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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

Epinephrine is a small endogenous catecholamine with multiple uses in emergencies. In most clinical settings, epinephrine comes packaged in 2 forms: a 1:1000 (1 mg/mL) ampule or vial that must be diluted before intravenous (IV) use, and a 1:10,000 (1 mg/10 mL; 100 µg/mL) prepackaged syringe that is ready for IV use. 1 In true emergency situations requiring epinephrine, 100 µg/mL solutions of epinephrine are typically used during advanced cardiac life support for cardiac arrest. 2 During more urgent situations, such as mild refractory hypotension, bronchospasm

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

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

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

.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

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

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

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

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