Document Detail

Effects of nasal application of an epinephrine and lidocaine mixture on the hemodynamics and nasal mucosa in oral and maxillofacial surgery.
MedLine Citation:
PMID:  18940484     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Our purpose was to investigate the influences of nasal pretreatment with a mixed solution of epinephrine and lidocaine (E-L pretreatment) on the systemic hemodynamics and the mucosa of the inferior nasal concha, which is carried out for expansion of the nasal cavity and the prevention of mucosal injury before nasotracheal intubation. PATIENTS AND METHODS: Subjects included 29 adult patients undergoing oral and maxillofacial surgery. This study consisted of 2 parts. In part 1 (n = 18), the effects of E-L pretreatment on the systemic hemodynamics were studied before (pre-Anesth group, n = 10) and after (post-Anesth group, n = 8) induction of anesthesia. Changes of the mucosal volume and the blood flow of the inferior nasal concha also were observed by optic bronchoscopy and noncontact type laser-Doppler flowmetry, respectively. In part 2 (n = 11), changes in the serum concentrations of epinephrine and lidocaine after the E-L pretreatment were determined by high performance liquid chromatography and enzyme immunoassay, respectively. RESULTS: The heart rate increased at 2 and 3 min after E-L pretreatment in pre-Anesth group (P < .05), but not in post-Anesth group. The cross section of the nasal cavity decreased from 66% to 42% (n = 8, P < .05). The mucosal blood flow decreased from 60 to 22 AU (n = 8, P < .01). The serum epinephrine concentration increased from 24 to 185 pg/mL. CONCLUSIONS: The E-L pretreatment provided characteristic evidence for useful expansion of the nasal cavity and for reduction of the nasal mucosal blood flow with less systemic hemodynamic effects, although further investigation is needed for the determination of the proper epinephrine concentration in E-L pretreatment.
Kimiko Kameyama; Seiji Watanabe; Tatsuhiko Kano; Jingo Kusukawa
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  66     ISSN:  1531-5053     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-22     Completed Date:  2008-11-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2226-32     Citation Subset:  AIM; D; IM    
Department of Anesthesiology, and the Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
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MeSH Terms
Anesthesia, Dental / methods
Anesthesia, Inhalation / methods
Anesthetics, Local / administration & dosage,  blood,  pharmacology*
Blood Pressure / drug effects
Drug Interactions
Epinephrine / administration & dosage,  blood,  pharmacology*
Heart Rate / drug effects
Intubation, Intratracheal
Lidocaine / administration & dosage,  blood,  pharmacology*
Middle Aged
Nasal Cavity / drug effects*
Nasal Mucosa / blood supply,  drug effects*
Oral Surgical Procedures / methods*
Postoperative Period
Preanesthetic Medication*
Vasoconstrictor Agents / administration & dosage,  blood,  pharmacology*
Reg. No./Substance:
0/Anesthetics, Local; 0/Vasoconstrictor Agents; 137-58-6/Lidocaine; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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