Advertisement

Odontology

, Volume 107, Issue 1, pp 29–36 | Cite as

Impact of dexmedetomidine on the tissue distribution, anesthetic action, and hemodynamic effects of mepivacaine

  • Yuri YasudaEmail author
  • Shuichi Hashimoto
  • Katsuhisa Sunada
Original Article
  • 63 Downloads

Abstract

The present study investigated the regional blood flow, tissue distribution, local anesthetic action, and hemodynamic effects of mepivacaine containing dexmedetomidine hydrochloride (DEX) in rats. Blood flow was measured after injection of 0.5% mepivacaine (M group), 12.5 µg/ml DEX (D group), or 0.5% mepivacaine containing 12.5 µg/ml DEX (DM group) into the upper lip. Mepivacaine distribution was autoradiographically observed in maxillary bone resected after injection of 0.5% 3H-mepivacaine (HM group) or 0.5% 3H-mepivacaine containing 12.5 µg/ml DEX (DHM group) into the palatal mucosa adjacent to the right maxillary first molar. Radioactivity was also measured using a liquid scintillation counter. SEP were measured to analyze anesthetic action. Blood pressure and heart rate were measured to compare hemodynamic effect. The addition of DEX significantly decreased blood flow compared to M group from 10 to 60 min after injection. The addition of DEX significantly increased the amount of radioactivity compared to HM group in the palatal mucosa from 5 to 60 min after injection and in the body of the maxilla from 2 to 60 min after injection. Maximum blood radioactivity was measured at 5 min after injection in HM group and 50 min after injection in DHM group. The addition of DEX significantly decreased peak-to-peak amplitudes compared to M group until 60 min after injection. No significant hemodynamic differences were observed. DEX enhances the action of mepivacaine in reducing regional blood flow prolongs its tissue retention, and increases the local anesthetic action without affecting hemodynamics on local administration.

Keywords

Dexmedetomidine Mepivacaine Vasoconstriction Ischemic heart disease and hypertension Pharmacokinetics 

