Hypoglycemia as a possible factor in the induction of vasovagal syncope

Salins, Paul C.; Kuriakose, Moni Abraham; Sharma, Sonal; Tauro, David P.

doi:10.1016/0030-4220(92)90340-v

Cited by 11 publications

(12 citation statements)

References 12 publications

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“…The results suggest that when considering the systemic effects of local anaesthetic injections metabolic as well as hemodynamic changes should be investigated. Hypoglycaemia is a common problem that arises on the dental chair and is one of the causes for vasovagal syncope [9]. As a corollary to this finding, it is logical to infer that vasovagal syncope could also be prevented by injecting local anesthetic with adrenaline as significant increase in blood glucose (mean 33 mg%) after injecting local anesthetic with adrenaline was observed in the present study.…”

Section: Discussionsupporting

confidence: 65%

Comparative Evaluation of Local Anaesthesia with Adrenaline and Without Adrenaline on Blood Glucose Concentration in Patients Undergoing Tooth Extractions

Kalra

Rana²,

Peravali

et al. 2011

J. Maxillofac. Oral Surg.

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Background Lignocaine hydrochloride is the most widely used and easily available local anaesthetic agent. Adrenaline is frequently combined with lignocaine to enhance the duration of anaesthesia, decrease toxicity, to achieve vasoconstriction and to provide a bloodless field. Aim and Objective This study was conducted to do the comparative evaluation of local anaesthesia with adrenaline and without adrenaline on blood glucose concentration in patients under going tooth extraction. Materials and Method The study was conducted on 120 patients comprising of 60 healthy and 60 diabetic patients. All these patients were in need of multiple extractions. The patients were in the age group of 18-50 years. On their first visit the patients were given plain lignocaine and tooth extraction was carried out. One week later the same patient was given lignocaine with 1:80,000 adrenaline to carry out tooth extraction. Serial blood glucose estimations were done at definite intervals (prior to administration of local anaesthetic, immediately after injecting the LA, 10 and 20 min following the injection of LA) on both the occasions. ResultsThe mean blood glucose concentration increased from the base line level of 84.81 to 85.09 mg/dl in healthy patients and from 206.82 to 207.09 mg/dl in diabetic patients 10 min following the injection of 2% plain lignocaine. This increase in blood glucose concentration following the administration of plain lignocaine was statistically not significant (P [ 0.05). There was statistically significant (P \ 0.005) increase in the blood glucose concentration from 88.81 to 105.55 mg/dl in healthy, and 208.77 to 242.46 mg/dl in diabetic patients 20 min following the injection of lignocaine with adrenaline. Interpretation and Conclusion While assessing the generalized effects of local anaesthetic solutions, metabolic as well as haemodynamic responses should be investigated. Adrenaline containing LA should be used with caution in Type 2 diabetics as adrenaline causes suppression of insulin release.

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Section: Discussionsupporting

confidence: 65%

Comparative Evaluation of Local Anaesthesia with Adrenaline and Without Adrenaline on Blood Glucose Concentration in Patients Undergoing Tooth Extractions

Kalra

Rana²,

Peravali

et al. 2011

J. Maxillofac. Oral Surg.

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“…It is defined as a state of disharmony or disturbances in homeostasis provoked by psychological, environmental or physiological stressor situations [1,2]. These situations promote immunoinflammatory and metabolic responses that are entangled in an intricate way, as the cells involved in these key events ontogenetically originate from a unique primordial organ combining both immune and metabolic functions [3][4][5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…Following this, the ability of anaesthetic agents and neural blockade to modify stress responses has been studied. Although it seems that the stress response developed to allow injured animals to survive by catabolising their own body fuels, it has been argued that the response is unnecessary in current clinical practise (Figure1 ) [1][2][3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…The circulating catecholamines, cortisol and growth hormone result in elevated blood glucose levels. Consequently, synthesis and release of insulin is stimulated to maintain blood glucose levels within normal range [1][2][3][4][5][6][7][8][9][10][11][12][13]. In the pancreas glucagon is released and insulin secretion may be diminished.…”

Section: Introductionmentioning

confidence: 99%

“…In the pancreas glucagon is released and insulin secretion may be diminished. The overall metabolic effect of hormonal changes is increased catabolism that mobilizes substrates to provide energy sources and a mechanism to retain salt and water and maintain fluid volume and cardiovascular homeostasis [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Using Blood Glucose Estimation to Interpret Stress in Patients Undergoing Minor Oral Surgery Procedures

Murugan

kulsum

Neelak

et al. 2017

JDHODT

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Purpose: A prospective randomised case control study was conducted to evaluate the stress induced in patients during minor oral surgical procedures based on the variations in blood glucose levels, blood pressure and pulse rate and thereby to assess the relation between stress and the aforesaid parameters. Materials and methods:A total of 100 subjects who required routine minor oral surgical procedures were randomly divided into two equal groups with subjects of test Group I receiving 2 % lignocaine with adrenaline, subjects of control Group II received the same with an added oral intake of 10 mg glucose in 200 ml water after administration of local anaesthesia. The blood glucose level, blood pressure, and pulse rate were recorded before the commencement of procedure with the patient on the chair, before and immediately after local anaesthetic administration, finally after the procedure, and the obtained data was statistically analysed. Results:The blood glucose levels were found to decline at a point before extraction and then increase to a value higher than the preoperative value in group I, while in groups II the blood sugar values maintain a steady state without decline, until it progressively increases to a higher post-operative value. In all groups blood pressure was found to elevate progressively and an increase in pulse rate was observed in all stages till the administration of LA after which there was a marked decline. Conclusion:Our results point towards the phenomenon of a short lasting decline in blood glucose levels for a period of not more than four or five minutes before an elevation in blood glucose levels. In minor oral surgical procedures under local anaesthesia, this momentary hypoglycaemia is of great clinical significance as even moderate hypoglycaemia can lead to episodes of psychogenic syncope.

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General Complications of Dental Local Anesthesia

2024

Local Anesthesia in Dentistry

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Hypoglycemia as a possible factor in the induction of vasovagal syncope

Cited by 11 publications

References 12 publications

Comparative Evaluation of Local Anaesthesia with Adrenaline and Without Adrenaline on Blood Glucose Concentration in Patients Undergoing Tooth Extractions

Comparative Evaluation of Local Anaesthesia with Adrenaline and Without Adrenaline on Blood Glucose Concentration in Patients Undergoing Tooth Extractions

Using Blood Glucose Estimation to Interpret Stress in Patients Undergoing Minor Oral Surgery Procedures

General Complications of Dental Local Anesthesia

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