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Epinephrine Affects Pharmacokinetics of Ropivacaine Infiltrated Into Palate
Mikiko Yamashiro DDS, PhD,
 Shuichi Hashimoto PhD,
 Asako Yasuda DDS, PhD, and
 Katsuhisa Sunada DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 63: Issue 2
Online Publication Date: Jan 01, 2016
DOI: 10.2344/0003-3006-63.2.71
Page Range: 71 – 79
palatal mucosa, including the injection site. It is reported that the addition of 5 μg/mL epinephrine to ropivacaine improves the anesthetic efficacy and duration of maxillary infiltration anesthesia. 6 However, there is no report demonstrating how epinephrine influences the efficacy of oral infiltration anesthesia with ropivacaine. We hypothesized that epinephrine affects the pharmacokinetics of ropivacaine by retaining ropivacaine in the mucosa of the injected area. The authors investigated the hypothesis using the time-dependent distribution of ropivacaine in the
Steven Katz DDS, MS,
 Melissa Drum DDS, MS,
 Al Reader DDS, MS,
 John Nusstein DDS, MS, and
 Mike Beck DDS, MA
Article Category: Research Article
Volume/Issue: Volume 57: Issue 2
Online Publication Date: Jan 01, 2010
Page Range: 45 – 51
Maxillary infiltration anesthesia is a common method of anesthetizing maxillary teeth. Previous studies 1 – 18 have evaluated the success of maxillary infiltrations using the electric pulp tester. With a volume of ≤1.8 mL and various anesthetic formulations, pulpal anesthetic success (ie, obtaining maximum output with an electric pulp tester) ranged from 62–100%. Four percent prilocaine with 1 : 200,000 epinephrine has been found to be equivalent to 2% lidocaine with 1 : 100,000 epinephrine for inferior alveolar nerve blocks. 19
Lidocaine Concentration in Oral Tissue by the Addition of Epinephrine
Eri Tanaka DDS, PhD,
 Kenji Yoshida DDS, PhD,
 Hiroyoshi Kawaai DDS, PhD, and
 Shinya Yamazaki DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 63: Issue 1
Online Publication Date: Jan 01, 2016
Page Range: 17 – 24
During dental and oral surgery, a significant local anesthetic effect is needed, as not only do the soft tissues require surgery, but also the hard tissue such as jawbones because of surgical interventions. In current clinical dentistry practice, vasoconstrictive agents such as epinephrine are commonly added to local anesthetics to inhibit bleeding from the surgical site and to enhance local anesthetic efficacy by delaying absorption of the local anesthetic into the blood and thus prolonging activity. 1 – 5 Currently, the vasoconstrictor
Yui Terakawa DDS, PhD and
 Tatsuya Ichinohe DDS, PhD
Article Category: Other
Volume/Issue: Volume 59: Issue 3
Online Publication Date: Jan 01, 2012
Page Range: 118 – 122
In dental treatment, especially in oral and maxillofacial surgery, control of bleeding from the surgical field is important in order to achieve smooth procedures. A common method for minimizing bleeding during surgery is an administration of a local anesthetic solution containing epinephrine. 1 – 4 Regionally administered epinephrine is immediately absorbed into the regional circulation, and a positive correlation has been observed between basal oral mucosal blood flow and maximum plasma epinephrine concentration. 3 Accordingly, though
Nayuka Usami DDS, PhD,
 Midori Tooyama DDS, PhD,
 Wakana Oda DDS, PhD,
 Yuu Kawamoto DDS,
 Saki Kishimoto DDS,
 Ayano Minamide DDS, and
 Hitoshi Niwa DDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 69: Issue 2
Online Publication Date: Jul 18, 2022
Page Range: 38 – 40
.1–0.2 μg/kg/min). Prior to the start of the surgical procedure, gauze soaked in a solution containing saline and 1:100,000 epinephrine (saline 100 mL + 1:1000 epinephrine 1 mL) was applied to the patient's nasal mucosa to minimize surgical bleeding from the nasal cavity. After confirming a negative aspiration, the surgeon then injected 10 mL of 1% lidocaine containing 1:100,000 epinephrine (total dose: lidocaine 100 mg and epinephrine 0.1 mg) into the left maxillary gingival mucosa via local infiltration. Approximately 7 minutes after placement of the epinephrine
Tsuyoshi Hoshi DDS,
 Takashi Suzuki MD, PhD,
 Masayuki Somei MD, PhD,
