title: Vasoconstrictors: indications and precautions.
abstract: Vasoconstrictors are useful additives to local anesthetic solutions. They can enhance the duration and quality of the anesthetic block while also decreasing surgical blood loss. Precautions must be taken, however, when using vasoconstrictors with certain patients, especially those with cardiovascular disease. Several drug interactions must also be considered before administration of a local anesthetic with a vasoconstrictor, and special care must be taken when injecting such preparations in patients on nonspecific beta-adrenergic blockers, tricyclic antidepressants, catechol-O-methyltransferase inhibitors, cocaine, and certain general anesthetics. Lastly, in the patient with true sulfite allergy, local anesthetics without a vasoconstrictor should be used.
authors.affiliation: Section of Anesthesiology, Division of Diagnostic and Surgical Sciences, University of California Los Angeles School of Dentistry, 10833 Le Conte Avenue, Box 951668, Los Angeles, CA 90095, USA.
authors.forename: Lenny W
authors.initials: LW
authors.lastname: Naftalin
authors.forename: John A
authors.initials: JA
authors.lastname: Yagiela
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D018681:Anesthetics, General / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000737:chemistry; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control; D065098:Catechol O-Methyltransferase Inhibitors; D003042:Cocaine / Q000737:chemistry; D000075202:Contraindications; D004347:Drug Interactions; D004357:Drug Synergism; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D006967:Hypersensitivity / Q000503:physiopathology; D009294:Narcotics / Q000737:chemistry; D004364:Pharmaceutical Preparations; D011247:Pregnancy; D012449:Safety; D013447:Sulfites / Q000009:adverse effects; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000737:chemistry
chemical_list: D000319:Adrenergic beta-Antagonists; D018681:Anesthetics, General; D000779:Anesthetics, Local; D000929:Antidepressive Agents, Tricyclic; D065098:Catechol O-Methyltransferase Inhibitors; D006490:Hemostatics; D009294:Narcotics; D004364:Pharmaceutical Preparations; D013447:Sulfites; D014662:Vasoconstrictor Agents; D003042:Cocaine