The Experts below are selected from a list of 264 Experts worldwide ranked by ideXlab platform
Yuzuru Kaneko - One of the best experts on this subject based on the ideXlab platform.
-
Felypressin but not epinephrine reduces myocardial oxygen tension after an injection of dental local anesthetic solution at routine doses
Journal of Oral and Maxillofacial Surgery, 2010Co-Authors: Motoaki Inagawa, Tatsuya Ichinohe, Yuzuru KanekoAbstract:Purpose The aim of this study was to evaluate the effect of epinephrine (Epi) or Felypressin (Fely) contained in dental local anesthetics on myocardial oxygen balance. Materials and Methods Male Japanese White tracheotomized rabbits were anesthetized with isoflurane. Three doses of 0.18, 0.36, and 0.72 mL of 2% lidocaine hydrochloride containing 1:80,000 Epi or 3% prilocaine hydrochloride containing Fely 0.03 IU/mL were injected into the rabbit tongue muscle. These doses were equivalent to 2, 4, and 8 of dental local anesthetic cartridges in humans weighing 50 kg by body weight correction, respectively. Heart rate, blood pressure, aortic blood flow, myocardial tissue blood flow, and myocardial tissue oxygen tension were continuously monitored. Data were recorded immediately before and 10, 20, 30, and 60 minutes after the injection. Results Heart rate decreased in the Fely group. Systolic blood pressure increased in the Epi group, and diastolic blood pressure increased in both groups. Aortic blood flow and myocardial tissue blood flow increased, whereas myocardial tissue oxygen tension did not change in the Epi group. In contrast, aortic blood flow, myocardial tissue blood flow, and myocardial tissue oxygen tension decreased in the Fely group. Conclusion It is suggested that Fely, but not Epi, decreases myocardial oxygen tension and aggravates myocardial oxygen demand/supply balance even after an injection of dental local anesthetic solution at routine doses.
-
Effects of local injection of prilocaine–Felypressin on the myocardial oxygen balance in dogs
European Journal of Oral Sciences, 2003Co-Authors: Kenji Miyachi, Tatsuya Ichinohe, Yuzuru KanekoAbstract:The authors investigated the effects of Felypressin (Fely), a non-adrenergic vasoconstrictor, used together with prilocaine on myocardial oxygen balance. Six open-chest dogs were studied under urethane and α-chloralose anesthesia. Systolic arterial pressure, diastolic arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure, heart rate, coronary blood flow (CBF), internal and external myocardial oxygen tension (int- or ext-PmO 2 ), and cardiac output were observed. Three doses of Citanest-Octapressin. which contains 3% prilocaine and 0.03 IU ml - 1 Fely (Pri-Fely)-0.09. 0.18, and 0.3 ml kg - 1 - were injected into the tongue. Observations were performed up to 60 min after the injection. The CBF and int-PmO 2 was reduced following the injection of each of the three doses of Pri-Fely. There were negative correlations between the Pri-Fely dose per body weight and the maximum reductions in CBF (r = 0.52, P > 0.05), in int-PmO 2 (r = 0.78, P > 0.05). and in extPmO 2 (r = 0.55, P > 0.05), respectively. These results suggest that an administration of Fely at doses more than 2.7-5.4 mIU kg - 1 (3-6 cartridges of Pri-Fely) may induce an imbalance between the oxygen supply and demand in myocardial tissues of patients with cardiovascular diseases.
-
effects of local injection of prilocaine Felypressin on the myocardial oxygen balance in dogs
European Journal of Oral Sciences, 2003Co-Authors: Kenji Miyachi, Tatsuya Ichinohe, Yuzuru KanekoAbstract:The authors investigated the effects of Felypressin (Fely), a non-adrenergic vasoconstrictor, used together with prilocaine on myocardial oxygen balance. Six open-chest dogs were studied under urethane and α-chloralose anesthesia. Systolic arterial pressure, diastolic arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure, heart rate, coronary blood flow (CBF), internal and external myocardial oxygen tension (int- or ext-PmO 2 ), and cardiac output were observed. Three doses of Citanest-Octapressin. which contains 3% prilocaine and 0.03 IU ml - 1 Fely (Pri-Fely)-0.09. 0.18, and 0.3 ml kg - 1 - were injected into the tongue. Observations were performed up to 60 min after the injection. The CBF and int-PmO 2 was reduced following the injection of each of the three doses of Pri-Fely. There were negative correlations between the Pri-Fely dose per body weight and the maximum reductions in CBF (r = 0.52, P > 0.05), in int-PmO 2 (r = 0.78, P > 0.05). and in extPmO 2 (r = 0.55, P > 0.05), respectively. These results suggest that an administration of Fely at doses more than 2.7-5.4 mIU kg - 1 (3-6 cartridges of Pri-Fely) may induce an imbalance between the oxygen supply and demand in myocardial tissues of patients with cardiovascular diseases.
