title: Cardiovascular risk: the safety of local anesthesia, vasoconstrictors, and sedation in heart disease.
abstract: As part of a large pragmatic study, the authors investigated heart rate, blood pressure, dysrhythmic and ischemic responses to lidocaine 2% with a combination vasoconstrictor (noradrenaline 1:50,000 and vasopressin 0.25 IU/mL), and midazolam sedation in a medically compromised population. There were anesthesia-induced physiological changes to both hemodynamics and the electrocardiogram. The use of midazolam significantly ameliorated the sympathoadrenal response to stress, and the greatest hemodynamic and electrocardiographic changes were observed during surgery.
authors.affiliation: University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, England.
authors.forename: R J
authors.initials: RJ
authors.lastname: Middlehurst
authors.forename: A
authors.initials: A
authors.lastname: Gibbs
authors.forename: G
authors.initials: G
authors.lastname: Walton
mesh_terms: D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects*; D016292:Procedural Sedation; D004562:Electrocardiography / Q000187:drug effects*; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology; D019647:Oral Surgical Procedures; D016037:Single-Blind Method; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D013312:Stress, Physiological / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use
chemical_list: D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D008012:Lidocaine; D008874:Midazolam; D004837:Epinephrine