The purpose of the present study is to determine the cardiovascular effects produced by intravascular injection of 2% lidocaine with 20 μg/mL of norepinephrine on systolic, diastolic, and mean arterial pressures and heart rate of rats at the following times: control period, during the injection (first 15 seconds), during the first minute, and at the end of 1, 2, 3, 4, 5, 10, 15, 20, 25, and 30 minutes after drug administration. The study was performed on 13 male Wistar rats with weights between 200 grams and 220 grams that were awake during the recording of these parameters. The dose administered was proportional to 1 cartridge of local anesthetic (1.8 mL) in an average-size human, which is equivalent to 0.51 mg/kg of lidocaine hydrochloride and 0.51 μg/kg of norepinephrine hydrochloride. The average time of injection was 15.7 seconds. The results of this study showed significant increases in systolic, diastolic, and mean arterial pressure and a noticeable decrease in heart rate. The greatest variation occurred in the systolic blood pressure. The greatest alterations occurred during injection and within the first minute following administration of the anesthetic solution. We would anticipate these changes in the parameters analyzed to be clinically significant. Thus, dentists using 2% lidocaine with norepinephrine 20 μg/mL should be very careful to avoid intravascular injection.
Averages for the systolic arterial pressure in mm Hg, after intravenous administration of 2% lidocaine hydrochloride (20 mg/mL) associated to norepinephrine hydrochloride (20 μg/mL)—Xylestesin 2%, in a dose proportional to 1.8 mL.
Figure 2.
Averages of the diastolic arterial pressure in mm Hg, after intravenous administration of 2% lidocaine hydrochloride (20 mg/mL) associated with norepinephrine hydrochloride (20 μg/mL)—Xylestesin 2%, in a dose proportional to 1.8 mL.
Figure 3.
Averages of the mean arterial pressure measured in mm Hg, after intravenous administration of 2% lidocaine hydrochloride (20 mg/mL) associated with norepinephrine hydrochloride (20 μg/mL)—Xylestesin 2%, in a dose proportional to 1.8 mL.
Figure 4.
Averages of the mean arterial pressure calculated in mm Hg, after intravenous administration of 2% lidocaine hydrochloride (20 mg/mL) associated with norepinephrine hydrochloride (20 μg/mL)—Xylestesin 2%, in a dose proportional to 1.8 mL.
Figure 5.
Averages of heart rate, in cycles per minute, after intravenous administration of 2% lidocaine hydrochloride (20 mg/mL) associated with norepinephrine hydrochloride (20 μg/mL)—Xylestesin 2%, in a dose proportional to 1.8 mL.
Contributor Notes
Address correspondence to Dr Fátima Neves Faraco, Rua Francisco Leitão, 469 cj. 409, CEP 05414-901, São Paulo, Capital, Brasil; email: fatimafaraco@terra.com.br.