-
adenosine and amrinone reverse Felypressin induced depression of myocardial tissue oxygen tension in dogs
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2000Co-Authors: Masataka Kasahara, Tatsuya Ichinohe, Yuzuru KanekoAbstract:Purpose: To determine whether continuous infusion of adenosine triphosphate (ATP), nitroglycerin (NTG) or amrinone (AM) would ameliorate the reductions in coronary blood flow (CBF) and myocardial oxygen tension (PmO2) induced by Felypressin.
-
Adenosine and amrinone reverse Felypressin-induced depression of myocardial tissue oxygen tension in dogs
Canadian Journal of Anaesthesia, 2000Co-Authors: Masataka Kasahara, Tatsuya Ichinohe, Yuzuru KanekoAbstract:Objectif: Vérifier si une perfusion continue d’adénosine triphosphate (ATP), de nitroglycérine (NTG) ou d’amrinone (AM) améliore la réduction du débit coronarien (DC) et de la pression partielle en oxygène myocardique (PmO_2) induits par la félypressine. Méthode: Sept chiens sous anesthésie avec uréthane et alpha-chloralose ont été étudiés à thorax ouvert. On a mesuré les variables hémodynamiques suivantes: la fréquence cardiaque (FC), la tension artérielle systolique (TAS), la tension artérielle diastolique (TAD), la tension artérielle pulmonaire moyenne, la tension capillaire pulmonaire, le DC (par ultrasonographie Doppler), la PmO_2 (par polarographie) et le débit cardiaque en qualité d’index cardiaque IC (par thermodilution). La félypressine a été injectée en dose de charge de 6 mlU·kg^−1 pendant cinq minutes, puis par une perfusion de 0,2 mlU·kg^−1·min^−1. Après 30 min, on a administré, pendant 15 min, une des perfusions de 100 et 200 µg·kg^−1·min^−1 d’ATP, 2,5 et 5 µg·kg^−1·min^−1 de NTG et 10 et 20 µg·kg^−1·min^−1 d’AM et on a évalué les changements hémodynamiques. Résultats: Après l’administration de félypressine, la TAD a augmenté de 17±5 (moyenne±écart type) %; le DC a diminué de 49±9 %; l’IC a baissé de 40±13 %; la FC a baissé de 29±11 %; la PmO_2 a baissé de 21±7 % dans la couche interne. L’IC et le DC sont revenus aux mesures de base après l’administration de 100 et 200 µg·kg^−1·min^−1 d’ATP, 10 et 20 µg·kg^−1·min^−1 d’AM, mais non après la NTG. La PmO_2 de la couche interne est revenue aux valeurs de base après toutes les perfusions, sauf après 5 µg·kg^−1·min^−1 de NTG. Conclusion: L’adénosine et l’amrinone, mais non la nitroglycérine, ont renversé les effets cardiovasculaires indésirables de la félypressine. Purpose: To determine whether continuous infusion of adenosine triphosphate (ATP), nitroglycerin (NTG) or amrinone (AM) would ameliorate the reductions in coronary blood flow (CBF) and myocardial oxygen tension (PmO_2) induced by Felypressin. Methods: Seven open-chest dogs were studied under urethane and alpha-chloralose anesthesia. Hemodynamic variables including heart rate (HR), systolic blood pressure, diastolic blood pressure (DBP), mean pulmonary artery pressure, pulmonary capillary wedge pressure, CBF (ultrasound flowmetry), PmO_2 (polarography) and cardiac output (thermodilution method) were recorded. Felypressin was infused in a loading dose of 6 mlU·kg^−1 for five minutes and then continued at 0.2 mlU·kg^−1·min^−1. After 30 min Felypressin infusion, each agent was administered for 15 min to evaluate hemodynamic changes. Infusions were 100 and 200 µg·kg^−1·min^−1 for ATP, 2.5 and 5 µg·kg^−1·min^−1 for NTG, and 10 and 20 µg·kg^−1·min^−1 for AM. Results: After Felypressin DBP increased by 17±5 (mean±SD) %; CBF decreased by 49±9%; Cl decreased by 40±13 %; HR decreased by 29±11 %; PmO_2 in the inner layer decreased by 21±7%. The Cl and CBF returned to baseline after ATP 100 and 200 µg·kg^−1·min^−1, AM 10 and 20 µg·kg^−1·min^−1, but not after NTG. The PmO_2 in the inner layer returned to the baseline value by any infusion except for NTG 5 µg·kg^−1·min^−1. Conclusion: Adenosine and amrinone, but not nitroglycerin reverses the adverse cardiovascular effects of Felypressin.
Tatsuya Ichinohe - One of the best experts on this subject based on the ideXlab platform.
-
Felypressin but not epinephrine reduces myocardial oxygen tension after an injection of dental local anesthetic solution at routine doses
Journal of Oral and Maxillofacial Surgery, 2010Co-Authors: Motoaki Inagawa, Tatsuya Ichinohe, Yuzuru KanekoAbstract:Purpose The aim of this study was to evaluate the effect of epinephrine (Epi) or Felypressin (Fely) contained in dental local anesthetics on myocardial oxygen balance. Materials and Methods Male Japanese White tracheotomized rabbits were anesthetized with isoflurane. Three doses of 0.18, 0.36, and 0.72 mL of 2% lidocaine hydrochloride containing 1:80,000 Epi or 3% prilocaine hydrochloride containing Fely 0.03 IU/mL were injected into the rabbit tongue muscle. These doses were equivalent to 2, 4, and 8 of dental local anesthetic cartridges in humans weighing 50 kg by body weight correction, respectively. Heart rate, blood pressure, aortic blood flow, myocardial tissue blood flow, and myocardial tissue oxygen tension were continuously monitored. Data were recorded immediately before and 10, 20, 30, and 60 minutes after the injection. Results Heart rate decreased in the Fely group. Systolic blood pressure increased in the Epi group, and diastolic blood pressure increased in both groups. Aortic blood flow and myocardial tissue blood flow increased, whereas myocardial tissue oxygen tension did not change in the Epi group. In contrast, aortic blood flow, myocardial tissue blood flow, and myocardial tissue oxygen tension decreased in the Fely group. Conclusion It is suggested that Fely, but not Epi, decreases myocardial oxygen tension and aggravates myocardial oxygen demand/supply balance even after an injection of dental local anesthetic solution at routine doses.
-
Effects of local injection of prilocaine–Felypressin on the myocardial oxygen balance in dogs
European Journal of Oral Sciences, 2003Co-Authors: Kenji Miyachi, Tatsuya Ichinohe, Yuzuru KanekoAbstract:The authors investigated the effects of Felypressin (Fely), a non-adrenergic vasoconstrictor, used together with prilocaine on myocardial oxygen balance. Six open-chest dogs were studied under urethane and α-chloralose anesthesia. Systolic arterial pressure, diastolic arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure, heart rate, coronary blood flow (CBF), internal and external myocardial oxygen tension (int- or ext-PmO 2 ), and cardiac output were observed. Three doses of Citanest-Octapressin. which contains 3% prilocaine and 0.03 IU ml - 1 Fely (Pri-Fely)-0.09. 0.18, and 0.3 ml kg - 1 - were injected into the tongue. Observations were performed up to 60 min after the injection. The CBF and int-PmO 2 was reduced following the injection of each of the three doses of Pri-Fely. There were negative correlations between the Pri-Fely dose per body weight and the maximum reductions in CBF (r = 0.52, P > 0.05), in int-PmO 2 (r = 0.78, P > 0.05). and in extPmO 2 (r = 0.55, P > 0.05), respectively. These results suggest that an administration of Fely at doses more than 2.7-5.4 mIU kg - 1 (3-6 cartridges of Pri-Fely) may induce an imbalance between the oxygen supply and demand in myocardial tissues of patients with cardiovascular diseases.
