Abstract
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-µg (group I), 10-µg (group II), 20-µg (group III), 40-µg (group IV), and 50-µg (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 β2 receptors on sympathetic nerve endings and on the adrenomedulla, and accelerate the release of endogenous epinephrine.
Similar content being viewed by others
References
G Someya (1999) ArticleTitleComplications associated with local anesthesia J Jpn Dent Soc 27 365–73
Y Kubota (1994) ArticleTitleResearches of systemic complications during dental treatment—a review of 30 year footsteps in the Department of Dental Anesthesiology J Oral Med Pathol 61 197–206
S Yoshimura (1983) ArticleTitleThe effects of vasoconstrictors contained in dental local anesthesia J Dental Med 17 109–15
K Sano T Nagoh (1988) ArticleTitleVasoconstrictors in local anesthesia Dental Diamond 23 62–5
M Oohashi K Sano T Kanri (1997) ArticleTitleEffect of local anesthetics and vasoconstrictors on the clearance of 133Xe in human oral mucosa J Jpn Dent Soc 25 451–7
T Nagoh K Sano T Kanri (1998) ArticleTitleA study of localization to local anesthetics. Influence of concentration to epinephrine JSPA 11 3–8
Y Yamatsuta T Kanri (1986) ArticleTitleInfluence of epinephrine on peripheral blood flow J Jpn Dent Soc 17 479–89
J Uehara (1983) ArticleTitleA study on the vasoconstrictors contained in local anesthetics solution. Clinical safety dosage of epinephrine and norepinephrine J Jpn Dent Soc 4 36–57
K Sasaki (1979) ArticleTitleA study on the vasoconstrictors contained in local anesthetics solutions. Clinically safe dosage of epinephrine in essential hypertension J Jpn Dent Soc 7 320–43
M Sakajiri (1987) ArticleTitleThe effects of local dental anesthesia on plasma epinephrine and norepinephrine concentrations and cardiovascular hemodynamics in human beings J Jpn Dent Soc 15 684–706
Y Kaneko (1997) Vasoconstrictors H Furyyama H Matsuura Y Amemiya H Ueda Y Kaneko M Unno (Eds) Dental Anesthesiology EditionNumber5th ed. Ishiyaku Tokyo 182–96
K Aono (1998) ArticleTitleStress responses in surgery, with reference to their mechanism and sympathetic response J Jpn Dent Soc 26 639–51
Z Oota I Nukina (1989) ArticleTitleStress induced analgesia Jpn J Clin Med 47 1206–10
T Ichinohe Y Kaneko T Nakamura (1990) ArticleTitleThe effects of epinephrine on circulation and respiration—investigation with epinephrine infusion technique J Jpn Dent Soc 18 477–97
E Knoll-Kohler A Frine J Becker D Ohledorf (1989) ArticleTitleChanges in Plasma epinephrine concentration after dental infiltration anesthesia with different doses of epinephrine J Dent Res 68 1098–101 Occurrence Handle2808867
M Salonen H Forssell M Schein (1988) ArticleTitleLocal dental anaesthesia with lidocaine and adrenaline. Effects on plasma catecholamine, heart rate and blood pressure Int J Oral Maxillofac Surg 17 392–4 Occurrence Handle10.1016/S0901-5027(88)80071-7 Occurrence Handle3145958
AG Tolas AE Pflug JB Halter (1982) ArticleTitleArterial plasma epinephrine concentrations and hemodynamic responses after dental injection of local anesthtic with epinephrine JADA 14 41–3
WB Barber LE Smith GP Zaloga JR Fletcher D Cook CR Lake B Chernow (1985) ArticleTitleHemodynamic and plasma catecholamine responses to epinephrine-containing perianal lidocaine anesthesia Anesth Analg 64 924–8 Occurrence Handle4025856
M Sakurai (1990) ArticleTitleEffects of epinephrine in local dental anesthetics on plasma catecholamine concentration and circulation Dental Anesthesiol 27 135–9
FW Li (1992) ArticleTitlePlasma catecholamine and hemodynamic responses after dental infiltrative anesthesia and stress-including stimuli Jpn J Psychosom Dentistry 11 149–74
T Toyama S Kobayashi T Matsumura (1992) ArticleTitleThe effects of vasoconstrictor contained in local dental anesthetics on plasma catecholamine and hemodynamics J Okayama Dent Soc 11 149–74
Chernow B, Balestrieri F, Ferguson CD, Terezhalmy GT, Fletcher JR, Lake CR. Local dental anesthesia with epinephrine: minimal effects on the sympathetic nervous system or on hemodynamic variables. Arch Intern Med; 143, 2141–3.
Davenport RE, Porecelli RJ, Iacono VJ, Bonura CF, Mallis GI, Baer PN. Effects of anesthetics containing epinephrine on catecholamine levels during periodontal surgery. J Periodontal; 61:553–8.
K Tsusaki T Nakaki (1995) ArticleTitleEpinephrine LiSA 9 1–19
H Kawasaki T Furuyama (1986) ArticleTitlePharmacology and mechanism of vasotropic factors (Catecholamine) Jpn J Clin Med 44 39–46
H Niwa Y Satoh H Matsuura (2000) ArticleTitleCardiovascular responses to epinephrine-containing local anesthetics for dental use: a comparison of hemodynamic responses to infiltration anesthesia and ergometer-stress testing Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90 171–81 Occurrence Handle10936836
AJ Cunningham M Donnelly A Bourke JF Murphy (1985) ArticleTitleCardiovascular and metabolic effects of cervical epinephrine infiltration Obstet Gynecol 66 93–8 Occurrence Handle4011076
H Furuya H Yagi (1984) ArticleTitleCatecholamine J Jpn Dent Soc 12 596–606
WE Clutter M Dennis SDS Bier EC Philip (1998) ArticleTitleEpinephrine plasma metabolic clearance rates and physiologic thresholds for metabolic and hemodynamic actions in man J Clin Invest 66 94–101
H Mashima (1986) Vasoconstrictors H Mashima (Eds) Physiology EditionNumber18th ed. Bunkoudo Tokyo 416–17
T Sato I Ono Y Miura K Abe K Yoshinaga (1971) ArticleTitleHypertension and catecolamine—mainly about pheochromocytoma and essential hypertension Clinic All-Round 20 1233–44
K Iimura T Ashunaga R Morikawa S Oyanagi Y Hamaue Y Hada I Wakabayashi S Murakami (1971) ArticleTitleAngina pectoris/myocardiac infarction and catecholamine Clinic All-Round 20 1200–10
Y Nakata H Sakurai K Kitamura (1971) ArticleTitleArrythmia and catecholamine receptor Clinic All-Round 20 1211–22
K Taniguchi (1971) ArticleTitleParkinsonism and dopamine Clinic All-Round 20 1189–99
T Tomomatsu (1971) ArticleTitleHemodynamics and catecholamine Clinic All-Round 20 1168–73
H Kawasaki H William JR Cline S Che (1982) ArticleTitleEnhanced presynaptic beta adrenoceptor-mediated modulation of vascular adrenergic neurotransmission in spontaneously hypertensive rats J Pharmacol Exp Ther 223 721–8 Occurrence Handle6128404
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Takahashi, Y., Nakano, M., Sano, K. et al. The effects of epinephrine in local anesthetics on plasma catecholamine and hemodynamic responses. Odontology 93, 72–79 (2005). https://doi.org/10.1007/s10266-005-0044-y
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10266-005-0044-y