title: Cardiovascular effects of bupivacaine and the role of this agent in preemptive dental analgesia.
abstract: Inappropriately high blood concentrations of bupivacaine have been reported to cause toxicity and even death. The potential for cardiovascular toxicity and the difficulty with which this may be reversed has made the dental practitioners reluctant to use this agent. Nevertheless, cardiovascular toxicity from its use in and around the mouth is exceedingly rare. This study was undertaken to assess bupivacaine's cardiotoxic potential in the practice of oral and maxillofacial surgery. Results showed a dose-dependent decrease in systolic blood pressure, but no other statistically significant cardiovascular change was noted. Preemptive treatment of postsurgical pain has been the subject of numerous trials. Bupivacaine administered preoperatively has been suggested to prevent central nervous system "conditioning," thus decreasing the perceived postoperative pain. However, there was no statistical support for any reduction in the perceived postoperative pain in the treatment groups in this study.
authors.affiliation: Royal North Shore Hospital, Sydney, Australia. ojyounessi@yahoo.com
authors.forename: O J
authors.initials: OJ
authors.lastname: Younessi
authors.forename: A
authors.initials: A
authors.lastname: Punnia-Moorthy
mesh_terms: D000293:Adolescent; D000328:Adult; D000344:Afferent Pathways / Q000187:drug effects; D000766:Anesthesia, Dental / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects*; D002045:Bupivacaine / Q000097:blood / Q000633:toxicity*; D002851:Chromatography, High Pressure Liquid; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D009407:Nerve Block; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D018709:Statistics, Nonparametric
chemical_list: D002045:Bupivacaine