-
effects of local injection of prilocaine Felypressin on the myocardial oxygen balance in dogs
European Journal of Oral Sciences, 2003Co-Authors: Kenji Miyachi, Tatsuya Ichinohe, Yuzuru KanekoAbstract:The authors investigated the effects of Felypressin (Fely), a non-adrenergic vasoconstrictor, used together with prilocaine on myocardial oxygen balance. Six open-chest dogs were studied under urethane and α-chloralose anesthesia. Systolic arterial pressure, diastolic arterial pressure, mean pulmonary arterial pressure and pulmonary capillary wedge pressure, heart rate, coronary blood flow (CBF), internal and external myocardial oxygen tension (int- or ext-PmO 2 ), and cardiac output were observed. Three doses of Citanest-Octapressin. which contains 3% prilocaine and 0.03 IU ml - 1 Fely (Pri-Fely)-0.09. 0.18, and 0.3 ml kg - 1 - were injected into the tongue. Observations were performed up to 60 min after the injection. The CBF and int-PmO 2 was reduced following the injection of each of the three doses of Pri-Fely. There were negative correlations between the Pri-Fely dose per body weight and the maximum reductions in CBF (r = 0.52, P > 0.05), in int-PmO 2 (r = 0.78, P > 0.05). and in extPmO 2 (r = 0.55, P > 0.05), respectively. These results suggest that an administration of Fely at doses more than 2.7-5.4 mIU kg - 1 (3-6 cartridges of Pri-Fely) may induce an imbalance between the oxygen supply and demand in myocardial tissues of patients with cardiovascular diseases.
-
adenosine and amrinone reverse Felypressin induced depression of myocardial tissue oxygen tension in dogs
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2000Co-Authors: Masataka Kasahara, Tatsuya Ichinohe, Yuzuru KanekoAbstract:Purpose: To determine whether continuous infusion of adenosine triphosphate (ATP), nitroglycerin (NTG) or amrinone (AM) would ameliorate the reductions in coronary blood flow (CBF) and myocardial oxygen tension (PmO2) induced by Felypressin.
-
Adenosine and amrinone reverse Felypressin-induced depression of myocardial tissue oxygen tension in dogs
Canadian Journal of Anaesthesia, 2000Co-Authors: Masataka Kasahara, Tatsuya Ichinohe, Yuzuru KanekoAbstract:Objectif: Vérifier si une perfusion continue d’adénosine triphosphate (ATP), de nitroglycérine (NTG) ou d’amrinone (AM) améliore la réduction du débit coronarien (DC) et de la pression partielle en oxygène myocardique (PmO_2) induits par la félypressine. Méthode: Sept chiens sous anesthésie avec uréthane et alpha-chloralose ont été étudiés à thorax ouvert. On a mesuré les variables hémodynamiques suivantes: la fréquence cardiaque (FC), la tension artérielle systolique (TAS), la tension artérielle diastolique (TAD), la tension artérielle pulmonaire moyenne, la tension capillaire pulmonaire, le DC (par ultrasonographie Doppler), la PmO_2 (par polarographie) et le débit cardiaque en qualité d’index cardiaque IC (par thermodilution). La félypressine a été injectée en dose de charge de 6 mlU·kg^−1 pendant cinq minutes, puis par une perfusion de 0,2 mlU·kg^−1·min^−1. Après 30 min, on a administré, pendant 15 min, une des perfusions de 100 et 200 µg·kg^−1·min^−1 d’ATP, 2,5 et 5 µg·kg^−1·min^−1 de NTG et 10 et 20 µg·kg^−1·min^−1 d’AM et on a évalué les changements hémodynamiques. Résultats: Après l’administration de félypressine, la TAD a augmenté de 17±5 (moyenne±écart type) %; le DC a diminué de 49±9 %; l’IC a baissé de 40±13 %; la FC a baissé de 29±11 %; la PmO_2 a baissé de 21±7 % dans la couche interne. L’IC et le DC sont revenus aux mesures de base après l’administration de 100 et 200 µg·kg^−1·min^−1 d’ATP, 10 et 20 µg·kg^−1·min^−1 d’AM, mais non après la NTG. La PmO_2 de la couche interne est revenue aux valeurs de base après toutes les perfusions, sauf après 5 µg·kg^−1·min^−1 de NTG. Conclusion: L’adénosine et l’amrinone, mais non la nitroglycérine, ont renversé les effets cardiovasculaires indésirables de la félypressine. Purpose: To determine whether continuous infusion of adenosine triphosphate (ATP), nitroglycerin (NTG) or amrinone (AM) would ameliorate the reductions in coronary blood flow (CBF) and myocardial oxygen tension (PmO_2) induced by Felypressin. Methods: Seven open-chest dogs were studied under urethane and alpha-chloralose anesthesia. Hemodynamic variables including heart rate (HR), systolic blood pressure, diastolic blood pressure (DBP), mean pulmonary artery pressure, pulmonary capillary wedge pressure, CBF (ultrasound flowmetry), PmO_2 (polarography) and cardiac output (thermodilution method) were recorded. Felypressin was infused in a loading dose of 6 mlU·kg^−1 for five minutes and then continued at 0.2 mlU·kg^−1·min^−1. After 30 min Felypressin infusion, each agent was administered for 15 min to evaluate hemodynamic changes. Infusions were 100 and 200 µg·kg^−1·min^−1 for ATP, 2.5 and 5 µg·kg^−1·min^−1 for NTG, and 10 and 20 µg·kg^−1·min^−1 for AM. Results: After Felypressin DBP increased by 17±5 (mean±SD) %; CBF decreased by 49±9%; Cl decreased by 40±13 %; HR decreased by 29±11 %; PmO_2 in the inner layer decreased by 21±7%. The Cl and CBF returned to baseline after ATP 100 and 200 µg·kg^−1·min^−1, AM 10 and 20 µg·kg^−1·min^−1, but not after NTG. The PmO_2 in the inner layer returned to the baseline value by any infusion except for NTG 5 µg·kg^−1·min^−1. Conclusion: Adenosine and amrinone, but not nitroglycerin reverses the adverse cardiovascular effects of Felypressin.
