title: Cardiovascular response to epinephrine-containing local anesthesia in patients with cardiovascular disease.
abstract: OBJECTIVE
  The purpose of the present study was to examine the safety of epinephrine-containing local anesthesia for use on patients with cardiovascular disease.
  
  
  METHODS
  Twenty-seven patients with cardiovascular disease were studied. The cardiac functional capacity of 9 patients was New York Heart Association class I; 11, class II; and 7, class III. Hemodynamic responses to intraoral injection of 1.8 mL of 2% lidocaine with 1:80,000 epinephrine were measured with impedance cardiography.
  
  
  RESULTS
  Systolic blood pressure and heart rate increased by 4.1% and 5.1%, respectively, immediately after the lidocaine-epinephrine injection. Consequently, rate pressure product increased by 10.0%. Cardiac index increased by 14.2%, and total peripheral resistance decreased by approximately 10%. No patient complained of cardiac symptoms. There were no significant differences in hemodynamic responses related to the extent of the cardiac functional capacity.
  
  
  CONCLUSIONS
  We concluded that lidocaine-epinephrine was safe and had few, if any, hemodynamic consequences in patients with cardiovascular disease.
authors.affiliation: Department of Dental Anesthesiology, Osaka University, Suita, Japan. niwa@dent.osaka-u.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Niwa
authors.forename: M
authors.initials: M
authors.lastname: Sugimura
authors.forename: Y
authors.initials: Y
authors.lastname: Satoh
authors.forename: A
authors.initials: A
authors.lastname: Tanimoto
mesh_terms: D000368:Aged; D000766:Anesthesia, Dental; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D017742:Dental Care for Chronically Ill; D004837:Epinephrine / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine