Effects of dental local anaesthetics in cardiac transplant recipients

Meechan, J G; Parry, Gareth; Rattray, D T; Thomason, JM

doi:10.1038/sj.bdj.4801323

Cited by 48 publications

(26 citation statements)

References 13 publications

(9 reference statements)

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“…For example it is known that transplanted hearts are supersensitive to catecholamines 16 and significant increases in heart rate attributable to epinephrine in dental local anaesthetic solutions have been demonstrated in adult cardiac transplant recipients. 17 At present there are no recommendations concerning the use of epinephrinecontaining local anaesthetics in children with heart transplants. The results of this study suggest that the choice of local anaesthetic in such children merits consideration.…”

Section: Discussionmentioning

confidence: 99%

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

2001

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Section: Discussionmentioning

confidence: 99%

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

2001

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“…Several haemodynamic studies have been carried out in patients subjected to local anaesthetic injection with a vasoconstrictor [18][19][20]. While some have reported no significant changes in either blood pressure (systolic and diastolic) or heart rate, others did and some authors have suggested that changes are dependent upon the injected vasoconstrictor dose [21].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Haemodynamic and Metabolic Effects of Local Anaesthetic Agent in Routine Dental Extractions

Akinmoladun

Okoje

Akinosun

et al. 2012

J. Maxillofac. Oral Surg.

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Introduction The systemic effects of adrenaline administered during dental local anesthesia have been the subject of many studies. The purpose of this study was to investigate the haemodynamic and metabolic effects attributable to adrenaline injected during local anesthesia in dental extraction patients. Methods Apparently medically fit patients were included and randomized into two groups. Participants had breakfast before coming in for tooth extraction. The weight, height, blood pressure and pulse rate were measured and blood sample taken before administration of local anaesthetic injections. Blood pressure, pulse and blood sample were again taken at 15 and 30 min. Results While the adrenaline group showed a modest increase between pre-and post-drug administration states, the control group showed no difference in median systolic blood pressures. Both groups showed a slight increase in diastolic blood pressure observed between pre-and postdrug administration states. Also both groups showed no significant difference in median pulse rate throughout. Although blood glucose values were widely dispersed in the pre-drug administration state in both groups, the control group showed no difference in median values throughout. However, a modest increase was observed in the adrenaline group between pre-and post-drug administration states, which persisted beyond 30 min. Conclusion The patients treated with local anesthesia with adrenaline showed a response similar to that observed in the control group.

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“…Avoidance of epinephrine would appear to be a sensible precaution due to the possible cardiac chronotropic, inotropic and arrhythmogenic properties, effects which may be exaggerated in some patients, such as cardiac transplant recipients. 4,5 However, it has also been suggested that felypressin at high concentrations may produce coronary vasoconstriction/ischaemia and its use in such cardiac conditions could also be contraindicated. 1,6 A plain solution, such as 4% prilocaine, is possibly more appropriate in such patients, although selected by only 7% of practitioners -14% selecting lidocaine.…”

Section: Medical Conditionsmentioning

confidence: 99%

A survey of local anaesthetic use among general dental practitioners in the UK attending postgraduate courses on pain control

Corbett

Ramacciato²,

Groppo³

et al. 2005

Br Dent J

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Objective The aim of this study was to identify which local anaesthetic solutions were used by general dental practitioners in the United Kingdom and to determine selection criteria. In addition, differences in anaesthetic choice between recent graduates (≤5 years) and more experienced practitioners were investigated. Material and methods Five hundred and six general dental practitioners attending postgraduate courses on pain control in dentistry completed a questionnaire. Participants were asked to indicate year and place of qualification, anaesthetic solutions available in their surgeries and criteria used in the choice of anaesthetic. In addition, the respondents were asked to indicate choice of local anaesthetic in a number of common medical conditions. Questionnaires were distributed and collected immediately prior to the start of the course presentation and participants were not asked to indicate whether the selection decisions were teaching, experience or evidence based. Data were analysed by using the Chi-square test. Results Lidocaine with epinephrine was the most widely available solution among this group of practitioners (94%), the second most common solution was prilocaine with felypressin (74%). The majority of practitioners had two or more solutions available. Practitioners who qualified within the last five years (14%) were more likely to have articaine available, the most recently introduced local anaesthetic into the UK (p = 0.04, one degree of freedom). Common medical conditions lead to a modification in anaesthetic selection: the use of prilocaine/felypressin increases in the majority of circumstances, although it is avoided in pregnant females by recent graduates. Conclusions Lidocaine/epinephrine continues to be the most common anaesthetic solution used by this group of UK general practitioners. The primary criterion for selection of an anaesthetic agent was perceived efficacy. Prilocaine/felypressin is commonly selected as an alternative solution in the presence of common medical conditions.

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Effects of dental local anaesthetics in cardiac transplant recipients

Abstract: The cardiovascular response to dental local anaesthesia in cardiac transplant recipients is governed by the solution injected.

Cited by 48 publications

References 13 publications

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

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

Evaluation of the Haemodynamic and Metabolic Effects of Local Anaesthetic Agent in Routine Dental Extractions

A survey of local anaesthetic use among general dental practitioners in the UK attending postgraduate courses on pain control

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