Effect of propranolol on mepivacaine serum concentrations in dental practice.
OBJECTIVE
The objective of this study was to determine the effect of propranolol pretreatment on mepivacaine serum concentrations in dental patients.


METHODS
In a double blind, randomized, 2-way crossover study, 10 patients ingested 30 mg propranolol or placebo, 2 hours before local anesthesia for dental scaling. Each subject received a single dose of 51 mg mepivacaine for posterior superior alveolar nerve block. Mepivacaine in venous serum was measured for up to 1 hour, after 5, 15, 30, 45, and 60 minutes from injection. Serum concentrations of mepivacaine were determined by gas chromatography. Blood pressure and heart rate were measured before and after propranolol or placebo and after each sampling.


RESULTS
Peak serum concentrations of mepivacaine, C(max) (1.214 +/- 0.746 microg/mL(-1)), were significantly increased by propranolol (2.249 +/- 1.559 microg/mL(-1), P < .05). Propranolol pretreatment reduced blood pressure and heart rate.


CONCLUSIONS
Although propranolol pretreatment increased almost doublefold mepivacaine serum concentrations and reduced blood pressure and heart rate, mepivacaine can be used safely in dental patients taking propranolol for short-duration interventions.
Popescu
Sanda Mihaela
SM
Department of Preventive Dentistry, Faculty of Dental Medicine, University of Medicine and Pharmacy, Craiova, Romania. sm_popescu@hotmail.com
Nechifor
Mihai
M
Baniceru
Mihaela
M
Croitoru
Octavian
O
Popescu
Florica
F
D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods; D000779:Anesthetics, Local / Q000097:blood* / Q000493:pharmacokinetics; D000959:Antihypertensive Agents / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004347:Drug Interactions; D006801:Humans; D008297:Male; D008442:Maxillary Nerve / Q000187:drug effects; D008619:Mepivacaine / Q000097:blood* / Q000493:pharmacokinetics; D009407:Nerve Block / Q000379:methods; D011433:Propranolol / Q000494:pharmacology*
D000779:Anesthetics, Local; D000959:Antihypertensive Agents; D011433:Propranolol; D008619:Mepivacaine