Efficacy of lignocaine with clonidine and adrenaline in minor oral surgical procedure

Use of vasoconstrictors in local anaesthesia is well known. The study was done on 30 patients who underwent removal of bilateral impacted third molars. The aim of the study was to compare the efficacy of lignocaine with clonidine and lignocaine with adrenaline in respect to onset, duration of anaesthesia, and postoperative analgesia along with hemodynamic stability (systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate in intraoral nerve block. The patients were randomly selected of both sexes (male and female) between the age group of 18-40 years. Patients received 2 mL of 2% lignocaine with adrenaline (12.5 μg/mL) on one side and 2 mL of 2% lignocaine with clonidine (15 μg/mL) on the other side at two different appointments. 2 millilitres of drug was administered in both the test group and the control group. Statistically there was significant decrease in intraoperative and postoperative systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate in the lignocaine with clonidine group. The efficacy of clonidine based on visual analog scale was similar to adrenaline. No significant operative complications were observed.     

A clinico-pharmacologic study of intraseptal spongiosa dental anesthesia with lidocaine and with/without adrenaline

Intraseptal anesthesia of the maxillary lateral incisor with a 2% lidocain solution with and without epinephrine was studied in 22 examinations of electric sensitivity of the teeth. Addition of epinephrine was conducive to an increase of the depth, frequency, length, and dissemination of pulpal anesthesia and to elimination of undesirable reactions.     

Hyperresponders and adrenaline in local anaesthetic solutions.

The presence of adrenaline in local anaesthetic solutions may cause disturbing systemic reactions in some patients. Putative allergies of 532 patients to local anaesthetics were investigated over a 15-year period in a clinic and 163 patients were found to experience these reactions, of whom 99% were female. Only 17 of these patients took drugs for the treatment of cardiovascular diseases; 11 of them were on thyroid replacement therapy. Practitioners should be careful not to attribute these systemic reactions to an allergic drug response. Furthermore, the medical history and drug intake of patients must be revised regularly.     

The effects of adrenaline on lignocaine nerve block anaesthesia

In experiments on rat sciatic nerves, the addition of adrenaline to lignocaine solution improved both the duration and depth of nerve block anaesthesia. Plain lignocaine solution sometimes failed to induce a satisfactory degree of nerve block.     

心血管病患者拔牙阿替卡因肾上腺素局麻临床效果观察

目的 比较局部麻醉剂阿替卡因肾上腺素和利多卡因用于老年心血管疾病患者拔牙时,对患者血压和心率等变化的影响,探寻阿替卡因肾上腺素用于老年心血管疾病患者拔牙的安全性.方法 本研究包括 228 例老年心血管疾病患者的 239 颗牙齿,随机分组为阿替卡因肾上腺素组(实验组)和利多卡因组(对照组),分别记录麻醉注射前3min,麻醉注射即刻,麻醉注射后3min、拔牙手术中、拔牙手术后3min患者的血压、心率.对数据进行统计分析.结果 与利多卡因相比,阿替卡因肾上腺素在麻醉注射即刻、拔牙手术中心率明显加快,差异具有统计学意义(P<0.05).在麻醉注射后3min收缩压升高,差异具有统计学意义(P<0.05).在任何时点舒张压均无明显升高.两组在麻醉注射后、拔牙手术后血压、心率均回复到麻醉注射前水平.结论 局部麻醉剂阿替卡因肾上腺素对无心动过速、经过全身系统治疗的、病情稳定的心血管疾病患者拔牙是安全可行的.     

Multi-mode in situ spectroelectrochemical studies of redox pathways of adrenaline

The electrochemical oxidation–reduction processes of adrenaline were studied by multi-mode in situ spectroelectrochemistry involving thin-layer cyclic voltammetry, UV–vis absorption, fluorescence spectroelectrochemistry and electrogenerated chemiluminescence based on a versatile long path-length thin-layer electrochemical cell with a glassy carbon working electrode. It was found that the redox pathways were related to the pH of the solution, the potential window and the oxygen dissolved in the solution. A mechanism was proposed for the redox process under different conditions. Furthermore, the reaction pathway for the electrooxidation of adrenaline was compared with the pathway for the permanganate oxidation of adrenaline, and a possible reason for the fact that the electrooxidation of adrenaline cannot generate chemiluminescence was proposed.     

Influence of adrenaline on the onset time of lignocaine anaesthesia

Rat sciatic nerves were employed to investigate the influence of adrenaline on the onset time for anaesthetic blockade induced by 2 per cent lignocaine HCl. The addition of adrenaline at three concentration levels to 2 per cent lignocaine HCl solutions delayed the onset time for conduction blockade.     

