Marked Hypotension Induced by Adrenaline Contained in Local Anesthetic

Abstract

Lidocaine (2%) or saline with adrenaline (1:200,000) does cause temporary hypotension and other hemodynamic changes during general anesthesia, which last no longer than 4 minutes. The causative mechanism is caused by the effect of adrenaline. This is a preliminary study.

Epinephrine/Lidocaine Injection Vs. Saline During Endoscopic Sinus Surgery

“…Systemic absorption of epinephrine via the nasal mucosa, because of its excellent vasoconstriction ability and cardiac effect, can be coupled with the potential for serious side effects (e.g., hypertension, hypotension, tachycardia, cardiac arrhythmias, etc.) 1,8,9 …”

Safety and efficacy of concentrated topical epinephrine use in endoscopic endonasal surgery

“…10 As with cocaine and phenylephrine, complications arising from the administration of epinephrine have been reported including temporary hypotension, hypertensive crisis, tachycardia, cardiomyopathy, and cardiac arrhythmia. 10,[12][13][14][15] Although these effects are of significant concern, they are largely the result of intravascular injection and there is limited literature on the safety of topical CE use or the optimal dose. 11,[16][17][18][19] One study concluded that topical CE use was safe in sinus surgery when combined with avoidance in patients with comorbid cardiac disease.…”

Hemodynamic Effects of Local Anesthesia and its Possible Correlation with Chromogranin A

“…The hypotensive effect of epinephrine at subtherapeutic concentrations was evaluated in a series of reports by Yang et al, (2005). [17] Although both α-and β-adrenocepters are stimulated, β2 vasodilator effect is most sensitive. Thus, in large doses, direct stimulatory effects on cardiac output plus potent vasoconstriction (particularly in precapillary resistance vessels of skin, mucosa, and kidney) produce a rapid increase in systolic arterial pressure.…”