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

Authors
  • Shionoya, Yoshiki1
  • Nakamura, Eishi1
  • Tsujimoto, Gentaro1
  • Koyata, Takayuki1
  • Yasuda, Asako1
  • Nakamura, Kiminari1
  • Sunada, Katsuhisa2
  • 1 Department of Dental Anesthesia, The Nippon Dental University Hospital, Tokyo, Japan. , (Japan)
  • 2 Department of Dental Anesthesiology, The Nippon Dental University School of Life Dentistry, Tokyo, Japan. , (Japan)
Type
Published Article
Journal
Anesthesia progress
Publication Date
Oct 01, 2021
Volume
68
Issue
3
Pages
141–145
Identifiers
DOI: 10.2344/anpr-68-02-01
PMID: 34606571
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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. Differences between the baseline measurements and those of each time point were analyzed using Dunnett test, and no statistically significant changes were observed. 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.

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