title: Plasma epinephrine levels and cardiovascular response to high administered doses of epinephrine contained in local anesthesia.
abstract: The effects of administering an epinephrine-containing local anesthetic on plasma catecholamine levels and cardiovascular parameters were evaluated. Significant elevations were observed following administration of 8 dental cartridges of 2% lidocaine with epinephrine 1:100,000 (144 μg) throughout the 20 minute observation period, while minimal changes were observed in the patients who received 6 cartridges of 3% mepivicaine. One minute after injection, the mean plasma epinephrine level in the group receiving epinephrine was 27.5 times higher than baseline. Concurrent elevations in systolic pressure (15%), heart rate (33%), and the rate-pressure product (52%) were also observed. These results indicate that significant amounts of epinephrine can be systemically absorbed following intraoral injection and the absorbed epinephrine can alter the cardiovascular status of the patient.
authors.forename: E S
authors.initials: ES
authors.lastname: Troullos
authors.forename: D S
authors.initials: DS
authors.lastname: Goldstein
authors.forename: K M
authors.initials: KM
authors.lastname: Hargreaves
authors.forename: R A
authors.initials: RA
authors.lastname: Dionne
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects*; D004837:Epinephrine / Q000008:administration & dosage / Q000097:blood* / Q000494:pharmacology; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D009638:Norepinephrine / Q000097:blood*
chemical_list: D008012:Lidocaine; D009638:Norepinephrine; D004837:Epinephrine