Literature DB >> 34606571

Hemodynamic Impact of Drug Interactions With Epinephrine and Antipsychotics Under General Anesthesia With Propofol.

Yoshiki Shionoya1, Eishi Nakamura1, Gentaro Tsujimoto1, Takayuki Koyata1, Asako Yasuda1, Kiminari Nakamura1, Katsuhisa Sunada2.   

Abstract

OBJECTIVE: Antipsychotic drugs exhibit α-1 adrenergic receptor-blocking activity. When epinephrine and antipsychotic drugs are administered in combination, β-2 adrenergic effects are thought to predominate and induce hypotension. This study aimed to assess hemodynamic parameters in patients regularly taking antipsychotics who were administered epinephrine-containing lidocaine under general anesthesia in a dental setting.
METHODS: Thirty patients taking typical and/or atypical antipsychotics and scheduled for dental procedures under general anesthesia were enrolled. Five minutes after tracheal intubation, baseline systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and percutaneous oxygen saturation (SpO2) measurements were taken. The SBP, DBP, HR, and SpO2 measurements were repeated 2, 4, 6, 8, and 10 minutes after the injection of 1.8 mL of 2% lidocaine (36 mg) with 1:80,000 epinephrine (22.5 mcg) via buccal infiltration.
RESULTS: Differences between the baseline measurements and those of each time point were analyzed using Dunnett test, and no statistically significant changes were observed.
CONCLUSIONS: Our findings demonstrate that the use of epinephrine at a clinically relevant dose of 22.5 mcg for dental treatment under general anesthesia is unlikely to affect the hemodynamic parameters of patients taking antipsychotic medications.
© 2021 by the American Dental Society of Anesthesiology.

Entities:  

Keywords:  Atypical antipsychotics; Drug interaction; Epinephrine; General anesthesia; Hypotension; Local anesthesia; Typical antipsychotics

Mesh:

Substances:

Year:  2021        PMID: 34606571      PMCID: PMC8500315          DOI: 10.2344/anpr-68-02-01

Source DB:  PubMed          Journal:  Anesth Prog        ISSN: 0003-3006


  16 in total

1.  A multicenter evaluation of total intravenous anesthesia with remifentanil and propofol for elective inpatient surgery.

Authors:  C W Hogue; T A Bowdle; C O'Leary; D Duncalf; R Miguel; M Pitts; J Streisand; G Kirvassilis; B Jamerson; S McNeal; R Batenhorst
Journal:  Anesth Analg       Date:  1996-08       Impact factor: 5.108

Review 2.  Vasoconstrictor agents for local anesthesia.

Authors:  J A Yagiela
Journal:  Anesth Prog       Date:  1995

Review 3.  Structure and function of alpha-adrenergic receptors.

Authors:  P A Insel
Journal:  Am J Med       Date:  1989-08-16       Impact factor: 4.965

Review 4.  Vasoconstrictors and local anesthesia: a review and rationale for use.

Authors:  J T Jastak; J A Yagiela
Journal:  J Am Dent Assoc       Date:  1983-10       Impact factor: 3.634

5.  Effect of adrenaline on the systemic absorption of local anaesthetic drugs.

Authors:  D P Braid; D B Scott
Journal:  Acta Anaesthesiol Scand Suppl       Date:  1966

Review 6.  Propofol anesthesia for outpatient oral and maxillofacial surgery.

Authors:  J E Cillo
Journal:  Oral Surg Oral Med Oral Pathol Oral Radiol Endod       Date:  1999-05

7.  Drug interactions and vasoconstrictors used in local anesthetic solutions.

Authors:  J A Yagiela; S R Duffin; L M Hunt
Journal:  Oral Surg Oral Med Oral Pathol       Date:  1985-06

Review 8.  Epinephrine: systemic effects and varying concentrations in local anesthesia.

Authors:  J P Cassidy; J C Phero; W H Grau
Journal:  Anesth Prog       Date:  1986 Nov-Dec

9.  Measured context-sensitive half-times of remifentanil and alfentanil.

Authors:  A Kapila; P S Glass; J R Jacobs; K T Muir; D J Hermann; M Shiraishi; S Howell; R L Smith
Journal:  Anesthesiology       Date:  1995-11       Impact factor: 7.892

Review 10.  Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review.

Authors:  Marco Solmi; Andrea Murru; Isabella Pacchiarotti; Juan Undurraga; Nicola Veronese; Michele Fornaro; Brendon Stubbs; Francesco Monaco; Eduard Vieta; Mary V Seeman; Christoph U Correll; André F Carvalho
Journal:  Ther Clin Risk Manag       Date:  2017-06-29       Impact factor: 2.423

View more

北京卡尤迪生物科技股份有限公司 © 2022-2023.