Key result
Lidocaine with epinephrine increased circulating epinephrine by 203% and cardiac output by 30% compared to control, while diazepam premedication attenuated the sympathoadrenal response.
Why the study?
Does diazepam premedication and epinephrine-containing local anesthetic affect plasma catecholamine levels and cardiovascular parameters during oral surgery?
Does diazepam premedication and epinephrine-containing local anesthetic affect plasma catecholamine levels and cardiovascular parameters during oral surgery?
Intraoral injections of epinephrine-containing local anesthetics increase circulating epinephrine and cardiac output, while diazepam premedication attenuates the sympathoadrenal response to surgical stress.
May warrant caution with epinephrine-containing anesthetics in cardiac patients; hypothesis-generating for diazepam attenuation.
The effects of diazepam premedication and administration of an epinephrine-containing local anesthetic on plasma catecholamine levels and cardiovascular parameters were evaluated prior to and during a minor surgical procedure, the removal of impacted third molars. Significant elevations in circulating epinephrine levels (203% above control) and cardiac output (30%) were seen in unsedated patients after administration of lidocaine with epinephrine before surgery, while no changes were seen after lidocaine alone. Unsedated patients had increased norepinephrine (24%) and epinephrine (57%) levels during surgery. Diazepam premedication decreased norepinephrine levels 29% below preoperative levels, followed by an increase during surgery to preoperative levels. These results indicate that intraoral injections of epinephrine-containing local anesthetics result in increased circulating epinephrine levels that are associated with cardiovascular changes and that diazepam premedication decreases plasma norepinephrine levels and attenuates the sympathoadrenal response to surgical stress.
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Dionne et al. (1984) studied Removal of impacted third molars. Diazepam premedication and lidocaine with epinephrine vs. No sedation and lidocaine alone was evaluated on Plasma catecholamine levels and cardiovascular parameters. Lidocaine with epinephrine increased circulating epinephrine by 203% and cardiac output by 30% compared to control, while diazepam premedication attenuated the sympathoadrenal response.
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