J.g. Meechan - One of the best experts on this subject based on the ideXlab platform.
-
Effects of dental local anaesthetics in cardiac transplant recipients
British Dental Journal, 2002Co-Authors: J.g. Meechan, Gareth Parry, D T Rattray, J. M. ThomasonAbstract:Objective To investigate the cardiovascular responses of cardiac transplant recipients to dental local anaesthetic solutions with and without epinephrine (adrenaline). Materials and methods A clinical study employing 30 patients (20 cardiac transplant recipients and ten healthy) awaiting gingival or minor oral surgery under local anaesthesia receiving either 4.4 ml lidocaine (lignocaine) with 1:80,000 epinephrine or 4.4 ml 3% prilocaine with 0.03IU/ml Felypressin. Results Cardiac transplant patients experienced a significant tachycardia 10 minutes after injection of the epinephrine-containing solution. No significant change in heart rate was detected after the injection of an epinephrine-free solution. Blood pressure was not affected. Periodontal surgery did not affect the responses to the local anaesthetics in the transplant recipients. Conclusions The cardiovascular response to dental local anaesthesia in cardiac transplant recipients is governed by the solution injected.
-
Effects of dental local anaesthetics in cardiac transplant recipients
British Dental Journal, 2002Co-Authors: J.g. Meechan, Gareth Parry, D T Rattray, J. M. ThomasonAbstract:Objective To investigate the cardiovascular responses of cardiac transplant recipients to dental local anaesthetic solutions with and without epinephrine (adrenaline). Materials and methods A clinical study employing 30 patients (20 cardiac transplant recipients and ten healthy) awaiting gingival or minor oral surgery under local anaesthesia receiving either 4.4 ml lidocaine (lignocaine) with 1:80,000 epinephrine or 4.4 ml 3% prilocaine with 0.03IU/ml Felypressin. Results Cardiac transplant patients experienced a significant tachycardia 10 minutes after injection of the epinephrine-containing solution. No significant change in heart rate was detected after the injection of an epinephrine-free solution. Blood pressure was not affected. Periodontal surgery did not affect the responses to the local anaesthetics in the transplant recipients. Conclusions The cardiovascular response to dental local anaesthesia in cardiac transplant recipients is governed by the solution injected. Transplanted hearts are supersensitive to the effects of circulating catecholamines. This paper examines the haemodynamic effects of dental local anaesthetics containing 1:80,000 epinephrine (adrenaline) in patients with cardiac transplants. The epinephrine in dental local anaesthetics did not affect blood pressure in cardiac transplant recipients. Epinephrine contained in dental local anaesthetics significantly increased heart rate in cardiac transplant recipients before periodontal surgery. Surgery did not mask the haemodynamic changes produced by the local anaesthetic in cardiac transplant recipients. Epinephrine-free solutions may be preferred for dental local anaesthesia in cardiac transplant recipients.
-
The influence of two different dental local anaesthetic solutions on the haemo-dynamic responses of children undergoing restorative dentistry: a randomised, single-blind, split-mouth study
British Dental Journal, 2001Co-Authors: J.g. Meechan, B Cole, R R WelburyAbstract:Objectives This investigation was designed to study the haemodynamic effects of two different local anaesthetic solutions during restorative dental treatment in children. Design A randomised, single-blind, split-mouth cross-over design was employed using children undergoing bilaterally similar restorative treatments over two visits. Setting The study was performed in a dental hospital paediatric dentistry department. Methods Ten children participated. At one visit the local anaesthetic was 2% lidocaine (lignocaine) with 1:80,000 epinephrine (adrenaline); at the other the anaesthetic was 3% prilocaine with 0.03IU/ml Felypressin. Local anaesthetic was administered at a dose of 0.5 ml/10 kg body weight. Blood pressure and heart rate were measured before and during treatment with an automatic blood pressure recorder. Data were analysed by ANOVA and Student's paired t test. Results Significant differences between treatments in diastolic blood pressure (F = 2.37; P = 0.05) and heart rate (F = 2.98; P < 0.02) were noted. The heart rate increased ten minutes following the injection of the epinephrine-containing solution. The diastolic blood pressure fell 20 minutes after injection of lidocaine with epinephrine. Conclusion The choice of local anaesthetic solution influences the haemodynamic response during restorative treatment in children.
