Felypressin, but not epinephrine, reduces myocardial oxygen tension after an injection of dental local anesthetic solution at routine doses.

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.

Vasopressin/oxytocin-related peptides influence long-term memory of a passive avoidance task in the cuttlefish, Sepia officinalis.

The vasopressin (VP)/oxytocin (OT)-related peptides constitute a large superfamily found in a wide range of both vertebrate and invertebrate species. While intensive literature reports that these neuropeptides influence behavior, especially learning and memory, in numerous species from diverse vertebrate groups, their roles in behavioral regulation have never been studied in invertebrates. Here, we investigated the role of two VP/OT superfamily peptides, octopressin (OP) and cephalotocin (CT), on long-term memory (LTM) formation of a passive avoidance task in a cephalopod mollusc, the cuttlefish, Sepia officinalis. Subadult cuttlefish were intravenously injected, in a dose range of 3-60 microg/kg, 1h after the training phase (consolidation design); retention performance was tested 24h post-training. We found that administration of OP at low dose (3 microg/kg) enhanced LTM, whereas a dose of 60 microg/kg attenuated it. No effect of OP on LTM was observed for the 15 microg/kg dose. Conversely, an enhancement of retention performance was observed at all doses of CT tested. This study is the first to demonstrate the behavioral effects of VP/OT superfamily peptides in an invertebrate species. The valuable role of VP/OT-like peptides on memory processes offers new evolutionary perspectives on peptidergic transmission and neuromodulation.

Estudio histológico del proceso de reparación alveolar después de la aplicación tópica de la solución anestésica prilocaína 3 por ciento con felipresina 003 UI/ML / Histological study of alveolar repair process after topical application of the anesthetic solution with 3 percent prilocaine Felypressin 0.03 IU / ML

El objetivo de este estudio fue evaluar la influencia de una solución anestésica, compuesta por Prilocaina 3% y felipresina 0,03 UI/ml, y el efecto que tiene sobre el proceso de reparación alveolar en ratones después de una exodoncia. Este estudio fue aprobado por el Comité de Etica en Investigación del Programa de Maestría de Cirugía y Traumatologia Bucomaxilofacial de la Universidad de Marilia (UNIMAR) Marília, São Paulo, Brasil. Este estudio fue de tipo experimental, aleatorio controlado, con análisis bifactorial (grupo control en relación al grupo experimental, en función de los tiempos operatorios (2X4)). Se utilizaron 32 ratones (Rattus norvegicus, albinus, Wistar), machos, adultos, pesando entre 280 y 320 gramos. Los animales fueron distribuidos de la siguiente forma: 16 especímenes fueron seleccionados para grupo control (Grupo I), no recibieron ningún tratamiento adicional después de la extracción del incisivo superior derecho; los otros 16 especímenes restantes, después de la exodoncia, un área de la herida quirúrgica fue tamponada con gasa embebida en la solución anestésica de Citocaína 3%® (Clorhidrato de Prilocaína 3% con Felipresina 0,03 UI/ml), y conformaron el grupo experimental (Grupo II). Los animales sufrieron eutanasia transcurridos los períodos de 3, 7, 15, 24 días post operatorios. Através del análisis histológico y con base en la metodología desarrollada, nos permitió concluir que la solución anestésica de Citocaína 3%® aplicada con compresas de gasa sobre la herida quirúrgica post-extracción dentaria, produjo eventos tisulares que comprometieron los principios básicos responsables por la regeneración del epitelio de la mucosa gingival y por el proceso de reparación alveolar. Se observó que en todos los períodos post operatorios estudiados y cuando se compararon los dos Grupos, se confirmó que el Grupo I presentó mejores resultados en relación al proceso de reparación alveolar

