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Cardiovascular responses to intraosseous injections containing catecholamines
Oral Surgery, Oral Medicine, and Oral Pathology
|November 1, 1975
Summary
Intraosseous injections of adrenaline caused rapid, unacceptable cardiovascular responses. Noradrenaline was asymptomatic, though it increased blood pressure, suggesting it may be a safer alternative for local anesthesia.
Area of Science:
- Anesthesiology
- Pharmacology
- Cardiovascular Physiology
Background:
- Catecholamines like adrenaline and noradrenaline are used in local anesthetics.
- Intraosseous administration allows rapid absorption into circulation.
- Cardiovascular effects of intraosseously administered catecholamines require investigation.
Purpose of the Study:
- To compare cardiovascular responses to intraosseous adrenaline and noradrenaline.
- To compare intraosseous versus infiltration routes for noradrenaline administration.
- To evaluate the clinical acceptability of intraosseous noradrenaline in local anesthetics.
Main Methods:
- Intraosseous injections of local anesthetics containing adrenaline or noradrenaline were administered.
- Cardiovascular parameters (heart rate, blood pressure) were monitored.
- Direct comparison of intraosseous and infiltration routes for noradrenaline was performed in the same individuals.
Main Results:
- Intraosseous adrenaline caused rapid increases in heart rate and blood pressure, often leading to tachycardia and chest tightness.
- Intraosseous noradrenaline resulted in asymptomatic cardiovascular changes, typically a decreased heart rate with increased peripheral resistance and blood pressure.
- Infiltration of noradrenaline produced insignificant cardiovascular responses, while intraosseous injection elicited notable responses.
Conclusions:
- Intraosseous administration of local anesthetics containing catecholamines leads to rapid systemic absorption and cardiovascular effects.
- Noradrenaline appears to be a potentially safer alternative to adrenaline for intraosseous local anesthesia due to its asymptomatic cardiovascular profile.
- While intraosseous lidocaine with noradrenaline may be clinically acceptable, further research into cardiovascularly inert anesthetics is warranted.
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