-
The effects of dental local anaesthetics on blood glucose concentration in healthy volunteers and in patients having third molar surgery
British Dental Journal, 1991Co-Authors: J.g. MeechanAbstract:The effects of adrenaline-containing and adrenaline-free dental local anaesthetic solutions on blood glucose concentration were investigated in single-blind cross-over studies in ten healthy volunteers and in ten patients having lower third molar surgery. The solutions compared were 2% lignocaine containing 1:80,000 adrenaline (Xylocaine) and 3% prilocaine with 0.03 IU/ml Felypressin (Citanest). In all cases, 4.4 ml of solution was used. In the volunteer study the blood glucose concentration increased from 4.48 +/− 0.72 mmol/litre immediately before the injection of Xylocaine to 5.07 +/− 0.99 mmol/litre 30 minutes following the injection; with Citanest the pretreatment concentration of 4.56 +/− 0.92 mmol/litre changed to 4.24 +/− 0.62 mmol/litre at 30 minutes. This increase in blood glucose concentration following the administration of Xylocaine was significant (t = 3.39, P less than 0.01), as was the difference between treatments (t = 2.64, P less than 0.05). In the patient study, the blood glucose level prior to the injection of Xylocaine was 4.56 +/− 1.59 mmol/litre and this increased to 5.24 +/− 0.86 mmol/litre 30 minutes after the local anaesthetic was injected. The pretreatment blood glucose level of 4.52 +/− 0.82 mmol/litre in patients when Citanest was used changed to 4.33 +/− 0.71 mmol/litre 30 minutes following the injection. The difference at 30 minutes in the changes in blood glucose concentration between local anaesthetic regimes in patients having third molar surgery was significant (t = 2.60, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
John G. Meechan - One of the best experts on this subject based on the ideXlab platform.
-
A survey of local anaesthetic use among general dental practitioners in the UK attending postgraduate courses on pain control
British Dental Journal, 2005Co-Authors: I. P. Corbett, Juliana Cama Ramacciato, Francisco Carlos Groppo, John G. MeechanAbstract:Objective The aim of this study was to identify which local anaesthetic solutions were used by general dental practitioners in the United Kingdom and to determine selection criteria. In addition, differences in anaesthetic choice between recent graduates (≤5 years) and more experienced practitioners were investigated. Material and methods Five hundred and six general dental practitioners attending postgraduate courses on pain control in dentistry completed a questionnaire. Participants were asked to indicate year and place of qualification, anaesthetic solutions available in their surgeries and criteria used in the choice of anaesthetic. In addition, the respondents were asked to indicate choice of local anaesthetic in a number of common medical conditions. Questionnaires were distributed and collected immediately prior to the start of the course presentation and participants were not asked to indicate whether the selection decisions were teaching, experience or evidence based. Data were analysed by using the Chi-square test. Results Lidocaine with epinephrine was the most widely available solution among this group of practitioners (94%), the second most common solution was prilocaine with Felypressin (74%). The majority of practitioners had two or more solutions available. Practitioners who qualified within the last five years (14%) were more likely to have articaine available, the most recently introduced local anaesthetic into the UK (p = 0.04, one degree of freedom). Common medical conditions lead to a modification in anaesthetic selection: the use of prilocaine/Felypressin increases in the majority of circumstances, although it is avoided in pregnant females by recent graduates. Conclusions Lidocaine/epinephrine continues to be the most common anaesthetic solution used by this group of UK general practitioners. The primary criterion for selection of an anaesthetic agent was perceived efficacy. Prilocaine/Felypressin is commonly selected as an alternative solution in the presence of common medical conditions.
