Santoro V, Marsicano C
Istituto di Chirurgia Orale e Maxillo-Facciale, Facoltà di Medicina e Chirurgia, Seconda Università degli Studi, Napoli.
Minerva Stomatol. 1998 Dec;47(12):649-53.
Some authors have shown that increased blood levels of adrenaline do not have any effect on cardiovascular function. Others have documented major changes in arterial blood pressure and heart rate even following non-maximal doses of adrenalin in association with anesthetics. The aim of this study was to evaluate the toxicity of local anesthetics when used with/without associated vasoconstrictors.
The authors studied the hemodynamic, cardiac and respiratory changes in two groups of patients respectively undergoing general and local anesthesia for a variety of pathologies of the oro-maxillo-facial district. At a preoperative stage, 4 ml of mepivacaine (carbocaine) 2% with 1:100,000 adrenaline was administered to patients in the first group. Data were compared to changes in the same parameters recorded in the second control group undergoing local anesthesia for day-hospital surgery who received the same quantities of local anesthetic (2 tubes of mepivacaine 2% with 1: 100,000 adrenaline or 3% without adrenaline).
The comparison between the two groups of data showed no significant change in cardiorespiratory parameters, except in patients with an abnormal response to dentistry stress.
No elements were found to support the systemic toxicity of local anesthetic or its association with adrenaline.