O objetivo deste estudo foi avaliar a influência da solução anestésica, composta por Prilocaína 3% com felipressina 0,03 UI/ml, sobre o processo de reparación alveolar em ratos, após a extração dental. O presente estudo foi previamente aprovado pelo comitê de ética em pesquisa do Programa de Mestrado em Cirurgia e Traumatologia Buço-maxilo-faciais da Universidade de Marília (UNIMAR), Marília, São Paulo, Brasil. Tratou-se de um estudo do tipo experimental, aleatório controlado, com análise bifatorial (grupo controle em relação ao grupo experimental, em função dos tempos operatórios (2x4)). Utilizou-se 32 ratos (Rattus norvegicus, albinus, Wistar), machos, adultos, pesando entre 280 e 320 gramas. Os animais foram distribuídos da seguinte forma: 16 espécimes foram selecionados para o grupo controle (Grupo I), não receberam nenhum tratamento adicional após a extração do incisivo superior direito; os outros 16 espécimes restantes, depois da exodontia, a área da ferida cirúrgica foi tamponada com gaze embebida em solução anestésica de Citocaína 3%® (Prilocaína 3% com Felipressina 0,03 UI/ml), e formaram o grupo experimental (Grupo II). Os animais sofreram eutanásia após decorrido os períodos de 3, 7, 15, 24 dias pós-operatórios. Através da análise histológica e com base na metodologia aplicada, permitiu-nos concluir que a solução de Citocaína 3%® aplicada com compressas de gaze sobre a ferida cirúrgica após extração dentária, produz eventos teciduais que comprometeram os princípios básicos responsáveis pela regeneração do epitélio da mucosa gengival e o processo de reparação alveolar em ratos. Observou-se que em todos os períodos pós-operatórios estudados e quando se compararam os dois Grupos, confirmou-se que o Grupo I apresentou melhores resultados em relação ao processo de reparo alveolar

The aim of this study was to evaluate the local anesthetic solution, composed by Prilocaine 3% and felipressin 0,03 UI/ml, influence on the alveolar repair process in rats after dental extraction. This research was previously approved by the Ethic Committee in Research of the Masters Degree Program in Oral and Maxillofacial Surgery of the Marília University (UNIMAR), Marília, São Paulo, Brazil. It was an experimental, randomly controlled study, with bifactorial analysis (group control versus experimental group, in function of the postoperative times (2 X 4)). For the accomplishment of this study 32 rats were used (Rattus norvegicus, albinus, Wistar), males, adults, weighing between 280 and 320 grams. The animals were selected and divided into Group I (control) and Group II (Citocain 3%® - Prilocaine 3% with felipressin 0,03UI/ml) with 16 rats each; being four animals of the Group I and four of the Group II, destined to the euthanasia in the postoperative periods of 3rd, 7th, 15th and 24th days. The histological analysis with base in the developed methodology, allowed us to conclude that the anesthetic solution of Citocain 3%® applied with gauze compress on the surgical dental wound, produced tissue events that committed the basic biological principles, that are responsible for the regeneration of the gingival epithelium and the alveolar process repair in rats. The Group I presented better results in the alveolar repair when compared to the Group II

The effect of different vasoconstrictors and local anesthetic solutions on substance P expression in human dental pulp.

The purpose of this study was to quantify the effect of the infiltration injection of different vasoconstrictor and anesthetic solutions on substance P (SP) expression in healthy human dental pulp. Thirty pulp samples were obtained from healthy upper premolars in which extraction was indicated for orthodontic reasons and were randomly assigned into three groups of 10 samples each: 2% lidocaine with 1:80,000 epinephrine (Lido group), 3% Prilocaine with 1:200000 felypressin (Prilo group); and 4% Prilocaine without vasoconstrictor (Prilo-no-VC group). All teeth were extracted 10 minutes after anesthetic application. Pulp samples were processed and SP was measured by radioimmunoassay. SP expression for the Lido, Prilo, and Prilo-no-VC groups were 616.49, 663.76, and 760.79 pmol/mg pulp tissue, respectively. Analysis of variance showed statistically significant differences between groups (p = 0.001). Tukey Honestly Significant Difference (HSD) post hoc tests showed significant statistical differences between the Prilo-no-VC group and the Lido group (p < 0.01) and between the Prilo-no-VC group and the Prilo group (p < 0.05). It can be concluded that infiltration injection of local anesthetics with vasoconstrictor attenuate SP expression in human dental pulp.

A double-blind, randomized, placebo-controlled trial of prilocaine and felypressin (Citanest and Octapressin) for the relief of pain associated with cervical biopsy and treatment with the Semm coagulator.

OBJECTIVE: To quantify the anticipated and actual pain experienced in association with preliminary cervical punch biopsies and subsequent ablative treatment with the Semm coagulator, and to test the hypothesis that the intracervical injection of prilocaine with felypressin reduces the intensity of the pain experienced. MATERIALS AND METHODS: One hundred consecutive women referred with abnormal cervical smears for colposcopic assessment and considered suitable for treatment with the Semm coagulator were recruited to a double-blind, randomized, prospective, placebo-controlled trial conducted in a colposcopy clinic in a university teaching hospital. Personal particulars were taken and anticipated pain scored. The patients were injected with randomized externally identical vials of prilocaine and felypressin (Citanest and Octapressin) or placebo. After biopsy and treatment, patients scored their actual pain experienced. Pain scores were compared as the main outcome measure. Relative risks with 95% CIs were calculated and compared using the CI Analysis computer programme (Professor Martin J Gardner and the British Medical Journal Version 1.1, copyright 1991). RESULTS: Anticipated pain was greater than the actual pain experienced in both groups. Women receiving the local anesthesia experienced a significantly greater reduction in pain (p < .05) with only 4.3% and 6.7% experiencing moderate pain during biopsy and treatment, respectively. The active drug abolished severe pain. In the placebo group, 44.7% felt mild pain at the most. CONCLUSIONS: Intracervical injection of prilocaine and felypressin reduces the intensity of pain experienced in women undergoing cervical biopsy and treatment with the Semm coagulator. Its use is commendable but is not absolutely necessary in all cases.

Takayasu's arteritis: what should the dentist know?

Takayasu's arteritis is a chronic inflammatory disease that affects large blood vessels, especially the aorta and/or its major branches. The condition presents with segmental lesions adjacent to normal, apparently unaffected, areas. The lesions include stenosis, occlusion, dilatations or aneurysm formations along the path of the affected artery. Because of the severity of the disease and the possibility of cardiovascular complications, patients with Takayasu's arteritis require medical treatment based on immunosuppressive and antihypertensive drugs, as well as regular follow up and surgical intervention in many instances. The aim of this paper was to describe the characteristics of Takayasu's arteritis, to report dental treatment carried out on an affected patient, and to discuss the main implications and care required during routine treatment for children in the dental office.

Effects of the prilocaine and of the association of prilocaine with different vasoconstrictors on the isolated hearts of rats.

This study aimed to observe the effects of prilocaine chloridate (P) and the associations of P with felypressin (P+F), and epinephrine (P+E) on the heart rate and force of contraction on the isolated hearts of rats. The hearts were perfused according to Langendorff's method. The experiments were performed with the following substances: prilocaine (P), felypressin (F), and epinephrine (E). P was used in doses of 1.25, 2.5, and 5.0 mg. The same doses of F and P (1.0, 1.5 and 3.0 microg) were used in association with the P, respectively. Right after the application of the three doses of P, a reduction in the force of contraction was observed, with higher intensity at a higher dose, which led to cardiac arrest. A similar result was obtained with the administration of the three associations of P+F. Also the application of the three associations P+E resulted in a reduction of the force of contraction, that was, however, less intense with the associations of 1.25 mg P + 1.0 microg E and 2.5 mg P+1.5 microg E, as compared to the same doses of P alone and P+F. The two higher doses of P and P+F on the heart rate elicited a significant reduction in relation to the control, but with the associations of P+E no alterations were observed, with any one of the doses used. The results obtained in the present study suggest that an association of P and E must be used in local anesthesia, since epinephrine may well protect the heart from the depressive effects of the anesthetic salts.

Effects of local injection of prilocaine-felypressin on the myocardial oxygen balance in dogs.

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 alpha-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-PmO2), 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-PmO2 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-PmO2 (r = -0.78, P < 0.05), and in ext-PmO2 (r = -0.55, P < 0.05), respectively [corrected]. 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.

Verification of protector effect of the norepinephrine and felypressin upon the cardiovascular system under action of the lidocaine hydrochloride and prilocaine hydrochloride in anesthetized rats.