-
A survey of local anaesthetic use among general dental practitioners in the UK attending postgraduate courses on pain control
British Dental Journal, 2005Co-Authors: I. P. Corbett, Juliana Cama Ramacciato, Francisco Carlos Groppo, John G. MeechanAbstract:Reviews evidence with regard to anaesthetic selection in common medical conditions. Indicates current practice within the dental population. Emphasises the need for evidence-based practice. Objective The aim of this study was to identify which local anaesthetic solutions were used by general dental practitioners in the United Kingdom and to determine selection criteria. In addition, differences in anaesthetic choice between recent graduates (≤5 years) and more experienced practitioners were investigated. Material and methods Five hundred and six general dental practitioners attending postgraduate courses on pain control in dentistry completed a questionnaire. Participants were asked to indicate year and place of qualification, anaesthetic solutions available in their surgeries and criteria used in the choice of anaesthetic. In addition, the respondents were asked to indicate choice of local anaesthetic in a number of common medical conditions. Questionnaires were distributed and collected immediately prior to the start of the course presentation and participants were not asked to indicate whether the selection decisions were teaching, experience or evidence based. Data were analysed by using the Chi-square test. Results Lidocaine with epinephrine was the most widely available solution among this group of practitioners (94%), the second most common solution was prilocaine with Felypressin (74%). The majority of practitioners had two or more solutions available. Practitioners who qualified within the last five years (14%) were more likely to have articaine available, the most recently introduced local anaesthetic into the UK (p = 0.04, one degree of freedom). Common medical conditions lead to a modification in anaesthetic selection: the use of prilocaine/Felypressin increases in the majority of circumstances, although it is avoided in pregnant females by recent graduates. Conclusions Lidocaine/epinephrine continues to be the most common anaesthetic solution used by this group of UK general practitioners. The primary criterion for selection of an anaesthetic agent was perceived efficacy. Prilocaine/Felypressin is commonly selected as an alternative solution in the presence of common medical conditions.
-
The influence of two different dental local anaesthetic solutions on the haemodynamic responses of children undergoing restorative dentistry: a randomised, single-blind, split-mouth study.
British Dental Journal, 2001Co-Authors: John G. Meechan, B Cole, R R WelburyAbstract:Objectives This investigation was designed to study the haemodynamic effects of two different local anaesthetic solutions during restorative dental treatment in children. Design A randomised, single-blind, split-mouth cross-over design was employed using children undergoing bilaterally similar restorative treatments over two visits. Setting The study was performed in a dental hospital paediatric dentistry department. Methods Ten children participated. At one visit the local anaesthetic was 2% lidocaine (lignocaine) with 1:80,000 epinephrine (adrenaline); at the other the anaesthetic was 3% prilocaine with 0.03IU/ml Felypressin. Local anaesthetic was administered at a dose of 0.5 ml/10 kg body weight. Blood pressure and heart rate were measured before and during treatment with an automatic blood pressure recorder. Data were analysed by ANOVA and Student's paired t test. Results Significant differences between treatments in diastolic blood pressure (F = 2.37; P = 0.05) and heart rate (F = 2.98; P < 0.02) were noted. The heart rate increased ten minutes following the injection of the epinephrine-containing solution. The diastolic blood pressure fell 20 minutes after injection of lidocaine with epinephrine. Conclusion The choice of local anaesthetic solution influences the haemodynamic response during restorative treatment in children.
-
Metabolic responses to oral surgery under local anesthesia and sedation with intravenous midazolam: the effects of two different local anesthetics.
Anesthesia Progress, 1992Co-Authors: John G. Meechan, R R WelburyAbstract:Abstract The effects of epinephrine-free and epinephrine-containing local anesthetic solutions on plasma potassium and blood glucose concentrations were investigated in 20 patients undergoing oral surgery with intravenous midazolam sedation. Ten patients were randomly assigned to receive 4.4 mL of 2% lidocaine with 1:80,000 epinephrine as a local anesthetic and 10 were given 4.4 mL of 3% prilocaine with 0.03 IU/mL Felypressin. There were significant changes from baseline potassium and glucose concentrations both within and between treatments in the early postinjection period. The epinephrine-containing local anesthetic significantly reduced the plasma potassium concentration 10 min after injection, by 0.16 +/- 0.20 mmol/L (mean +/- SD), and increased the blood glucose concentration at 10, 20, and 30 min (by 0.46 +/- 0.37, 0.63 +/- 0.45, and 0.56 +/- 0.28 mmol/L, respectively). Conversely, plasma potassium increased and blood glucose decreased 10, 20, and 30 min following the administration of the epinephrine-free solution. At 30 min potassium was increased by 0.24 +/- 0.16 mmol/L, and glucose was decreased by 0.23 +/- 0.16 mmol/L. It is concluded that epinephrine-free and epinephrine-containing local anesthetics differ in their metabolic effects during oral surgery with midazolam sedation.