Notes

Acknowledgements

The support of the research staff at both the Department of Dental Anesthesiology, The Nippon Dental University School of life Dentistry at Tokyo and Section of Radioisotope Research, Center of Odontology, The Nippon Dental University School of Life Dentistry at Tokyo is gratefully acknowledged.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Abraham-Inpijn L, Borgmeijer-Hoelen A, Gortzak RA. Changes in blood pressure, heart rate, and electrocardiogram during dental treatment with use of local anesthesia. J Am Dent Assoc. 1988;116(4):531–6.CrossRefGoogle Scholar
  2. 2.
    Meiller TF, Overholser CD, Kutcher MJ. Bennett R. Blood pressure fluctuations in hypertensive patients during oral surgery. J Oral Maxillofac Surg. 1983;41(11):715–8.CrossRefGoogle Scholar
  3. 3.
    Inagawa M, Ichinohe T, Kaneko Y. Felypressin, but not epinephrine, reduces myocardial oxygen tension after an injection of dental local anesthetic solution at routine doses. J Oral Maxillofac Surg. 2010;68(5):1013–7.CrossRefGoogle Scholar
  4. 4.
    Miyachi K, Ichinohe T, Kaneko Y. Effects of local injection of prilocaine-felypressin on the myocardial oxygen balance in dogs. Eur J Oral Sci. 2003;114:339 – 45.CrossRefGoogle Scholar
  5. 5.
    Kasahara M, Ichinohe T, Kaneko Y. Adenosine and amrinone revers felypressin-induced depression of myocardial tissue oxygen tension in dogs. Can J Anaesth. 2000;47(11):1107–13.CrossRefGoogle Scholar
  6. 6.
    Agata H, Ichinohe T, et al. Felypressin-induced reduction in coronary blood flow and myocardial tissue oxygen tension during anesthesia in dogs. Can J Anaesth. 1999;46:1070–5.CrossRefGoogle Scholar
  7. 7.
    Vanderheyden PJ, Williams RA, Sims TN. Assessment of ST segment depression in patients with cardiac disease after local anesthesia. J Am Dent Assoc. 1989;119(3):407 – 12.CrossRefGoogle Scholar
  8. 8.
    Yoshimura Y, Kishimoto H, Sugihara T. Myocardial ischemia and tooth extractions: comparison of old myocardial infarction, angina pectoris, and non-specific ischemic heart disease. Int J Oral Surg. 1982;11(5):331–5.CrossRefGoogle Scholar
  9. 9.
    Yoshitomi T, Kohjitani A, Maeda S, et al. Dexmedetomidine enhances the local aneathetic action of lidocaine Via anα2A adrenoceptor. Anesth Analg. 2008;107:96.CrossRefGoogle Scholar
  10. 10.
    Akimoto T, Shuichi, Hashimoto. Katsuhisa Sunada. Dexmedetomidine(12.5 µg/ml) improves tissue distribution, anesthetic action, and hemodynamic effects of lidocaine after palatal infiltration in rats. Odontology. 2015; 22.Google Scholar
  11. 11.
    Dhuner KG, Lewis DH. Effect of local anaesthetics and vasoconstrictors upon regional blood flow. Acta Anaesth Scand (Suppl). 1966;23:347–52.CrossRefGoogle Scholar
  12. 12.
    Yamashiro M, Hashimoto S, Yasuda A, Sunada K. Epinephrine affects pharmacokinetics of Ropivacaine infiltrated into palate. Anesth Prog. 2016;63:71–9.CrossRefGoogle Scholar
  13. 13.
    Shuichi, Hashimoto, et al. efects of epinephrine on lidocaine pharmacokinetics and blood volume in the dental pulp. J Endod. 2014;40:1370–4.CrossRefGoogle Scholar
  14. 14.
    Kimi H, Yamashiro M, Hashimoto S. The local pharmacokinetics of 3H-ropivacaine and 14C-lidocaine after maxillary infiltration anesthesia in rats. Anesth Prog. 2012;59:75–81.CrossRefGoogle Scholar
  15. 15.
    Katz J. The distribution of 14C-labelled lidocaine injected intravenously in the rat. Anesthesiology. 1968;29(2):249–53.CrossRefGoogle Scholar
  16. 16.
    Lakhlani PP, MacMillan LB, Guo TZ, et al. Substitution of a mutant alpha2a-adrenergic receptor via “hit and run”gene targeting reveals the role of this subtype in sedative, analgesic, and anesthetic-sparing responses in vivo. Proc Natl Acad Sci USA. 1997;94(18):9950–5.CrossRefGoogle Scholar
  17. 17.
    Link RE, Desai K, Hein L, Stevens ME, Chruscinski A, Bernstein D, Barsh GS. Kobilka BK. Cardiovascular regulation in mice lacking alpha2-adrenergic receptor subtypes b and c. Science. 1996;273(5276):803–5.CrossRefGoogle Scholar
  18. 18.
    Memiş D, Turan A, Karamanlioğlu B, Pamukçu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg. 2004;98(3):835 – 40.CrossRefGoogle Scholar
  19. 19.
    Masuki S, Dinenno FA, Joyner MJ, Eisenach JH. Selective alpha2-adrenergic properties of dexmedetomidine over clonidine in the human forearm. J Appl Physiol. 2005;99(2):587–92.CrossRefGoogle Scholar
  20. 20.
    Hamamoto M, Morita K. Dohi T. Reduction of local circulation and the mechanisms of blood vessel contraction by local anesthesia. J Hiroshima Univ Dent Soc. 2006;38:30–7.Google Scholar
  21. 21.
    Kamm KE. Stull JT:The function of myosin and myosin light chain kinase phosphorylation in smooth muscle. Annu Rev Pharmacol Toxicol. 1985;25:593–620.CrossRefGoogle Scholar
  22. 22.
    Mitruka BM, Rawnsley HM. Clinical Biochemical and Haematological Reference Values in Normal Experimental Animals. Masson Publishing, New York; 1977.Google Scholar
  23. 23.
    Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effect of increasing plasma concentration of dexmedetomidine in humans. Anesthesiology. 2000;93:382–94.CrossRefGoogle Scholar

Copyright information

© The Society of The Nippon Dental University 2018

Authors and Affiliations

  1. 1.Department of Dental AnesthesiologyThe Nippon Dental University School of Life Dentistry at TokyoTokyoJapan
  2. 2.The Nippon Dental University School of Life Dentistry at TokyoTokyoJapan

Personalised recommendations