title: Plasma catecholamine concentrations and hemodynamic responses to vasoconstrictor during conventional or Gow-Gates mandibular anesthesia.
abstract: OBJECTIVE
  The literature supports that systemic responses to injected vasoconstrictors depend on the volume and concentration administered, patient's age and health status, as well as site of injection. Thus, the influence of mandibular anesthesia technique on hemodynamic and plasma responses to epinephrine-containing local anesthetics was investigated.
  
  
  METHODS
  Conventional or Gow-Gates anesthesia with 2% lidocaine and epinephrine, 1:100,000, was performed in 18 subjects who required third molar extraction. A control group of 9 subjects was submitted to conventional anesthesia with plain 3% mepivacaine. Blood pressure, heart rate, and plasma catecholamines were measured.
  
  
  RESULTS
  Analysis of variance showed that plasma epinephrine level after conventional lidocaine anesthesia was significantly elevated (P < .01), while there was no difference between the Gow-Gates and control groups. The hemodynamic parameters did not demonstrate correlation to the injection technique.
  
  
  CONCLUSIONS
  Presumably, there was less exogenous epinephrine absorption in the Gow-Gates technique than in the conventional mandibular anesthesia injection.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Universidade de São Paulo, São Paulo, Brazil. amviana@usp.br
authors.forename: Adriana M
authors.initials: AM
authors.lastname: Viana
authors.forename: Antonio Carlos de
authors.initials: AC
authors.lastname: Campos
authors.forename: Mayra T
authors.initials: MT
authors.lastname: Morlin
authors.forename: Verónica K L
authors.initials: VK
authors.lastname: Chin
mesh_terms: D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D004837:Epinephrine / Q000008:administration & dosage* / Q000097:blood*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008334:Mandible; D008619:Mepivacaine / Q000008:administration & dosage; D008964:Molar, Third / Q000601:surgery; D009638:Norepinephrine / Q000097:blood; D014081:Tooth Extraction; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000097:blood*
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D008619:Mepivacaine; D009638:Norepinephrine; D004837:Epinephrine