 Takehiko Iijima DDS, PhD, and
 Yuka Kurihara DDS
Article Category: Case Report
Volume/Issue: Volume 65: Issue 4
Online Publication Date: Jan 01, 2018
Page Range: 259 – 260
Nasal pretreatment with an epinephrine solution is an accepted technique for preventing epistaxis during nasotracheal intubation. 1 – 3 Topical epinephrine used for this purpose normally has minimal hemodynamic effects in most patients. 2 , 3 Recently, we encountered the sudden onset of severe tachycardia when applying a cotton swab soaked with epinephrine solution into the nasal cavities. We presume the tachycardia was evoked by submucosal migration of the epinephrine solution-soaked swab into the blind end of a false passage created by a
Paul A. Moore DMD, PhD, MPH,
 Elliot V. Hersh DMD, MS, PhD,
 Athena S. Papas DMD, PhD,
 J. Max Goodson DDS, PhD,
 John A. Yagiela DDS, PhD,
 Bruce Rutherford DDS, PhD,
 Seigried Rogy PhD, and
 Laura Navalta MS
Article Category: Research Article
Volume/Issue: Volume 55: Issue 2
Online Publication Date: Jan 01, 2008
Page Range: 40 – 48
Soft tissue and pulpal anesthesia induced by the administration of local anesthetic agents containing a vasoconstrictor (epinephrine or levonordefrin) is an essential part of outpatient dentistry. 1 – 3 A shortcoming of most dental local anesthetic agents is that the duration of soft tissue anesthesia (numbness to the lip and tongue) typically lasts for 3–5 hours. 4 Persistent anesthesia, which is often associated with difficulty in eating, drinking, and speaking and with inadvertent biting of the lips, tongue, and/or cheek, is considered
José Lacet Lima Junior DDS, MSc,
 Eduardo Dias-Ribeiro DDS, MSc,
 Julierme Ferreira-Rocha DDS, MSc,
 Ramon Soares DDS,
 Fábio Wildson Gurgel Costa DDS, MSc,
 Song Fan DDS, and
 Eduardo Sant'ana DDS, MSc, PhD
Article Category: Other
Volume/Issue: Volume 60: Issue 2
Online Publication Date: Jan 01, 2013
Page Range: 42 – 45
using antibiotic therapy when there are signs of acute infection with systemic involvement such as fever. In cases of chronic or nonacute clinical manifestations, treatment should be limited to antiseptic mouthwashes, irrigation, and anti-inflammatory and/or anesthetic medication. Surgically, the usual treatment is the extraction of the impacted tooth. 1 , 11 – 15 The aim of the present study was to evaluate the differences between articaine hydrochloride with 1 : 100,000 and 1 : 200,000 epinephrine (adrenaline) administered by buccal infiltration alone
Steven Smith DDS, MS,
 Al Reader DDS, MS,
 Melissa Drum DDS, MS,
 John Nusstein DDS, MS, and
 Mike Beck DDS, MA
Article Category: Other
Volume/Issue: Volume 60: Issue 1
Online Publication Date: Jan 01, 2013
Page Range: 3 – 10
previous study by Wolf et al 7 demonstrated that lidocaine in combination with mannitol significantly improved the success of the IAN block. The proposed mechanism is that mannitol opens the perineurial membrane to allow for enhanced penetrability for lipophilic compounds 8 (such as lidocaine), and it may also directly affect nerve conduction. 9 While Wolf et al 7 demonstrated that 2.84 mL of 36 mg lidocaine with 18 μg epinephrine (1.80 mL) plus 0.5 M mannitol (1.04 mL) was significantly better than 1.8 mL of 36 mg lidocaine with 18 μg epinephrine for the IAN
Yoshiki Shionoya DDS, PhD,
 Eishi Nakamura DDS,
 Gentaro Tsujimoto DDS, PhD,
 Takayuki Koyata DDS,
 Asako Yasuda DDS, PhD,
 Kiminari Nakamura DDS, PhD, and
 Katsuhisa Sunada DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 68: Issue 3
Online Publication Date: Oct 04, 2021
Page Range: 141 – 145
Successful local anesthesia is essential to virtually all dental procedures. Many local anesthetics used today are combined with a vasoconstrictor (eg, epinephrine), which provides several advantages including increased anesthetic duration, decreased local anesthetic systemic toxicity, surgical site hemostasis, and enhanced neural blockade. 1 – 4 Because typical (first-generation) and atypical (second-generation) antipsychotic drugs have an α-1 adrenergic receptor blocking action, 5 it is thought that β-2 adrenergic receptor activity
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