R R Welbury - One of the best experts on this subject based on the ideXlab platform.
-
The influence of two different dental local anaesthetic solutions on the haemo-dynamic responses of children undergoing restorative dentistry: a randomised, single-blind, split-mouth study
British Dental Journal, 2001Co-Authors: J.g. Meechan, B Cole, R R WelburyAbstract:Objectives This investigation was designed to study the haemodynamic effects of two different local anaesthetic solutions during restorative dental treatment in children. Design A randomised, single-blind, split-mouth cross-over design was employed using children undergoing bilaterally similar restorative treatments over two visits. Setting The study was performed in a dental hospital paediatric dentistry department. Methods Ten children participated. At one visit the local anaesthetic was 2% lidocaine (lignocaine) with 1:80,000 epinephrine (adrenaline); at the other the anaesthetic was 3% prilocaine with 0.03IU/ml Felypressin. Local anaesthetic was administered at a dose of 0.5 ml/10 kg body weight. Blood pressure and heart rate were measured before and during treatment with an automatic blood pressure recorder. Data were analysed by ANOVA and Student's paired t test. Results Significant differences between treatments in diastolic blood pressure (F = 2.37; P = 0.05) and heart rate (F = 2.98; P < 0.02) were noted. The heart rate increased ten minutes following the injection of the epinephrine-containing solution. The diastolic blood pressure fell 20 minutes after injection of lidocaine with epinephrine. Conclusion The choice of local anaesthetic solution influences the haemodynamic response during restorative treatment in children.
-
The influence of two different dental local anaesthetic solutions on the haemodynamic responses of children undergoing restorative dentistry: a randomised, single-blind, split-mouth study.
British Dental Journal, 2001Co-Authors: John G. Meechan, B Cole, R R WelburyAbstract:Objectives This investigation was designed to study the haemodynamic effects of two different local anaesthetic solutions during restorative dental treatment in children. Design A randomised, single-blind, split-mouth cross-over design was employed using children undergoing bilaterally similar restorative treatments over two visits. Setting The study was performed in a dental hospital paediatric dentistry department. Methods Ten children participated. At one visit the local anaesthetic was 2% lidocaine (lignocaine) with 1:80,000 epinephrine (adrenaline); at the other the anaesthetic was 3% prilocaine with 0.03IU/ml Felypressin. Local anaesthetic was administered at a dose of 0.5 ml/10 kg body weight. Blood pressure and heart rate were measured before and during treatment with an automatic blood pressure recorder. Data were analysed by ANOVA and Student's paired t test. Results Significant differences between treatments in diastolic blood pressure (F = 2.37; P = 0.05) and heart rate (F = 2.98; P < 0.02) were noted. The heart rate increased ten minutes following the injection of the epinephrine-containing solution. The diastolic blood pressure fell 20 minutes after injection of lidocaine with epinephrine. Conclusion The choice of local anaesthetic solution influences the haemodynamic response during restorative treatment in children.
-
Metabolic responses to oral surgery under local anesthesia and sedation with intravenous midazolam: the effects of two different local anesthetics.
Anesthesia Progress, 1992Co-Authors: John G. Meechan, R R WelburyAbstract:Abstract The effects of epinephrine-free and epinephrine-containing local anesthetic solutions on plasma potassium and blood glucose concentrations were investigated in 20 patients undergoing oral surgery with intravenous midazolam sedation. Ten patients were randomly assigned to receive 4.4 mL of 2% lidocaine with 1:80,000 epinephrine as a local anesthetic and 10 were given 4.4 mL of 3% prilocaine with 0.03 IU/mL Felypressin. There were significant changes from baseline potassium and glucose concentrations both within and between treatments in the early postinjection period. The epinephrine-containing local anesthetic significantly reduced the plasma potassium concentration 10 min after injection, by 0.16 +/- 0.20 mmol/L (mean +/- SD), and increased the blood glucose concentration at 10, 20, and 30 min (by 0.46 +/- 0.37, 0.63 +/- 0.45, and 0.56 +/- 0.28 mmol/L, respectively). Conversely, plasma potassium increased and blood glucose decreased 10, 20, and 30 min following the administration of the epinephrine-free solution. At 30 min potassium was increased by 0.24 +/- 0.16 mmol/L, and glucose was decreased by 0.23 +/- 0.16 mmol/L. It is concluded that epinephrine-free and epinephrine-containing local anesthetics differ in their metabolic effects during oral surgery with midazolam sedation.
