Basic and patient-oriented research
Felypressin, but Not Epinephrine, Reduces Myocardial Oxygen Tension After an Injection of Dental Local Anesthetic Solution at Routine Doses

https://doi.org/10.1016/j.joms.2009.07.080Get rights and content

Purpose

The aim of this study was to evaluate the effect of epinephrine (Epi) or felypressin (Fely) contained in dental local anesthetics on myocardial oxygen balance.

Materials and Methods

Male Japanese White tracheotomized rabbits were anesthetized with isoflurane. Three doses of 0.18, 0.36, and 0.72 mL of 2% lidocaine hydrochloride containing 1:80,000 Epi or 3% prilocaine hydrochloride containing Fely 0.03 IU/mL were injected into the rabbit tongue muscle. These doses were equivalent to 2, 4, and 8 of dental local anesthetic cartridges in humans weighing 50 kg by body weight correction, respectively. Heart rate, blood pressure, aortic blood flow, myocardial tissue blood flow, and myocardial tissue oxygen tension were continuously monitored. Data were recorded immediately before and 10, 20, 30, and 60 minutes after the injection.

Results

Heart rate decreased in the Fely group. Systolic blood pressure increased in the Epi group, and diastolic blood pressure increased in both groups. Aortic blood flow and myocardial tissue blood flow increased, whereas myocardial tissue oxygen tension did not change in the Epi group. In contrast, aortic blood flow, myocardial tissue blood flow, and myocardial tissue oxygen tension decreased in the Fely group.

Conclusion

It is suggested that Fely, but not Epi, decreases myocardial oxygen tension and aggravates myocardial oxygen demand/supply balance even after an injection of dental local anesthetic solution at routine doses.

Section snippets

Materials and Methods

All animals received humane care in accordance with the Guidelines for the Treatment of Experimental Animals approved by Tokyo Dental College, Chiba, Japan. Male Japanese White rabbits weighing 2.3 to 2.7 kg were purchased from SLC (Tokyo, Japan). Six rabbits received an intramuscular injection of 2% lidocaine hydrochloride solution containing 1:80,000 Epi (Xylesthesin A; 3M Health Care, Tokyo, Japan) at doses of 0.18 mL (E2 group), 0.36 mL (E4 group), and 0.72 mL (E8 group) into the tongue

Results

HR decreased in the F2, F4, and F8 groups. Systolic blood pressure (SBP) increased in the E4 and E8 groups in a dose-dependent manner. Diastolic blood pressure (DBP) increased in the E4, E8, F4, and F8 groups. Mean arterial pressure increased in the E4 and E8 groups. AoF increased in the E4 and E8 groups in a dose-dependent manner. In contrast, AoF decreased in the F2, F4, and F8 groups in a dose-dependent manner (Table 1).

MBF increased in the E2, E4, and E8 groups in a dose-dependent manner.

Discussion

In the present study, 0.18, 0.36, and 0.72 mL of local anesthetic solutions were injected in the rabbit tongue muscle. These doses were equivalent to 2, 4, and 8 cartridges of a dental local anesthetic solution in humans weighing 50 kg by body weight correction. Two cartridges of a dental local anesthetic solution are frequently used in routine dental practices. In addition, 4 to 8 cartridges are possibly used in oral surgery such as in dental implantation or periodontal surgeries. Therefore,

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    This study was partly supported by a grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

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