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Changes of sympathetic activity during tooth extraction.

P Papadimitriou, P Harsoulis, C Zamboulis

    International Journal of Oral and Maxillofacial Surgery
    |April 1, 1986
    PubMed
    Summary
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    Tooth extraction and local anesthesia do not affect urinary VMA excretion. Vanillylmandelic acid (VMA) levels remained consistent across groups receiving lignocaine alone or with adrenaline/noradrenaline.

    Area of Science:

    • Pharmacology and Toxicology
    • Biochemistry
    • Dental Anesthesiology

    Background:

    • Tooth extraction is a common dental procedure.
    • Local anesthetics are routinely used, sometimes with vasoconstrictors like adrenaline and noradrenaline.
    • Vanillylmandelic acid (VMA) is a major metabolite of catecholamines, reflecting sympathetic nervous system activity.

    Purpose of the Study:

    • To investigate the effect of tooth extraction and local anesthesia on urinary VMA excretion.
    • To determine if the addition of noradrenaline or adrenaline to lignocaine affects VMA levels.

    Main Methods:

    • Studied urinary VMA excretion in three groups of healthy subjects before and after tooth extraction.
    • Groups received lignocaine 2% alone, lignocaine with noradrenaline, or lignocaine with adrenaline.

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  • VMA levels were measured and normalized to creatinine.

    • Main Results:

    • Urinary VMA excretion increased significantly after tooth extraction in all three groups.
    • The magnitude of VMA increase was similar across the groups.
    • Addition of noradrenaline or adrenaline to lignocaine did not alter the VMA excretion response.

    Conclusions:

    • Tooth extraction and the use of local anesthetics (lignocaine with or without adrenaline/noradrenaline) do not significantly impact overall sympathetic nervous system activity as measured by VMA excretion.
    • The observed increase in VMA is likely a physiological response to the stress of the surgical procedure itself.