Beta‐adrenoceptor blockade in stress due to oral surgery.

Abstract

1 The effects of a single oral dose of 5 mg pindolol (P) and 100mg metoprolol (M) were assessed in a double-blind study in 30 patients undergoing oral surgery. 2 Systolic and diastolic blood pressures and heart rate were reduced 90 min after oral medication and did not exceed initial values at rest during the procedure. 3 Noradrenaline, adrenaline and c-AMP concentrations did not differ at any time from the control values at rest after P, but were increased after local anaesthesia and during oral surgery after M as were the metabolic responses reflected by plasma concentrations of glucose and free-fatty acids. 4 Plasma levels of ACTH and cortisol showed the typical increase during the procedure, being independent of ,B-adrenoceptor blockade. In contrast to the cardioselective antagonist M, prophylactic administration of the non-selective drug P prevented the sympathetic and metabolic responses to the stress of oral surgery.5 Hypothalamic and adrenal stimulation were not reduced by either selective or non-selective ,B-adrenoceptor blockade.

Beta‐adrenoceptor blockade and psychic stress in man. A comparison of the acute effects of labetalol, metoprolol, pindolol and propranolol on plasma levels of adrenaline and noradrenaline.

“…During psychic stress the plasma concentration of adrenaline increased markedly after labetalol, metoprolol and propranolol, but remained unchanged after placebo and pindolol. This is in good agreement with the findings of Bonelli et al (1979) and Brisse et al (1982). These investigators found a significantly reduced catecholamine response to stress after pretreatment with mepindolol and pindolol as compared to propranolol and metoprolol.…”

Taking Diabetes to Heart—Deregulation of Myocardial Lipid Metabolism in Diabetic Cardiomyopathy

“… 208 Although their predominant mode of action is to reduce cardiac workload through both negative inotropic and negative chronotropic effects, some of their beneficial effects may also be through metabolic modulation. 209 Although short‐term stimulation of β‐adrenergic receptors increases glucose uptake, glycolysis, and glucose oxidation, long‐term stimulation antagonizes the actions of insulin, promotes lipolysis, and increases circulating free FA levels, all of which can exacerbate insulin resistance. 210 By inhibiting catecholamine‐induced lipolysis, β‐blockers may reduce the mobilization of free FAs from adipose tissue and therefore decrease circulating plasma free FA concentrations.…”

Effect of a Beta-adrenergic Blocking Agent on Dental Anxiety

“…Diazepam only temporarily lowered the epinephrine levels and slightly increased the heart rates. When beta-blockers were used as pre-medication on healthy patients undergoing dental surgical and restorative procedures, Taggart et al (1976) and Brisse et al (1982) found a positive effect on heart rates and blood pressure values. Pichot et al (1977) attempted to test the effects of a beta-blocker (oxprenolol) as pre-medication for patients anticipating restorative dentistry.…”