J Dent Anesth Pain Med.  2018 Jun;18(3):143-149. 10.17245/jdapm.2018.18.3.143.

Comparative evaluation of the efficacy, safety, and hemostatic effect of 2% lidocaine with various concentrations of epinephrine

Affiliations
  • 1Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Republic of Korea.
  • 2Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea. dentane@snu.ac.kr

Abstract

BACKGROUND
We evaluated the changes in mean arterial pressure (MAP) and heart rate (HR), and the anesthetic and hemostatic effects, after injection of 2% lidocaine containing various concentrations of epinephrine in rats and mice to determine the appropriate concentration of epinephrine in various anesthetic mixtures.
METHODS
Rats and mice were randomly allocated to experimental groups: 2% lidocaine without epinephrine (L0), 2% lidocaine with epinephrine 1:200,000 (L200), 1:100,000 (L100), and 1:80,000 (L80). Changes in MAP and HR after administration of the anesthetic mixture were evaluated using a physiological recording system in rats. Onset and duration of local anesthesia was evaluated by pricking the hind paw of mice. A spectrophotometric hemoglobin assay was used to quantify the hemostatic effect.
RESULTS
MAP increased in response to epinephrine in a dose-dependent manner; it was significantly higher in the L80 group than in the L0 group at 5 min post-administration. The HR was relatively lower in the L0 group than in the L80 group. The time required for onset of action was < 1 min in all evaluation groups. The duration of action and hemostatic effect of the local anesthetic were significantly better in the L200, L100, and L80 groups than in the L0 group.
CONCLUSION
L200 demonstrated relatively stable MAP and HR values with satisfactory efficacy and hemostatic effect. L200 might be a better local anesthetic for dental patients in terms of anesthetic efficacy and safety.

Keyword

Arterial Pressure; Epinephrine; Hemostasis; Lidocaine; Local Anesthetics

MeSH Terms

Anesthesia, Local
Anesthetics, Local
Animals
Arterial Pressure
Epinephrine*
Heart Rate
Hemostasis
Humans
Lidocaine*
Mice
Rats
Anesthetics, Local
Epinephrine
Lidocaine
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