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  • Abstract
  • MATERIALS AND METHODS
  • RESULTS
  • DISCUSSION
  • REFERENCES
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Abstract

Adrenaline (epinephrine) is included in dental local anesthesia for the purpose of vasoconstriction. In Japan, adrenaline is contraindicated for use in patients receiving antipsychotic therapy, because the combination of adrenaline and an antipsychotic is considered to cause severe hypotension; however, there is insufficient evidence supporting this claim. The purpose of the present study was to clarify the changes in hemodynamics caused by drug interaction between adrenaline and an antipsychotic and to evaluate the safety of the combined use of adrenaline and an antipsychotic in an animal study. Male Sprague-Dawley rats were anesthetized with sodium pentobarbital. A catheter was inserted into the femoral artery to measure blood pressure and pulse rate. Rats were pretreated by intraperitoneal injection of chlorpromazine or chlorpromazine and propranolol, and after 20 minutes, saline or 1 of 3 different doses of adrenaline was administered by intraperitoneal injection. Changes in the ratio of mean arterial blood pressure and pulse rate were measured after the injection of adrenaline. Significant hypotension and tachycardia were observed after the injection of adrenaline in the chlorpromazine-pretreated rats. These effects were in a dose-dependent manner, and 100 μg/kg adrenaline induced significant hemodynamic changes. Furthermore, in the chlorpromazine and propranolol–pretreated rats, modest hypertension was induced by adrenaline, but hypotension and tachycardia were not significantly shown. Hypotension was caused by a drug interaction between adrenaline and chlorpromazine through the activation of the β-adrenergic receptor and showed a dose-dependent effect. Low-dose adrenaline similar to what might be used in human dental treatment did not result in a significant homodynamic change.

Keywords: Local anesthesia; Drug interaction; Adrenaline; Epinephrine; Antipsychotics
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Citations

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Article Contents

Perioperative Management of a Patient With Idiopathic Pulmonary Hypertension and a History of Syncope: A Case Report

Aiji Sato (Boku) DDS, PhD;,
 MinHye So MD, PhD;,
 Kazuma Fujikake MD, PhD;,
 Motoshi Tanaka MD;,
 Yuji Kamimura MD, PhD;,
 Haruko Ota MD, PhD;,
 Tomomi Mizutani DDS,
 Kenichiro Ishibashi DDS, PhD;,
 Yasuyuki Shibuya DDS, PhD;, and
 Kazuya Sobue MD, PhD

How Safe Is Anesthesia Management by Dentist Anesthesiologists? The Need for an International Collaborative Study on the Safety of Anesthesia Management by Dentist Anesthesiologists

Takuro Sanuki DDS, PhD,
 Shota Tsukimoto DDS, PhD,
 Hidetaka Kuroda DDS, PhD,
 Uno Imaizumi DDS, PhD, and
 Naotaka Kishimoto DDS, PhD

General Anesthetic Management of a Patient With Spondyloepiphyseal Dysplasia Congenita Undergoing Palatoplasty Revision

Hiroka Hattori DDS,
 Aiji Sato (Boku) DDS, PhD,
 Mayuko Kanazawa DDS, PhD,
 Erika Harada DDS,
 Mami Asai DDS,
 Yuko Shikama DDS,
 Hiroko Kobayashi DDS,
 Makoto Hirohata DDS,
 Naoko Tachi DDS, PhD, and
 Masahiro Okuda MD, PhD
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