Vasoconstrictor substances, as norepinephrine and epinephrine, were mixtured to local anesthetics to decrease their toxic effects and to prolong the depth of the anesthesia. However, these catecholamines produce systolic and diastolic hypertension. The effects of felypressin, a synthetic vasoconstrictor, upon arterial blood pressure and heart are lesser than those of norepinephrine or epinephrine, but due to its effects like oxytocin these catecholamines are yet the most used vasoconstrictors in association with lidocaine or another anesthetic salt. These vasoconstrictors are contraindicated for some physician, mainly for cardiac patients. But, are the catecholamines or is the salt the most dangerous components of the local anesthetic? The effects of the salt and catecholamines are opposite, but which of these exercises their effects first when inside blood vessel? Singi et al. [Pharmacol. Res. 44 (2001)] demonstrated that the first effect is always of the salt and that norepinephrine promotes protector effects upon guinea-pig isolated heart against lidocaine action. But, is this true for in vivo animals? The present study was performed with the aiming to answer this question and to verify if felypressin can induce the same effect of the norepinephrine. Fourteen Rattus norvegicus albinus, weighing 350g on average, were used. After being anesthetized with sodic thiopental, they were tracheostomizeds and one jugular and one carotid were cannuled for application of substances and to record the blood arterial pressure, respectively. The ECG was gotten through electrodes located in the front and back paws of the animals. The animals were separated in two groups, each one with seven rats. The lidocaine hydrochloride 2% in the doses of 600 microg and 3% in the doses of 900 microg acted on the cardiovascular system reducing the arterial pressure and modifying the electrocardiogram, while the prilocaine hydrochloride, in the same doses, also reduced the arterial pressure, but did not modify the electrocardiogram. When norepinephrine was associated to lidocaine 3% hydrochloride, it was possible to observe that this salt always exercised its effect first and a protective effect against the fall of pressure produced for the lidocaine. The same protective effect did not occur when felypressin was associated with prilocaine hydrochloride 3%.

Clinical and radiographic evaluation of pulpotomies performed under intrapulpal injection of anaesthetic solution.

AIM: The purpose of this study was to evaluate clinically and radiographically pulpotomies carried out under intrapulpal injection of anaesthetic solution. METHODOLOGY: Forty-one permanent mandibular molar teeth presenting with deep carious lesions and/or exposed pulps, with or without periapical changes on radiographic examination, were treated with pulpotomy and dressed with calcium hydroxide. The teeth were divided into three groups. Group A consisted of 15 teeth, where intrapulpal anaesthesia was administered by a slow injection of lidocaine hydrochloride 2%. Group B, with 14 teeth, where intrapulpal anaesthesia was obtained with lidocaine hydrochloride 2% with adrenaline 1:100,000. Group C consisted of 12 teeth in which anaesthesia was performed with a mandibular block using prilocaine hydrochloride 3% with felypressin 1: 100,000. Healing was evaluated using clinical and radiographic criteria: dentine barrier formation, absence of clinical symptoms and resolution of periapical involvement. RESULTS: After an observation time of 6-8 weeks (postoperative control) and 24-32 weeks (intermediate control), healing occurred in 13 teeth from group A (87%), in 11 teeth from group B (79%) and in 10 teeth from group C (83%). No statistical difference was demonstrated between the three groups (Fisher's exact test). CONCLUSIONS: Based on the methodology adopted, intrapulpal injection of anaesthetic solution did not impair healing in pulpotomized teeth.

Estudo comparativo do uso do cloridrato de prilocaína a 3 por cento com felipressina a 0, 03 UI e do cloridrato de lidocaína a 2 por cento com adrenalina a 1: 100000 em pacientes hipertensos / Comparative study of the use of the prilocaine chloridrate at 3 per cent with felipressin at 0, 03UI and the lidocaine chloridrate at 2 per cent with epinephrine at 1: 100000 in the blood pressure of hypertensive patients

Este trabalho tem como objetivo avaliar comparativamente os efeitos da soluçäo anestésica de cloridrato de prilocaína a 3 por cento, com felipressina a 0, 03 UI, com a soluçäo anestésica de cloridrato de lidocaína a 2 por cento, com adrenalina a 1: 100000, sobre a a pressäo arterial (PA) de pacientes hipertensos submetidos a exodontias convencionais

Alterations in monitored vital constants induced by various local anesthetics in combination with different vasoconstrictors in the surgical removal of lower third molars.

