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Medical Forum / General / Dentistry / October 2005Brief spell of pulse rate increase after injection
I notice that right after I get an injection I get an increase in pulse rate, sort of like if I was nervous about something, even though I don't think I have any fear of dental procedures. I read that something in the local (which is lidocaine nowadays), sometimes briefly increases heart rate. It's an adrenoline I think. The purpose is to constrict the blood vessels in the area so the area stays numb longer. I don't have any heart problems but should I be concerned anyway? >I notice that right after I get an injection I get an increase in pulse >rate, sort of like if I was nervous about something, even though I >don't think I have any fear of dental procedures. TOO MUCH epinephrine!! CUT WAY DOWN ......... >I read that something >in the local (which is lidocaine nowadays), sometimes briefly increases >heart rate. It's an adrenoline I think. YUP, 1:100,000 ...... > The purpose is to constrict the >blood vessels in the area so the area stays numb longer. I don't have >any heart problems but should I be concerned anyway? YUP. Joel M. Eichen a écrit : > >I read that something > >in the local (which is lidocaine nowadays), sometimes briefly increases > >heart rate. It's an adrenoline I think. > > YUP, 1:100,000 ...... This is why I use Zorcaine only in infiltrations. It doesn't come in 1:200, 000. Especially for the elderly, and for Inferior Alveolar Nerve blocks, I use Astracaine 4% articaine with 1:200,000 and things are good enough with that. If anybody comes out with a 3% articaine, I'd go with that, but it doesn't seem to exist. JMO and JME SP >This is why I use Zorcaine only in infiltrations. She was on Joe Millionaire program ....... Zora Caine. > I notice that right after I get an injection I get an increase in pulse > rate, sort of like if I was nervous about something, even though I [quoted text clipped - 3 lines] > blood vessels in the area so the area stays numb longer. I don't have > any heart problems but should I be concerned anyway? Some local anesthetic contains epinephrine, which is added as it will result for more profound and/or longer lasting anesthesia. If too much of this gets into your blood stream you may experience just what you did...a racing of the heart or a flustered , anxious feeling. If you are otherwise healthy this is not a problem, just an annoyance. It could, however, signal you are hypersensitive to the epinephrine....so you may want to mention this to your dentist and ask him/her to use an anesthesia without the epinephrine. T I will mention this to the dentist. I'd prefer less epinephrine, but I don't want to make it so the numbing lasts less than 5 min or so. > I will mention this to the dentist. I'd prefer less epinephrine, but I > don't want to make it so the numbing lasts less than 5 min or so. Usually there is plenty of time to complete basic procedures with a local that doesn't have epi...don't quote me on these figures, but without epi, lidocaine will usually last between 30 and 90 minutes...depending on person, while with epi those numbers are doubled. Some of my patients will feel the effects of anesthesia wearing off in 20 or 30 minutes, while others, even without epi, will tell me they were numb all afternoon. If you are the latter type, you may not need the epi. As I said, mention your concern and ask your dentist to use something without the epi. If it presents a major problem in your care...because the anesthesia wears off too fast...you'll both know soon enough! Good luck to you. T I use 3% mepivicaine for regular lower nerve blocks all of the time. It does great if you put it where it belongs <G>. For uppers, it does wear off pretty fast on infiltrations. I wonder if plain Citanest 4% last any longer? Also, the guy could be dumping a whole carpule where 1/2 of one would be plenty. Dartos >>I will mention this to the dentist. I'd prefer less epinephrine, but I >>don't want to make it so the numbing lasts less than 5 min or so. [quoted text clipped - 13 lines] > > T Dartos 23 oct 09:04 afficher les options Groupes de discussion : sci.med.dentistry De : Dartos <tuthjoc...@myturbonet.com> - Rechercher les messages de cet auteur Date : Sun, 23 Oct 2005 08:04:59 -0500 Local : Dim 23 oct 2005 09:04 Objet : Re: Brief spell of pulse rate increase after injection Répondre | Répondre à l'auteur | Transférer | Imprimer | Message individuel | Afficher l'original | Signaler un cas d'utilisation abusive I use 3% mepivicaine for regular lower nerve blocks all of the time. It does great if you put it where it belongs <G>. For uppers, it does wear off pretty fast on infiltrations. I wonder if plain Citanest 4% last any longer? Also, the guy could be dumping a whole carpule where 1/2 of one would be plenty. Dartos In my own experience, Citanest Plain is only really useful in one instance: when the patient has resistance to anesthesia. I have one or two of those. You infiltrate and they STILL feel it. I reappoint, and put in the Citanest Plain, ask them to tell me when they feel numb, and it usually goes well. In those patients where adrenaline in contraindicated (hypersensibility) it works (+/-). In cardiac patients, I STILL give articaine with 1:200,000 epi, and s..l..o..w.. injections, regardless of whether it is infilt or block. JMO SP >I will mention this to the dentist. I'd prefer less epinephrine, but I > don't want to make it so the numbing lasts less than 5 min or so. Epinephrine from a single dental injection can total 0.018 mg. How much endogenous epinephrine is released if there is pain during the procedure?  Signature/ Amatus / >I will mention this to the dentist. I'd prefer less epinephrine, but I > don't want to make it so the numbing lasts less than 5 min or so. >> I notice that right after I get an injection I get an increase in pulse >> rate, sort of like if I was nervous about something, even though I [quoted text clipped - 13 lines] > >T And use an aspirating syringe! Joel I did ask him today about it. He said there's a very small % of epi in there and that it would only have a reaction if it was into a vessel. I didn't get any kind of reaction (other than being numb) from the injection today. Perhaps I was just tense about something that day. > I did ask him today about it. He said there's a very small % of epi in > there and that it would only have a reaction if it was into a vessel. I > didn't get any kind of reaction (other than being numb) from the > injection today. Perhaps I was just tense about something that day. Or...the prior injection could have been close to or in to a blood vessel. It happens! T >I did ask him today about it. He said there's a very small % of epi in >there and that it would only have a reaction if it was into a vessel. I >didn't get any kind of reaction (other than being numb) from the >injection today. Perhaps I was just tense about something that day. We think in terms of cars too much. My radiator hose either leaks or it does not. Blood vessels? Oh they all diffuse into the interstitial space! So goes the epinephrine too! into and outof. >I notice that right after I get an injection I get an increase in pulse >rate, sort of like if I was nervous about something, even though I [quoted text clipped - 3 lines] >blood vessels in the area so the area stays numb longer. I don't have >any heart problems but should I be concerned anyway? Adrenoline ? Is that like Valvoline ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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