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PubMed2002

Effects of vasoconstrictors used in local anesthesia upon isolated rat heart.

Some reports have demonstrated that the vasoconstrictor effect of catecholamines may be amplified by felypressin. Thus, the association of felypressin and epinephrine with local anesthetics may be indicated to achieve more effective vasoconstrictor actions with fewer collateral effects from both the anesthetic and the vasoconstrictor. This study aimed to characterize the effects of felypressin and associations of felypressin and epinephrine upon the contraction force and the cardiac rate of the isolated rat heart (n=20) perfused by Langendorff's method. The following solutions were utilized: epinephrine, 4.5nmol; felypressin at doses of 0.5, 1.6 and 5.5IU and associations of felypressin at the same doses with 4.5nmol epinephrine. Contraction force and cardiac rate were recorded at 15, 30, 60 and 120s after the administration of each solution, and before the administration, a control measurement (time 0) was taken. Felypressin at a dose of 0.5IU did not have any effect upon the heart, but the doses of 1.6 and 5.5IU decreases the cardiac rate and the contraction force, respectively. Epinephrine and all of the felypressin and epinephrine associations produced increases in these parameters. The association of 0.5IU felypressin and 4.5nmol epinephrine promoted a similar effect to that of epinephrine (4.5nmol) alone up to 120s. The association of 1.6IU felypressin and 4.5nmol epinephrine increases the contraction force up to 60s. After the administration of the association of 5.5IU felypressin and 4.5nmol epinephrine this increase was observed up to just 30s. The cardiac rate values obtained after the administration of the associations of 1.6 and 5.5IU felypressin with 4.5nmol epinephrine were lower than those seen after the use of 4.5nmol epinephrine alone. In this study it was observed that the association of felypressin with epinephrine decreased the effects of epinephrine which increases the cardiac rate and the contraction force in the isolated rat heart.

Anesthetics, Local↗
PubMed1988

Local anaesthetic with vasoconstrictor combinations in septal surgery.

Local anaesthetic with vasoconstrictor combinations are often used to reduce bleeding and hence improve the operating field in septal surgery. Two commonly used combinations are lignocaine with adrenaline and prilocaine with felypressin (citanest with octapressin). Most surgeons prefer to use lignocaine with adrenaline but because of the risks of cardiac dysrhythmias when used with halothane anaesthetists prefer prilocaine with felypressin. In a trial with lignocaine 2 per cent and adrenaline 1 in 200,000 against prilocaine 3 per cent and felypressin 0.03 international units/ml in 18 patients undergoing septal surgery with local anaesthesia alone there was significantly less blood loss in the lignocaine with adrenaline group, p less than 0.01. The mean blood loss in the adrenaline group was 7.5 ml. and 32.7 ml. with felypressin. Both combinations were equally effective in producing adequate local anaesthesia. It is concluded that lignocaine with adrenaline is superior to prilocaine with felypressin in achieving a dry operating field in septal surgery under local anaesthesia.

Anesthetics, Local↗
PubMed1991

Postoperative pain experience after gingivectomies using different combinations of local anaesthetic agents and periodontal dressings.

The present study examines postoperative pain experience following 243 gingivectomies in Norwegian patients using possible combinations of 3 local anaesthetics (lidocaine-adrenalin, prilocaine-felypressin or mepivacaine) and 3 periodontal dressings (Coe-pak, Wondrpak or Nobetec). When Coe-pak was used, the mean pain score was higher (P less than 0.05) in the group treated with lidocaine-adrenalin 4 to 6 h after gingivectomy than the groups treated with prilocaine-felypressin or mepivacaine. There was no significant difference between the groups treated with prilocaine-felypressin or mepivacaine. When Wondrpak or Nobetec were used, there was no significant difference between any of the local anaesthetics used. The present finding shows that the local anaesthetic combination of lidocaine-adrenalin (1:80,000) gives rise to a higher mean postoperative pain experience after gingivectomy than prilocaine-felypressin or mepivacaine. However, the relative difference in pain experience seen after gingivectomy when using the present local anaesthetic agents is masked when using an eugenol-containing periodontal dressing. Thus, the higher pain experience reported after lidocaine-adrenalin may only be clinically important when using periodontal dressings without local anaesthetic components such as eugenol.

Adult↗
PubMed1996

Effects of prilocaine local anaesthetic solutions on pulpal blood flow in maxillary canines.

The effects of prilocaine local anaesthetic solutions on pulpal blood flow (PBF) in maxillary canines were investigated in nine adult subjects. Buccal infiltration of 2 ml of the following solutions were carried out: 3% prilocaine; 3% prilocaine with 0.03 IU/ml felypressin; and 3% prilocaine with 1:100,000 adrenaline. Blood flow in the anaesthetized tooth was monitored by a laser Doppler flowmeter and data stored in a computer. An electric pulp tester was used to assess pulpal anaesthesia. The duration of anaesthesia was recorded. After administration of plain prilocaine, PBF changed little throughout the experiment in all nine subjects. When prilocaine with felypressin was injected. PBF fluctuated greatly, but there was no sustained increase or decrease. In comparison, prilocaine with adrenaline caused a significant decline in PBF in every subject (p < 0.05), but then gradually started to return to the pre-injection level: there was no such change in PBF of the contralateral tooth. Injection of 3% plain prilocaine achieved a short duration of pulpal anaesthesia (median 7 min) in only three subjects. When prilocaine with felypressin was injected, eight out of nine subjects experienced pulpal anaesthesia (median duration 10.5 min). Injection of prilocaine with adrenaline caused pulpal anaesthesia in six of nine subjects (median duration 10.5 min). The use of vasoconstrictors with prilocaine anaesthetics had less pronounced effects on blood flow and shorter periods of anaesthesia than those reported previously for lignocaine with adrenaline.

Adult↗
PubMed1978

The use of mixtures of octapressin and adrenaline in local anaesthetic solutions to obtain more effective vasoconstriction.

The synergistic effects of felypressin with adrenaline have been studied using the isolated central artery of the rabbit ear as a vascular model. Sub-constrictor doses of felypressin were shown to increase adrenaline's vasoconstrictor effect on this vessel. It is therefore suggested that a mixture of felypressin and adrenaline be used in local anaesthetic solutions in order to provide more effective vasoconstriction.

Anesthetics, Local↗
PubMed1990

Local anaesthesia in elderly patients. An experimental study of oral infiltration anaesthesia.

The proportion of elderly people is increasing. Normal ageing causes a reduced physiological capacity and ability to meet challenges. In future more elderly people will have functioning natural dentitions and undergo routine dental procedures for which local anaesthesia is required. In this experimental investigation the effect of infiltration anaesthesia from 3 commonly used agents was compared in healthy elderly and young subjects. The subjects comprised 40 volunteers and the anaesthetic agents tested were lidocaine (20 mg/ml) with epinephrine (12.5 micrograms/ml), prilocaine (30 mg/ml) with felypressin (0.54 microgram/ml) and mepivacaine (30 mg/ml). The elderly subjects had a highly significantly shorter onset time compared to the young group. There was no statistically significant difference in duration of tooth anaesthesia between lidocaine with epinephrine and prilocaine with felypressin. Because elderly people have lower drug tolerance, prilocaine with felypressin is therefore recommended for routine dentistry.

Adolescent↗
PubMed1991

Vasoconstrictors in facial plastic surgery.

The effectiveness of local anesthetics is improved by the addition of a vasoconstrictor with an increased duration of action and the ability to decrease both systemic toxic reactions and local bleeding. Epinephrine, the standard drug for vasoconstriction, has some limitations due to potential cardiac and local toxic effects. Using an animal model, we compared the effects of various concentrations of epinephrine and two other vasoconstrictors, phenylephrine hydrochloride and felypressin, on local blood flow. We also examined the local effects of bupivacaine hydrochloride and ropivacaine hydrochloride, a new local anesthetic. We found that felypressin was as effective a vasoconstrictor as epinephrine, with fewer potential toxic reactions. Phenylephrine (Neo-Synephrine), on the other hand, was less effective, with a shorter duration of action. As expected, bupivacaine produced vasodilation, while ropivacaine was found to have vasoconstrictive properties.

Amides↗
PubMed1976

Inhibition of the adrenalectomy-induced increase in plasma renin concentration by vasoconstrictor agents in rats.

Plasma renin concentrations in rats increase after bilateral adrenalectomy without sodium substitution. The effects of i.v. infused (asp1-beta-amid, val5)-angiotensin II (1 mug/kg min), felypressin (phen2, lys8-vasopressin) (40 mU/kg min) and phenylephrine (30 mug/kg min) were investigated on the increase in plasma renin concentration. These effects of the agents were compared with their actions on blood pressure, heart rate and renal hemodynamics. In rats with destroyed macula densa cells the effect of bilateral adrenalectomy without sodium substitution was also studied. Adrenalectomy still increased the plasma renin concentration. Angiotensin II and felypressin, also depressed under these conditions the elevation of plasma renin concentration caused by adrenalectomy. The mechanism of the adrenalectomy-induced renin release and its suppression by vasoconstrictor agents is discussed.

Adrenalectomy↗
PubMed1985

Reduction of vagal pressor reflexes by neurohypophyseal peptides and related compounds.

The effects of intracisternal injections of [Lys8]vasopressin and [Arg8]vasopressin (25, 50, 100, 200 mU/kg) and related compounds oxytocin (25, 50, 100, 200 mU/kg), felypressin (25, 50, 100, 200 mU/kg) and vasotocin (100, 200, 400, 800 ng/kg) on the acute neurogenic pressor responses to afferent vagal stimulation (5, 10, 20 and 30 Hz) were studied in urethane-anaesthetized dogs. [Arg8]vasopressin and [Lys8]vasopressin (50, 100, 200 mU/kg) elicited a significant decrease in the pressor responses. The depressor effects of oxytocin (50, 100, 200 mU/kg) were less marked and felypressin or vasotocin remained inactive. These results suggest that vasopressin, and oxytocin, containing neurons may be modulators involved in central cardiovascular regulation. Since these cardiovascular reflexes are related to an increase in sympathetic tone, the present work suggests that neurohypophyseal peptides could play an inhibitory role in the regulation of blood pressure through a central inhibition of sympathetic tone. In term of structure-activity relationships the present work suggests that under our experimental conditions the sequence 1-5 of amino acids in vasopressin is important for the depressor action.

Animals↗