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To assess the effect of epinephrine-containing local anesthetics on vasoconstriction, we immunohistochemically measured the intravascular lumen area in different regions of the mandible. Twelve male Wistar rats were used. General anesthesia was induced and maintained with sevoflurane. Infiltration anesthesia was performed with 0.2 mL of epinephrine-free 2% lidocaine (E−) near the left mandibular first molar and with 0.2 mL of epinephrine-containing 2% lidocaine (E+) near the right mandibular first molar. After decalcification, the specimens were paraffinized, and thin sections were prepared and immunohistologically stained with an antismooth muscle actin antibody. The intravascular lumen area was measured in the mucosa, periodontal membrane, Haversian/Volkmann's canal, and bone marrow. A Mann-Whitney U test was used for statistical processing, and p < .05 was considered to indicate a statistically significant difference. In the oral mucosa and the periodontal membrane, E+ had a significantly smaller vascular lumen area than E−. In the Haversian/Volkmann's canal and the bone marrow, no significant intergroup difference was observed in the intravascular lumen area. We postulate that this is due to a low smooth muscle content of blood vessels in the mandible and suggest that the vasoconstrictive effect of epinephrine-containing local anesthetics within the mandible is ineffective.

Keywords: Local anesthesia; Infiltration anesthesia; Epinephrine; Vasoconstriction; Mandible
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Copyright: © 2018 by the American Dental Society of Anesthesiology
<bold>Figure 1.</bold>
Figure 1.

Preparation for the study of rats. General anesthesia was induced and maintained by sevoflurane. Infiltration anesthesia of 0.2 mL of 2% lidocaine without epinephrine was injected in the left side, and 0.2 mL of 2% lidocaine with 1:80,000 epinephrine was injected in the right side. Twenty minutes after injection, fixation was performed by 4% paraformaldehyde via a left ventricle.


<bold>Figure 2.</bold>
Figure 2.

Planes of the sections made in this study. (a) Sagittal section. (b) Coronal section. (c) Horizontal section.


<bold>Figure 3.</bold>
Figure 3.

Measurement of the intravascular lumen area. Dark brown regions denote vascular smooth muscles. Values in red indicate intravascular lumen areas.


<bold>Figure 4.</bold>
Figure 4.

Intravascular lumen area. *p < .05; **p < .01; mean ± SD. VR, vasoconstriction rate.


Contributor Notes

Address correspondence to Shinya Yamazaki, Department of Dental Anesthesiology, School of Dentistry, Ohu University, 31-1 Misumido, Tomita, Koriyama, Fukushima, 963-8611 Japan; zakiyama@ops.dti.ne.jp.
Received: Sep 28, 2017
Accepted: Jan 24, 2018