CHANGES OF HEMODYNAMICS AND CATECHOLAMINE CONCENTRATIONS AFTER THE ADMINISTRATION OF 1/200,000 EPINEPHRINE IN ELDERLY PATIENTS

2002 Fiscal Year Final Research Report Summary

• Project/Area Number: 13672107
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Surgical dentistry
• Research Institution: Kagoshima University
• Principal Investigator: SUGIYAMA Kazuna Kagoshima University, Dental Hospital, Professor, 歯学部附属病院, 教授 (50124772)
• Co-Investigator(Kenkyū-buntansha): WAKAMATSU Aiko Kagoshima University, Dental Hospital, Research Associate, 歯学部附属病院, 助手 (50343372) ; YOKOYAMA Kozo Kagoshima University, Dental Hospital, Associate Professor, 歯学部附属病院, 助教授 (80191518)
• Project Period (FY): 2001 – 2002
• Keywords: Elderly patients / Vasoconstrictor / Epinephrine / Norepinephrine / Dopamine / Hemodynamics / Local anesthesia

Research Abstract

The purpose of the present study was to investigate the changes of hemodynamics and catecholamine concentrations after the administration of 1/200,000 epinephrine contained in local anesthetic solution in elderly patients. Eleven patients scheduled for oral and maxillofacial surgery were divided into two groups; the patients under 64 years old (group 1, N=7) and over 65 years old (group 2, n=4). Anesthesia was induced with the intravenous administration of thiopental or midazolam, and tracheal intubation was facilitated with the administration of vecuronium. After cardiovascular and respiratory conditions were stabilized, 1/200,000 epinephrine contained in 0.5% lidocaine was infiltrated, then the hemodynamic parameters and the serum concentrations of epinephrine, norepinephrine, and dopamine were measured.
In the group 1, systolic, diastolic and mean blood pressure were reduced by 8.1〜10.1%, heart rate increased by 9.0%, cardiac output increased by 16.5%, total peripheral resistance was lowered by 9.1% 80〜90 seconds after the administration of epinephrine contained in lidocaine. The control value of epinephrine concentration in blood was 0.051±0.094 ng/ml, but increased 0.647±0.492 and 0.640±0.213 ng/ml after 120 and 300 seconds, respectively. Norepinephrine and dopamine concentrations did not change significantly.
In the group 2, systolic, diastolic and mean blood pressure were reduced by 7.6〜8.6%, heart rate increased by 6.0%, cardiac output increased by 14.9%, total peripheral resistance was lowered by 17.9% 110〜140 seconds after the administration of epinephrine contained in lidocaine. The control value of epinephrine concentration in blood was 0.018±0.012 ng/ml, but increased 0.094±0.035 and 0.173±0.079 ng/ml after 120 and 300 seconds, respectively. No significant changes in norepinephrine and dopamine concentrations were observed.