The purpose of this study was to observe the hemodynamic changes during surgical extraction of lower third molars induced by three local anesthetics solutions associated with different vasoconstrictors. A double-blind observational and longitudinal study was made of 45 healthy adult volunteers subjected to surgical removal of an impacted lower third molar under local anesthesia. Three groups were established (n = 15) according to the anesthetic solution and associated vasoconstrictor administered (4% articaine + epinephrine 1:200,000; 3% mepivacaine without vasoconstrictor; and 3% prilocaine + felypressin 1:1,850,000). Heart rate, systolic and diastolic pressure, and oxygen saturation were recorded at different times before, during and at the end of surgery, along with the type and amount of anesthetic solution administered. The study variables were found to be more stable with articaine + epinephrine 1:200,000, although the three studied solutions caused no significant hemodynamic changes with respect to the basal values when administered in healthy patients subjected to surgical removal of a lower third molar.

Utilizaçäo de cloridrato de prilocaína a 3 por cento com felipressina a 0, 03UI em pacientes hipertensos / The application of the prilocaine chloridrate at 3 per cent with felypressin at 0, 03UI in hypertensive patients

Este trabalho tem como propósito avaliar os efeitos da combinaçäo do cloridrato de prilocaína a 3 por cento a 0,03UI sobre a pressäo arterial de pacientes hipertensos submetidos a exodontias convencionais

Estudo comparativo de duas soluçöes anestésicas associadas à betametasona, no controle da dor decorrente da remoção de terceiros molares mandibulares inclusos / Compartive study of two anesthetic solutions combination with betamethasone, in the pain control decurrent of mandibular third molar surgery

Este trabalho teve por objetivo avaliar, de forma comparativa, a eficácia da administração pré-anestésica de betametasona, associada a duas preparaçöes anestésicas distintas - bupivacaína 0,5(por cento) com adrenalina 1:200.000 ou prilocaína 3(por cento) com felipressina 0,03 UI/mL -, no controle da dor pós-operatória decorrente da remoção de terceiros molares inferiores inclusos. Participaram deste estudo 30 paciente, de ambos os sexos, com os terceiros molares inferiores inclusos em posição simétrica, que receberam 4 mg de betametasona, em dose única, por via oral, 1 hora antes da intervenção, independente do lado operado. Para a técnica anestésica regional foi empregada uma ou outra das soluçöes anestésicas citadas, de acordo com o lado operado, designadas de forma aleatória e cruzada. A dor pós-operatória foi avaliada por um período de 48 horas, através de uma escala visual analógica (E.V.A) e do consumo de analgésicos (dipirona - comprimidos 500 mg), sendo que ao final do experimento os pacientes eram inquiridos sobre a preferência por um dos tratamentos. Os resultados mostraram a ocorrência de um menor grau de dor pós-operatória, com associação de betametasona à solução anestésica contendo bupivacaína, nas primeira 24 horas que se seguiram ao ato cirúrgico, não havendo uma diferença estatisticamente significante no dia subsequente à intervenção. Do total da amostra, 24 pacientes (80 por cento) preferiram o tratamento com a betametasona/bupivacaína, enquanto apenas 6 pacientes (20 por cento) manifestaram sua preferência pela associação do mesmo corticosteróide com a solução anestésica à base de prilocaína. Concluiu-se que ambos os tratamentos são eficazes - e portanto indicados no controle da dor pós operatória decorrente da remoção dos terceiros molares inferiores inclusos - sendo mais efetivo, nas primeiras 24 horas após a intervenção, o protocolo que incluiu a administração de betametasona e da solução anestésica à base de bupivacaína

Clinically safe dosage of felypressin for patients with essential hypertension.

Hemodynamic changes were evaluated in patients with essential hypertension when felypressin of various concentrations was administered. The parameters studied were systolic pressure, diastolic pressure, heart rate, left ventricular systolic phase, and endocardial viability ratio. Results showed that blood pressure tended to increase, and the value of 1/pre-ejection period2 (PEP2) tended to decrease, upon administration of 3 ml of 2% propitocaine containing 0.06 international units/ml (IU/ml) of felypressin. Significant increase of blood pressure and decrease in 1/PEP2 was noted upon administration of 3 ml of anesthetic solution containing 0.13 IU/ml of felypressin. No ischemic change of the myocardium was detected even with the highest felypressin concentration (3 ml of 2% propitocaine containing 0.25 IU/ml of felypressin). These results suggest that the clinically safe dosage of felypressin for patients with essential hypertension is approximately 0.18 IU. This amount is equivalent to 6 ml of 3% propitocaine with 0.03 IU/ml of felypressin, which is a commercially available local anesthetic for dental use. It seems that the decrease in 1/PEP2 that occurred during blood pressure increase was due to the increase in afterload caused by contraction of the arterioles. Although in the present study no ischemic change was noted, special care should be taken to prevent myocardial ischemia in patients with severe hypertension.

