Key result
2% lidocaine with epinephrine 1:100,000 increased plasma epinephrine to 592 pg/ml compared to 150 pg/ml with lidocaine alone, but produced no significant cardiovascular response.
Why the study?
Does 2% lidocaine with epinephrine 1:100,000 alter plasma epinephrine levels or cardiovascular responses compared to lidocaine alone in stable cardiovascular disease patients undergoing periodontal surgery?
RCT (n=9)
Double-blind
Does 2% lidocaine with epinephrine 1:100,000 alter plasma epinephrine levels or cardiovascular responses compared to lidocaine alone in stable cardiovascular disease patients undergoing periodontal surgery?
Local dental anesthesia containing epinephrine causes acute elevations in plasma epinephrine but does not produce significant cardiovascular responses, suggesting it can be safely used in stable cardiovascular disease patients.
Answers are grounded in this paper and cite their sources.
Supports safe use of epinephrine-containing lidocaine in stable CVD patients; RCT confirms no hemodynamic effects despite plasma elevation.
Nine stable cardiovascular disease patients were evaluated in a double-blind cross-over trial during periodontal surgery using 2% lidocaine with epinephrine 1:100,000 or lidocaine alone. In the lidocaine with epinephrine group, epinephrine levels increased from 198 +/- 54 pg/ml to 592 +/- 166 pg/ml at 2 minutes post-injection. In the lidocaine alone group, epinephrine levels increased from a baseline of 115 +/- 34 pg/ml to 150 +/- 34 pg/ml at 2 minutes post-injection. Despite these elevations in epinephrine, no significant changes in heart rate or mean arterial pressure were noted. Plain lidocaine provided unsatisfactory levels of hemostasis and/or anesthesia during periodontal surgery. This study documents acute elevations in plasma epinephrine levels following local dental anesthesia for periodontal surgery. These elevations in plasma epinephrine failed to produce a significant cardiovascular response in a group of stable cardiovascular disease patients. This suggests that the cardiac effects of local anesthetics containing epinephrine are small and that they can be safely used in stable cardiovascular disease patients.
No takes yet. Share an insight, caveat, or question.
Davenport et al. (1990) conducted an RCT in Stable cardiovascular disease (n=9). 2% lidocaine with epinephrine vs. Lidocaine alone was evaluated on Epinephrine levels at 2 minutes post-injection. 2% lidocaine with epinephrine 1:100,000 increased plasma epinephrine to 592 pg/ml compared to 150 pg/ml with lidocaine alone, but produced no significant cardiovascular response.
Synapse has enriched 10 related papers. Consider them for comparative context: