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PubMed2003

Effects of the prilocaine and of the association of prilocaine with different vasoconstrictors on the isolated hearts of rats.

This study aimed to observe the effects of prilocaine chloridate (P) and the associations of P with felypressin (P+F), and epinephrine (P+E) on the heart rate and force of contraction on the isolated hearts of rats. The hearts were perfused according to Langendorff's method. The experiments were performed with the following substances: prilocaine (P), felypressin (F), and epinephrine (E). P was used in doses of 1.25, 2.5, and 5.0 mg. The same doses of F and P (1.0, 1.5 and 3.0 microg) were used in association with the P, respectively. Right after the application of the three doses of P, a reduction in the force of contraction was observed, with higher intensity at a higher dose, which led to cardiac arrest. A similar result was obtained with the administration of the three associations of P+F. Also the application of the three associations P+E resulted in a reduction of the force of contraction, that was, however, less intense with the associations of 1.25 mg P + 1.0 microg E and 2.5 mg P+1.5 microg E, as compared to the same doses of P alone and P+F. The two higher doses of P and P+F on the heart rate elicited a significant reduction in relation to the control, but with the associations of P+E no alterations were observed, with any one of the doses used. The results obtained in the present study suggest that an association of P and E must be used in local anesthesia, since epinephrine may well protect the heart from the depressive effects of the anesthetic salts.

Animals↗
PubMed1999

Peribulbar anaesthesia: a double-blind comparison of three local anaesthetic solutions.

A prospective, randomised, double-blinded study comparing three agents for peribulbar anaesthesia is reported. Sixty patients undergoing extracapsular cataract extraction under local anaesthesia were randomly allocated to receive peribulbar anaesthesia with lignocaine 2% with adrenaline; prilocaine 3% with felypressin 0.03 IU.ml-1 or 2% lignocaine and 0.5% bupivacaine in a ratio of 1:1, using a standardised two-injection technique. The pain of injection, time of onset of the block and the operating conditions at the start and finish of surgery were assessed. Peribulbar anaesthesia using lignocaine 2% was significantly more painful than the other solutions. The onset of anaesthesia adequate for surgery was similar in all three groups. Prilocaine 3% with felypressin was associated with the greatest number of blocks providing total akinesia of the eye. Inadequate duration of anaesthesia was seen in only one case; the solution used for this block was 2% lignocaine.

Aged↗
PubMed1988

Low volume, high concentration block of the sciatic nerve.

Sciatic nerve block was performed in two groups of patients using a low power peripheral nerve stimulator to aid nerve location. In group A 1% prilocaine with felypressin was used as the local anaesthetic agent in a volume of 0.25 ml/kg body weight. In group B 3% prilocaine with felypressin was used in a volume of 0.08 ml/kg body weight (i.e. equal total drug dosages). Use of the 3% solution resulted in highly significant reductions in the mean latency for analgesia of the nerve block and in the latency and degree of motor block achieved (p less than 0.005 in each case). The clinical value of high concentration, low volume nerve block is discussed.

Blood Pressure↗
PubMed1991

[Can choice of medications and adjuvants reduce risks of local anesthetic complications?].

Local anesthetic agents in high concentrations may cause local irritation by ischemia especially after the use of adrenaline whereas felypressin has no tissue-irritating properties. Adrenaline but not felypressin increases the intravenous systemic toxicity. Noradrenaline has to be avoided as a vasoconstrictor. An aspiration test before injection will decrease the risk of inadvertent intravenous injection.

Adjuvants, Anesthesia↗
PubMed1987

Vasopressin receptors influencing the secretion of ACTH by the rat adenohypophysis.

The effects of selective agonists and antagonists of type 1 (V1) and type 2 (V2) vasopressin receptors on the secretion of ACTH in vitro by segments of adenohypophysial tissue and in vivo in rats pretreated with pentobarbitone and chlorpromazine were studied in the presence and absence of the 41 amino acid-containing peptide, corticotrophin-releasing factor-41 (CRF-41). The non-selective vasopressin receptor agonist, arginine vasopressin (AVP) and the V1-receptor agonist, felypressin caused dose-related increases in ACTH release in vivo and in vitro but the V2-receptor agonist, desmopressin was only weakly active in this respect. Their actions in vitro were antagonized competitively by the V1-receptor antagonist, d(C2H5)2-AVP, but were unaffected by the V2-receptor antagonist, d(CH2)5-D-Iso2-Thr4-AVP. Arginine vasopressin, felypressin and desmopressins in concentrations considerably lower than those necessary to elicit directly the release of ACTH, potentiated, in a dose-related manner, the activity of CRF-41 in vitro. The potentiating effects were not antagonized by the V2-receptor antagonist or by low concentrations of the V1-receptor antagonist. At a higher concentration, the V1-receptor antagonist reduced, but did not abolish, the potentiating effects of AVP and its analogues. However, at this concentration, it also exhibited weak intrinsic activity and, like the agonists, potentiated the response to CRF-41. The results suggest that the direct effect of AVP on ACTH release is mediated by V1-like receptors. The vasopressin receptors involved in the potentiation of CRF-41 activity appear to be different.

Adrenocorticotropic Hormone↗
PubMed1992

The effects of two different local anaesthetic solutions administered for oral surgery on plasma potassium levels in patients taking kaliuretic diuretics.

The effects of two different dental local anaesthetic solutions, administered for oral surgery, on the plasma potassium levels of patients taking non-potassium sparing diuretics has been investigated. There was a significant reduction in plasma potassium concentration in eight subjects who received 4.4 ml of 2% lignocaine with 1:80,000 adrenaline; the mean reduction from baseline being 0.30 mmol.l-1 10 min following intraoral extravascular injection of the local anaesthetic. There was no significant difference from the pre-treatment plasma potassium concentration 10 min following similar injections of 3% prilocaine with 0.03 IU.ml-1 felypressin in 8 patients; the mean change in these subjects being -0.05 mmol.l-1. It is suggested that the use of adrenaline-free local anaesthetics would seem to be appropriate in patients receiving kaliuretic diuretics.

Aged↗
PubMed1988

The effects of two different dental local anesthetic solutions on plasma potassium levels during third molar surgery.

The influence of two different dental local anesthetic solutions on plasma potassium levels during third molar surgery has been investigated in a single-blind cross-over study in twelve volunteers. The solutions employed were 2% lidocaine (xylocaine) containing 1:80,000 epinephrine and 3% prilocaine (Citanest) containing 0.03 IU/ml felypressin. The different treatments produced similar effects on blood pressure and heart rate. However, the effect on plasma potassium levels differed significantly in the early postinjection period.

Adult↗
PubMed2001

The influence of two different dental local anaesthetic solutions on the haemodynamic responses of children undergoing restorative dentistry: a randomised, single-blind, split-mouth study.

OBJECTIVES: This investigation was designed to study the haemodynamic effects of two different local anaesthetic solutions during restorative dental treatment in children. DESIGN: A randomised, single-blind, split-mouth cross-over design was employed using children undergoing bilaterally similar restorative treatments over two visits. SETTING: The study was performed in a dental hospital paediatric dentistry department. METHODS: Ten children participated. At one visit the local anaesthetic was 2% lidocaine (lignocaine) with 1:80,000 epinephrine (adrenaline); at the other the anaesthetic was 3% prilocaine with 0.03IU/ml felypressin. Local anaesthetic was administered at a dose of 0.5 ml/10 kg body weight. Blood pressure and heart rate were measured before and during treatment with an automatic blood pressure recorder. Data were analysed by ANOVA and Student's paired t test. RESULTS: Significant differences between treatments in diastolic blood pressure (F = 2.37; P = 0.05) and heart rate (F = 2.98; P< 0.02) were noted. The heart rate increased ten minutes following the injection of the epinephrine-containing solution. The diastolic blood pressure fell 20 minutes after injection of lidocaine with epinephrine. CONCLUSION: The choice of local anaesthetic solution influences the haemodynamic response during restorative treatment in children.

Analysis of Variance↗
PubMed2002

Effects of dental local anaesthetics in cardiac transplant recipients.

OBJECTIVE: To investigate the cardiovascular responses of cardiac transplant recipients to dental local anaesthetic solutions with and without epinephrine (adrenaline). MATERIALS AND METHODS: A clinical study employing 30 patients (20 cardiac transplant recipients and ten healthy) awaiting gingival or minor oral surgery under local anaesthesia receiving either 4.4 ml lidocaine (lignocaine) with 1:80,000 epinephrine or 4.4 ml 3% prilocaine with 0.031 U/ml felypressin. RESULTS: Cardiac transplant patients experienced a significant tachycardia 10 minutes after injection of the epinephrine-containing solution. No significant change in heart rate was detected after the injection of an epinephrine-free solution. Blood pressure was not affected. Periodontal surgery did not affect the responses to the local anaesthetics in the transplant recipients. CONCLUSIONS: The cardiovascular response to dental local anaesthesia in cardiac transplant recipients is governed by the solution injected.

Adult↗
PubMed1991

The effects of dental local anaesthetics on blood glucose concentration in healthy volunteers and in patients having third molar surgery.

The effects of adrenaline-containing and adrenaline-free dental local anaesthetic solutions on blood glucose concentration were investigated in single-blind cross-over studies in ten healthy volunteers and in ten patients having lower third molar surgery. The solutions compared were 2% lignocaine containing 1:80,000 adrenaline (Xylocaine) and 3% prilocaine with 0.03 IU/ml felypressin (Citanest). In all cases, 4.4 ml of solution was used. In the volunteer study the blood glucose concentration increased from 4.48 +/- 0.72 mmol/litre immediately before the injection of Xylocaine to 5.07 +/- 0.99 mmol/litre 30 minutes following the injection; with Citanest the pretreatment concentration of 4.56 +/- 0.92 mmol/litre changed to 4.24 +/- 0.62 mmol/litre at 30 minutes. This increase in blood glucose concentration following the administration of Xylocaine was significant (t = 3.39, P less than 0.01), as was the difference between treatments (t = 2.64, P less than 0.05). In the patient study, the blood glucose level prior to the injection of Xylocaine was 4.56 +/- 1.59 mmol/litre and this increased to 5.24 +/- 0.86 mmol/litre 30 minutes after the local anaesthetic was injected. The pretreatment blood glucose level of 4.52 +/- 0.82 mmol/litre in patients when Citanest was used changed to 4.33 +/- 0.71 mmol/litre 30 minutes following the injection. The difference at 30 minutes in the changes in blood glucose concentration between local anaesthetic regimes in patients having third molar surgery was significant (t = 2.60, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Clinical and radiographic evaluation of pulpotomies performed under intrapulpal injection of anaesthetic solution.

AIM: The purpose of this study was to evaluate clinically and radiographically pulpotomies carried out under intrapulpal injection of anaesthetic solution. METHODOLOGY: Forty-one permanent mandibular molar teeth presenting with deep carious lesions and/or exposed pulps, with or without periapical changes on radiographic examination, were treated with pulpotomy and dressed with calcium hydroxide. The teeth were divided into three groups. Group A consisted of 15 teeth, where intrapulpal anaesthesia was administered by a slow injection of lidocaine hydrochloride 2%. Group B, with 14 teeth, where intrapulpal anaesthesia was obtained with lidocaine hydrochloride 2% with adrenaline 1:100,000. Group C consisted of 12 teeth in which anaesthesia was performed with a mandibular block using prilocaine hydrochloride 3% with felypressin 1: 100,000. Healing was evaluated using clinical and radiographic criteria: dentine barrier formation, absence of clinical symptoms and resolution of periapical involvement. RESULTS: After an observation time of 6-8 weeks (postoperative control) and 24-32 weeks (intermediate control), healing occurred in 13 teeth from group A (87%), in 11 teeth from group B (79%) and in 10 teeth from group C (83%). No statistical difference was demonstrated between the three groups (Fisher's exact test). CONCLUSIONS: Based on the methodology adopted, intrapulpal injection of anaesthetic solution did not impair healing in pulpotomized teeth.

Adolescent↗
PubMed1995

Effects of local anaesthesia on formalin-induced Fos expression in the rat dorsal horn.

A subcutaneous injection of formalin into foot pad of the rat produces a bimodal nociceptive response including an early intense response in the first 5 min and a later moderate response that is exhibited from 20 to 60 min after injection. In this study, we investigated the effects of blocking the early phase and late phase input, respectively, on Fos-like immunoreactivity (Fos-LI) expression in dorsal horn neurones. Rats of the early phase block (EB) group were injected with 5% formalin (0.05 ml) into the footpad 5 min after a s.c. injection of 4% lidocaine (0.15 ml) into the angle. The rats of the late phase block (LB) group were injected with 5% formalin into the footpad 10 min before the s.c. injection of 3% prilocaine (0.20 ml) containing felypressin into the ankle. The rats of the control group were given the formalin injection alone. Fos-LI was detected in the dorsal horn 2 h after the formalin injection. The numbers of Fos-LI neurones in the dorsal horn of both EB and LB group were markedly decreased compared with the control group, being 31.3% (laminae I-III of EB), 37.1% (laminae I-III of LB), 13.9% (laminae IV-VI of EB) and 16.2% (laminae IV-VI of LB) of the control values. No significant difference was observed between EB and LB group. These findings suggested that the early and late phase contribute in concert to the induction of genetic changes in dorsal horn neurones after formalin injection.

Anesthesia, Local↗
PubMed1985

Severe hypertension during anaesthesia for dacryocystorhinostomy.

A healthy 82-year-old woman presented for dacryocystorhinostomy under general anaesthesia. Following the application of intranasal cocaine and subcutaneous injection of felypressin she developed severe hypertension, multiple ventricular ectopic beats and depression of the ST segment on the electrocardiogram. A drug interaction is suspected.

Aged↗
PubMed1986

A randomized trial of Citanest with Octapressin for relief of pain associated with laser vaporization of the cervix.

Fifty women undergoing laser vaporization of the cervix for cervical intraepithelial neoplasia were randomly allocated to one of two groups. In one group the patients received no anaesthesia, in the other the ectocervix was infiltrated with 2 ml of Citanest with Octapressin (prilocaine 3% with 0.03 i.u./ml. of felypressin) immediately before the procedure. The pain experienced by each group was assessed immediately after treatment by visual analogue and verbal rating scales. The pain experienced by those women receiving local anaesthesia was significantly reduced as assessed by the visual analogue scale (P = 0.011) and this reduction was not quite significant by the verbal rating scale (P = 0.06). The Citanest group had less troublesome bleeding but the difference in bleeding between the two groups was not significant.

Adult↗
PubMedDate not supplied

Alterations in monitored vital constants induced by various local anesthetics in combination with different vasoconstrictors in the surgical removal of lower third molars.

The purpose of this study was to observe the hemodynamic changes during surgical extraction of lower third molars induced by three local anesthetics solutions associated with different vasoconstrictors. A double-blind observational and longitudinal study was made of 45 healthy adult volunteers subjected to surgical removal of an impacted lower third molar under local anesthesia. Three groups were established (n = 15) according to the anesthetic solution and associated vasoconstrictor administered (4% articaine + epinephrine 1:200,000; 3% mepivacaine without vasoconstrictor; and 3% prilocaine + felypressin 1:1,850,000). Heart rate, systolic and diastolic pressure, and oxygen saturation were recorded at different times before, during and at the end of surgery, along with the type and amount of anesthetic solution administered. The study variables were found to be more stable with articaine + epinephrine 1:200,000, although the three studied solutions caused no significant hemodynamic changes with respect to the basal values when administered in healthy patients subjected to surgical removal of a lower third molar.

Adolescent↗
PubMed1996

Lidocaine and prilocaine with vasoconstrictors as cause for cardiovascular reactions. A pulse oximetric study. Preliminary report.

MATERIALS AND METHODS: Cardiovascular effects of two local anesthetic agent solutions containing 2% lidocaine with 1:80,000 epinephrine (LE) and 3% prilocaine with 0.54 microgram/ml felypressine (PF) used separately and in combination were observed. We made 38 separate monitoring sessions (30 minutes each) with healthy voluntary dental students. Participants were monitored with Cardiocap multiparameter physiological monitor. The monitored values were heart rate, systolic and diastolic blood pressure, SaO2 and peripheral blood flow. Values were registered into computer memory for further analysis. Group 1 received 7.2 ml of PF to the buccal sulcus just distal of the second upper right molar and 7.2 ml of LE to the left buccal sulcus ten minutes later. Group 2 had the same injection positions but they received 3.6 ml of PF to both sides of maxilla and then, ten minutes later, 3.6 ml of LE to each side. RESULTS: There were no radical changes in systolic or diastolic blood pressure. The blood oxygen saturation values were constant and the displayed SaO2 values were between 96-98% during the measurement period. Mean heart rate decreased about 10 beats/min after PF injection and increased about 10 beats/min after injection of LE in both groups. The peripheral blood flow (pbf) was the most sensitive parameter in our measurements. In general, pbf diminished in the period preceding the injection. It showed lowest values during the injection phases in both groups. CONCLUSIONS: Despite large doses of local anesthetics SaO2, systolic and diastolic blood pressure showed no clinically important changes, which suggests that local anesthetics have only a minimal effect on parameters mentioned above. This means that if the effect of one local anesthesia preparate (PF) is not sufficient, it is possible to safely reinforce the anesthesia with another substance (LE) in young healthy patients. Additionally, heart rate and pbf demonstrated quite clearly the symphatetic stimulation effect of the stress of injection and the stimulating action of epinephrine was seen clearly in heart rate values in both groups.

Adult↗
PubMed1992

A case of coronary artery spasm during oral surgery under general anesthesia.

A case of coronary artery spasm during oral surgery under general anesthesia is reported. The patient, aged 44 years, 160 cm in height, and 55 kg in weight, was scheduled for radical surgery for right maxillary sinusitis and was healthy except for the disease requiring surgery. Just before the start of the surgery, severe and persistent hypotension with tachycardia after local injection of 3% propitocaine with 0.03 IU/mL felypressin (Citanest-Octapressin) was followed by sudden ST elevations in the ECG. Immediate continuous intravenous injection of nitroglycerin was thought to be effective. The patient recovered without any sequelae.

Adult↗
PubMed1991

[Clinical comparative study of local anesthetics. Random double blind study with four commercial preparations].

In a randomized double blind study effects and tolerability of the local anesthetics Prilocaine 3% with Felypressin, Articaine 4% with Epinephrine 1/200,000 and 1/100,000, and Lidocaine 2% with Epinephrine 1/100,000 were tested. There was no significant difference between the four agents as far as effect on blood pressure, pulse, and tissue rehabilitation are concerned. Prilocaine can be used for extractions and surgical tooth removal. It can not be recommended for apicoectomy or implantation. The better results of Articaine 4% compared to Lidocaine 2% were statistically not significant.

Anesthetics, Local↗