidocaine 2% with epinephrine… Expand
ConditionsBrugada Syndrome, Channelopathies, Long QT Syndrome, (+1 more)
InterventionProcedure
Clinical evaluation of different epinephrine concentrations for local dental anesthesia
TLDR
Considering the volume used in this study, decreased epinephrine concentration on lidocaine solution has not affected its clinical efficacy and has not influenced cardiovascular parameters. Expand
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TLDR
A200 is considered safer than L80 and A100 and is recommended for LA before teeth extraction in normal patient, and the changings of DBP, HR and SpO2 after anesthesia and extraction showed no significant difference among the three groups. Expand
Effect of different epinephrine concentrations on local bleeding and hemodynamics during dermatologic surgery.
TLDR
It is concluded that, for local anesthesia, the rate of intraoperative bleeding is influenced by epinephrine concentration, and that 1:50,000Epinephrine provides optimal clinical efficacy for the local bleeding control during dermatologic surgery. Expand
Glucose levels and hemodynamic changes in patients submitted to routine dental treatment with and without local anesthesia
TLDR
Hemodynamic parameters, including systolicBlood pressure, diastolic blood pressure, heart rate, and glucose levels, did not change significantly in healthy patients, regardless of whether a LAVA was administered during the dental treatment. Expand
Hypoperfusion in response to epinephrine in local anaesthetics: Investigation of dependence on epinephrine concentration, spread of hypoperfusion and time to maximal cutaneous vasoconstriction.
TLDR
Local anaesthetic with an epinephrine concentration of approximately 10 μg/ml appears to be adequate for vasoconstriction before surgery, and must be clinically assessed before being considered for infiltration anaesthesia during plastic surgery procedures. Expand
Difference in the Effects of Lidocaine With Epinephrine and Prilocaine With Felypressin on the Autonomic Nervous System During Extraction of the Impacted Mandibular Third Molar: A Randomized Controlled Trial.
TLDR
Investigating the differences in the influence of 2 different local anesthetic preparations on the autonomic nervous system during extraction of the mandibular third molar found changes in circulatory dynamics during tooth extraction were the result of a decrease in parasympathetic nervous activity with lidocaine-epinephrine and an increase in sympathetic nervous Activity with prilocaine -felypressin. Expand
MEDICAL MANAGEMENT AND PHARMACOLOGY UPDATE
TLDR
The management of patients with malignant hyperthermia in the oral and maxillofacial surgery setting and the recent advances in the field of MH are presented. Expand
Beta-adrenergic blocking agents and dental vasoconstrictors.
A clinically significant interaction between epinephrine or levonordefrin with nonselective beta-adrenergic blocking agents, although apparently rare in the dental setting, is potentially serious andExpand
Local anesthetics in dentistry
TLDR
The aim of this chapter will be to introduce the basic pharmacology of local anesthetic agents and to familiarize the reader with the variety of drugs currently available on the market, their unique properties, and potential risks and complications associated with their use. Expand
Hemodynamic Effects of Local Anesthesia and its Possible Correlation with Chromogranin A
TLDR
It was shown that there was significant inverse correlation between systolic blood pressure and chromogranin A levels(p < 0.05) after administration of infiltrations local anesthesia during dental treatments (tooth extraction). Expand
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The use of vasoconstrictors in local anesthetics, as topical hemostatic agents, and in gingival retraction cord, remains controversial although data exists from which to formulate reasonableExpand
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TLDR
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TLDR
The results suggest that cardiac function of dental patients on beta-blocker therapy can be adversely affected by epinephrine-containing local anesthetics, and when such an anesthetic solution has to be used in patients on Beta-blockers, careful systemic monitoring is needed. Expand
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TLDR
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TLDR
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TLDR
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TLDR
Lidocaine-epinephrine was safe and had few, if any, hemodynamic consequences in patients with cardiovascular disease and there were no significant differences in hemodynamic responses related to the extent of the cardiac functional capacity. Expand
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