Summary
The effects of two different dental local anaesthetic solutions, administered for oral surgery, on the plasma potassium levels of patients taking non-potassium sparing diuretics has been investigated.
There was a significant reduction in plasma potassium concentration in eight subjects who received 4.4 ml of 2% lignocaine with 1:80 000 adrenaline; the mean reduction from baseline being 0.30 mmol·l−1 10 min following intra-oral extravascular injection of the local anaesthetic.
There was no significant difference from the pre-treatment plasma potassium concentration 10 min following similar injections of 3% prilocaine with 0.03 IU·ml−1 fely-pressin in 8 patients; the mean change in these subjects being −0.05 mmol·l−1.
It is suggested that the use of adrenaline-free local anaesthetics would seem to be appropriate in patients receiving kaliuretic diuretics.
Similar content being viewed by others
References
Cawson RA, Curson I, Whittington DR (1983) The hazards of dental local anaesthetics. Br Dent J 154: 253–258
Clausen T, Flatman JA (1980) β2-adrenoreceptors mediate the stimulating effect of adrenaline on active electrogenic Na-K transport in rat soleus muscle. Br J Pharmacol 68: 749–755
D'Silva JL (1934) The action of adrenaline on serum potassium. J Physiol 82: 393–398
Duke M (1978) Thiazide-induced hypokalaemia. Association with acute myocardial infarction and ventricular fibrillation. JAMA 239: 43–45
Dyckner T, Wester PO (1979) Ventricular extrasystoles and intracellular electrolytes before and after potassium and magnesium infusions in patients on diuretic treatment. Am Heart J 97: 12–18
Fisch C (1973) Relation of electrolyte disturbances to cardiac arrhythmias. Circulation 47: 408–419
Heagerty AM (1988) Recent advances in therapy for hypertension. Br J Anaesth 61: 360–364
Hemsley SM (1984) Drug therapy in dental practice. Br Dent J 157: 368
Holland OB, Nixon JV, Kunnert L (1981) Diuretic-induced ventricular ectopic activity. Am J Med 70: 762–768
Kunin AS, Surawicz B, Sims EA (1962) Decrease in serum potassium concentrations and appearance of cardiac arrhythmias during infusion of potassium with glucose in potassium-depleted patients. N Engl J Med 266: 228–233
McGovern B (1985) Hypokalaemia and cardiac arrhythmias. Anesthesiol 63: 127–129
Medical Research Council Working Party on Mild to Moderate Hypertension (1983) Ventricular extrasystoles during thiazide treatment: substudy of MRC mild hypertension trial. Br Med J 287: 1249–1253
Meechan JG, Rawlins MD (1987a) The effect of adrenaline in lignocaine anaesthetic solutions on plasma potassium in healthy volunteers. Eur J Clin Pharmacol 32: 81–83
Meechan JG, Rawlins MD (1987b) A comparison of the effect of two different dental local anaesthetic solutions on plasma potassium concentration. Br Dent J 163: 191–193
Meechan JG, Rawlins MD (1988) The effects of two different dental local anaesthetic solutions on plasma potassium levels during third molar surgery. Oral Surg Oral Med Oral Pathol 66: 650–653
Pick A (1966) Arrhythmias and potassium in man. Am Heart J 72: 295–306
Punnia Moorthy A, Coghlan K, O'Neil R (1984) Drug therapy among dental outpatients. Br Dent J 156: 261
Struthers AD, Reid JL, Whitesmith R, Rodger JL (1983a) Effect of intravenous adrenaline on electrocardiogram, blood pressure and serum potassium. Br Heart J 49: 90–93
Struthers AD, Reid JL, Whitesmith R, Rodger JL (1983b) The effects of cardioselective and non-selective beta adrenoreceptor blockade on the hypokalaemic and cardiovascular response to adrenal medullary hormones in man. Clin Sci 65: 143–147
Struthers AD, Whitesmith R, Reid JL (1983c) Prior thiazide diuretic treatment increases adrenaline-induced hypokalaemia. Lancet 1358–1361
Vincent HH, Veld AJ, Boomsma F, Schalekamp MADH (1985) Prevention of epinephrine-induced hypokalaemia by non-selective β-blockers. Am J Cardiol 56: 10D-14D
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Meechan, J.G., Rawlins, M.D. The effects of two different local anaesthetic solutions administered for oral surgery on plasma potassium levels in patients taking kaliuretic diuretics. Eur J Clin Pharmacol 42, 155–158 (1992). https://doi.org/10.1007/BF00278476
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00278476