Anestesicos

Keywords

• Local anesthetics;

• Pharmacology;

• Toxicity reaction;

• MRD

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Figures and tables from this article:

Fig. 1.

Serum concentrations of lidocaine and mepivacaine after a single cartridge of each agent administered with a vasoconstrictor and without a vasoconstrictor. Open circles represent 2% lidocaine plain; closed circle, 2% lidocaine with 1:100,000 epinephrine; open squares, 2% mepivacaine plain; close squares, 2% mepivacaine with 1:20,000 levonordefrin; and open triangles, 3% mepivacaine plain.

Data from Goebel WM, Allen G, and Randall F. Circulating serum levels of mepivacaine after dental injection. Anesth Prog 1978;25:52–6; and Goebel WM, Allen G, and Randall F. The effect of commercial vasoconstrictor preparations on the circulating venous serum level of mepivacaine and lidocaine. J Oral Med 1980;35:91–6.

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Fig. 2.

Plasma concentrations of epinephrine after the administration of 2 mL of 4% articaine containing tritiated epinephrine (1:100,000). Epinephrine levels measured in the 4 patients who inadvertently received intravascular injections are shown (dotted line). Tritiated epinephrine levels (dashed line) and total epinephrine concentrations (solid line) representing subjects receiving submucosal injections are also shown.

From Lipp M, Dick W, Daubländer M, et al. Exogenous and endogenous plasma levels of epinephrine during dental treatment under local anesthesia. Reg Anesth 1993;18(1):6–12; with permission.

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Table 1.

Local anesthetic formulations

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Table 2.

Local anesthetics administered for third molar extraction

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Table 3.

MRDs of injectable local anesthetics

All cartridges are assumed to contain approximately 1.8 mL.

Abbreviations: epi, epinephrine; levo, levonordefrin; MRD, maximum recommended dose; NR, not recommended.

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Table 4.

Safe dose for local anesthetics: the Rule of 25a

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Corresponding author. Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15261.

Copyright © 2010 Elsevier Inc. All rights reserved.

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