Action of adrenaline on the effect of dental local anaesthetic Solutions

Abstract This study investigated the effects of dental local anaesthetic solutions containing either 2% plain lignocaine or 2% lignocaine with 1:80,000 adrenaline. The duration of anaesthesia and the occurrence of a reduction in blood flow together with its duration were examined in the dental pulps of maxillary central incisor teeth in 10 human subjects. The local anaesthetic solution was injected into the soft tissues adjacent to the apex of the sound maxillary incisor tooth. The blood flow in the dental pulp was assessed by a laser Doppler flowmeter, and the effectiveness of pulpal anaesthesia was determined by an electric pulp tester, both at timed intervals. The injection of 1–2 ml of 2% plain lignocaine had no significant effect on blood flow in the pulp of the incisor tooth in eight of 10 subjects. In the other two, there was a small but significant increase. The duration of pulpal anaesthesia was 25.1 min (SD 6.23). Following injection of 1 ml of 2% lignocaine with 1:80,000 adrenaline, there was a significant reduction (31%) of pulpal blood flow in every subject (p<0.05). The duration of reduced blood flow was 68.5 min (SD 9.73). The duration of pulpal anaesthesia was 100 min (SD 15.09), four times the duration of anaesthesia induced by plain lignocaine. The anaesthetic solution with vasoconstrictor produced far longer anaesthesia more consistently at a lower dose than the plain solution.     

Local dental anaesthesia with lidocaine and adrenaline. Effects on plasma catecholamines, heart rate and blood pressure

5 volunteers took part in this double-blind, cross-over study to evaluate the role of adrenaline 1:80,000 in lidocaine used in dental local anaesthesia on haemodynamics and the concentrations of catecholamines and their metabolites in plasma. The exogenous adrenaline statistically significantly elevated the heart rate (from 66 +/- 7 to 79 +/- 9 bpm), but did not affect systolic or diastolic blood pressure. Plasma adrenaline concentrations were increased more than 10-fold (from 0.02 +/- 0.02 to 1.0 +/- 0.3 nmol/l). We conclude that the adrenaline present in the local anaesthetic is a major source of adrenergic activation during minor oral surgery.     

The effects of adrenaline on lignocaine anaesthesia of the isolated nerve

The improvement of depth and duration of local anaesthesia by the addition of adrenaline is usually attributed to the effective localization of the anaesthetic by local vasoconstriction.

To examine the possibility that adrenaline acts upon nerves and enhances the blockade induced by lignocaine, isolated rat sciatic nerves were exposed to plain lignocaine hydrochloride solution or lignocaine with 1 : 50 000 adrenaline. No differences in the degree of block were identified.     

Cardiohaemodynamic and plasma level responses to intraoral submucosal injection of adrenaline.

Since knowledge of the bioavailability of adrenaline from the intraoral submucosal depot is a prerequisite for its safe use in dentistry, the time-dependent effects of adrenaline on the plasma adrenaline level and cardiohaemodynamic parameters were studied with invasive methods in adrenalectomized, anaesthetized rats after injection of adrenaline (4.0 micrograms/kg body wt) into the mucobuccal fold lateral to the upper right incisor. The absolute bioavailability of adrenaline from this intraoral submucosal depot was 16.8 per cent. Peak values for arterial plasma adrenaline and arterial blood pressure, maximal rate of rise of pressure in the left ventricle and heart rate were measured as early as 5 s after an injection period of 10 s. The different velocities at which the individual parameters returned to the basal state showed that the measurement of heart rate is an insensitive indicator of systemic adrenaline. Due to the absorption kinetics of adrenaline from intraoral tissue it may be concluded that the method of injection has a decisive influence on arterial adrenaline concentration and thus on cardiovascular response.     

A comparative study between 0.5% centbucridine HCl and 2% lignocaine HCl with adrenaline (1:2,00,000)

Even today the ability to provide the patient with clinically adequate pain control with minimum systemic side effects is one of the major concerns all over the world. Lignocaine, the most commonly used local anesthetic agent in oral surgery due to its rapid onset & reasonably good potency, does not have adequate duration of action, unless used with Adrenaline, a drug known for its cardiovascular effects. Centbucridine, a non-ester, non-amide group local anesthetic agent developed in India at C D R I Lucknow, has advantage of inherent vasoconstrictor property. This study was planned to compare 0.5% Centbucridine and 2% Lignocaine with Adrenaline, in exodontia patients. The results were recorded for their efficacy and C V S action and statistically analyzed. Centbucridine was found to be an ideal local anesthetic agent with no effects on cardiovascular parameters and exhibiting a sufficient degree of local anesthetic activity suitable for use in routine minor surgery cases. This will be advantageous where Adrenaline is absolutely contraindicated due to systemic problems.     

Effects of adrenaline on circulatory dynamics and cardiac function in rats administered chlorpromazine

We aimed to elucidate changes in circulatory dynamics and cardiac function during concomitant use of chlorpromazine (CPZ) and adrenaline (AD). An arterial line and left intraventricular pressure–volume measurement catheter were inserted in rats. CPZ 10 mg/kg was administered to the left great adductor muscle, followed by normal saline (NS) or AD 50 μg/kg through the tongue 20 min later. End-diastolic volume (V _ed), end-systolic pressure (P _es), stroke volume (SV), stroke work (SW), end-systolic volume elastance (E _es), systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were measured. Following AD administration, V _ed significantly decreased at 2–4 and 10 min than that in control rats; P _es significantly decreased at 1 min; E _es significantly increased from 2 to 10 min; SV did not change significantly, and SW significantly reduced at 1 and 2 min; SBP and DBP were lower at 1–3 min than in the control; and PR increased at 10 min. These findings suggest that when AD-containing local anesthetics are administered during dental treatment of patients taking CPZ, there is a risk of a temporary drop in blood pressure. However, the blood pressure is recovered a few minutes later by the increase in afterload and the myocardial contractile force.