Lidocaine and prilocaine with vasoconstrictors as cause for cardiovascular reactions. A pulse oximetric study. Preliminary report.

MATERIALS AND METHODS: Cardiovascular effects of two local anesthetic agent solutions containing 2% lidocaine with 1:80,000 epinephrine (LE) and 3% prilocaine with 0.54 microgram/ml felypressine (PF) used separately and in combination were observed. We made 38 separate monitoring sessions (30 minutes each) with healthy voluntary dental students. Participants were monitored with Cardiocap multiparameter physiological monitor. The monitored values were heart rate, systolic and diastolic blood pressure, SaO2 and peripheral blood flow. Values were registered into computer memory for further analysis. Group 1 received 7.2 ml of PF to the buccal sulcus just distal of the second upper right molar and 7.2 ml of LE to the left buccal sulcus ten minutes later. Group 2 had the same injection positions but they received 3.6 ml of PF to both sides of maxilla and then, ten minutes later, 3.6 ml of LE to each side. RESULTS: There were no radical changes in systolic or diastolic blood pressure. The blood oxygen saturation values were constant and the displayed SaO2 values were between 96-98% during the measurement period. Mean heart rate decreased about 10 beats/min after PF injection and increased about 10 beats/min after injection of LE in both groups. The peripheral blood flow (pbf) was the most sensitive parameter in our measurements. In general, pbf diminished in the period preceding the injection. It showed lowest values during the injection phases in both groups. CONCLUSIONS: Despite large doses of local anesthetics SaO2, systolic and diastolic blood pressure showed no clinically important changes, which suggests that local anesthetics have only a minimal effect on parameters mentioned above. This means that if the effect of one local anesthesia preparate (PF) is not sufficient, it is possible to safely reinforce the anesthesia with another substance (LE) in young healthy patients. Additionally, heart rate and pbf demonstrated quite clearly the symphatetic stimulation effect of the stress of injection and the stimulating action of epinephrine was seen clearly in heart rate values in both groups.

Effects of local anaesthesia on formalin-induced Fos expression in the rat dorsal horn.

A subcutaneous injection of formalin into foot pad of the rat produces a bimodal nociceptive response including an early intense response in the first 5 min and a later moderate response that is exhibited from 20 to 60 min after injection. In this study, we investigated the effects of blocking the early phase and late phase input, respectively, on Fos-like immunoreactivity (Fos-LI) expression in dorsal horn neurones. Rats of the early phase block (EB) group were injected with 5% formalin (0.05 ml) into the footpad 5 min after a s.c. injection of 4% lidocaine (0.15 ml) into the angle. The rats of the late phase block (LB) group were injected with 5% formalin into the footpad 10 min before the s.c. injection of 3% prilocaine (0.20 ml) containing felypressin into the ankle. The rats of the control group were given the formalin injection alone. Fos-LI was detected in the dorsal horn 2 h after the formalin injection. The numbers of Fos-LI neurones in the dorsal horn of both EB and LB group were markedly decreased compared with the control group, being 31.3% (laminae I-III of EB), 37.1% (laminae I-III of LB), 13.9% (laminae IV-VI of EB) and 16.2% (laminae IV-VI of LB) of the control values. No significant difference was observed between EB and LB group. These findings suggested that the early and late phase contribute in concert to the induction of genetic changes in dorsal horn neurones after formalin injection.

Prilocaine: an old anesthetic agent and a new ophthalmic procedure.

We present a new local anesthetic technique for ophthalmic surgery that reduces the risks associated with retrobulbar and peribulbar anesthesia. This method uses topical proparacaine plus 1.5 mL of prilocaine (3%) with felypressin injected into the subconjunctival (sub-Tenon's) space. Of 5210 consecutive adult patients in whom the technique was used, all demonstrated adequate analgesia. Sixty-three (1.2%) of the eyes required supplemental analgesia, provided by a single injection of prilocaine (0.5 mL). Ecchymosis and subconjunctival hemorrhage developed in 63 (1.2%) of the eyes. There were no instances of ptosis.