Top

BMC Oral Health

Published in:

Open Access 01-12-2021 | Anesthetics | Research

Effect of epinephrine on the absorption of lidocaine following application to the oral mucosa in rats

Authors: Rui Sasaki, Katsuhisa Sunada

Published in: BMC Oral Health | Issue 1/2021

Abstract

Background

We investigated the role of epinephrine in prolonging the localization of lidocaine on the oral mucosa and inhibiting its absorption in the blood of rats.

Methods

We used 7–8-week-old pathogen-free Wistar male rats (n = 128) for our study. We divided them into the control group administered with ¹⁴C-labeled lidocaine hydrochloride gel only and the study group administered with ¹⁴C-labeled lidocaine hydrochloride gel with epinephrine. The medications were administered in the palatal mucosa of the rats. The amount of mucosa, palatine bone, and serum lidocaine was measured by radioactivity using a liquid scintillation counter and was observed using autoradiograms.

Results

Initially, there was no significant difference in the lidocaine levels between the lidocaine and lidocaine with epinephrine groups in the palatal mucosa (751.9 ± 133.8 vs. 669.8 ± 101.6 ng/mg [2 min]). After 4 min, the values were significantly lower in the lidocaine with epinephrine group (1040.0 ± 142.8 vs. 701.2 ± 109.0 ng/mg [20 min]). After 40 min, the lidocaine level became significantly higher in the lidocaine with epinephrine group (586.8 ± 112.4 vs. 1131.3 ± 155.2 ng/mg [40 min]). Similar results were observed in the palatine bone and serum.

Conclusion

Epinephrine prolonged the localization of lidocaine applied to the mucosa and inhibited its absorption into the bloodstream of rats. Clinical studies are required to evaluate the use of epinephrine-containing topical anesthetics on the oral mucosa.

Meechan JG. The use of EMLA for an intra-oral biopsy in a needle phobic: a case report. Anesth Prog. 2001;48:32–4.PubMedPubMedCentral

Roller NW, Ship II. Lidocaine topical film strip for oral mucosal biopsies. J Oral Med. 1975;30:55–8.PubMed

Gangarosa LP. Iontophoresis for surface local anaesthesia. J Am Dent Assoc. 1974;88:125–8. https://doi.org/10.14219/jada.archive.1974.0038.CrossRefPubMed

Taware CP, Mazumdar S, Pendharkar M, MPharm, Adani MH, Devarajan PV. A bioadhesive delivery system as an alternative to infiltration anaesthesia. Oral Surg Oral Med Oral Path. 1997;84:609–15. https://doi.org/10.1016/S1079-2104(97)90360-7.CrossRef

Lee HS. Recent advances in topical anesthesia. J Dent Anesth Pain Med. 2016;16:237–44. https://doi.org/10.17245/jdapm.2016.16.4.237.CrossRefPubMedPubMedCentral

Warren OU, Blackwood B. Acquired methemoglobinemia. N Engl J Med. 2019;381:1158. https://doi.org/10.1056/nejmicm1816026.CrossRefPubMed

Catterall W, Mackie K. Local anesthetics. In: Hardman JG, Limbird LE, editors. Goodman & Gilman’s the pharmacological basis of therapeutics. 9th ed. New York: McGraw-Hill Professional; 1996. p. 341.

Adriani J, Zepernick R. Some recent studies on the clinical pharmacology of local anesthetics of practical significance. Ann Surg. 1963;158:666–71. https://doi.org/10.1097/00000658-196310000-00013.CrossRefPubMedPubMedCentral

Löfström B. Aspects of the pharmacology of local anesthetic agents. Br J Anaesth. 1970;42:194–206. https://doi.org/10.1093/bja/42.3.194.CrossRefPubMed

10.

Campbell D, Adriani J. Absorption of local anesthetics. JAMA. 1958;168:873–7.CrossRef

11.

Pryor GJ, Kilpatrick WR, Opp DR. Local anesthesia in minor lacerations: topical TAC vs lidocaine infiltration. Ann Emerg Med. 1980;9:568–71. https://doi.org/10.1016/S0196-0644(80)80227-7.CrossRefPubMed

12.

Smith SM, Barry RC. A comparison of three formulations of TAC (tetracaine, adrenaline, cocaine) for anesthesia of minor lacerations in children. Pediatr Emerg Care. 1990;6:266–70. https://doi.org/10.1097/00006565-199012000-00004.CrossRefPubMed

13.

Ernst AA, Marvez-Valls E, Nick TG, Chin E, Wood E, Gonzaba WT. Lidocaine, adrenaline, tetracaine gel versus tetracaine, adrenaline, cocaine gel for topical anesthesia in linear scalp and facial lacerations in children aged 5–17 years. Pediatrics. 1995;95:255–8.PubMed

14.

Ernst AA, Marvez-Valls E, Nick TG, Mills T, MinVielle L, Houry D. Topical lidocaine adrenaline tetracaine (LAT Gel) versus injectable buffered lidocaine for local anesthesia in laceration repair. WJM. 1997;167:79–81.PubMedPubMedCentral

15.

Bush S. Is cocaine needed in topical anaesthesia? Ann Emerg Med. 2002;19:418–22. https://doi.org/10.1136/emj.19.5.418.CrossRef

16.

Kravitz ND. The use of compound topical anesthetics: a review. J Am Dent Assoc. 2007;138:1333–9. https://doi.org/10.14219/jada.archive.2007.0048.CrossRefPubMed

17.

Vinci RJ, Fish SS. Efficacy of topical anesthesia in children. Arch Pediatr Adolesc Med. 1996;150:466–9. https://doi.org/10.1001/archpedi.1996.02170300020005.CrossRefPubMed

18.

Akimoto T, Hashimoto S, Sunada K. Dexmedetomidine (12.5 lg/mL) improves tissue distribution, anesthetic action, and hemodynamic effects of lidocaine after palatal infiltration in rats. Odontology. 2016;104:390–6. https://doi.org/10.1007/s10266-015-0221-6.CrossRefPubMed

19.

Hashimoto S, Yamashiro M, Fujita K, Yasuda A, Sunada K. Effects of epinephrine on lidocaine pharmacokinetics and blood volume in the dental pulp. J Endod. 2014;40:1370–4. https://doi.org/10.1016/j.joen.2014.02.029.CrossRefPubMed

20.

Stern I, Giddon DB. Topical anesthesia for periodontal procedures. Anesth Prog. 1975;22:105–8.PubMedPubMedCentral

21.

Gill CJ, Orr DL II. A double blind crossover comparison of topical anesthetics. J Am Dent Assoc. 1979;98:213–4. https://doi.org/10.14219/jada.archive.1979.0476.CrossRefPubMed

22.

Curran J, Hamilton C, Taylor T. Topical analgesia before tracheal intubation. Anaesthesia. 1975;30:765–8. https://doi.org/10.1111/j.1365-2044.1975.tb00952.x.CrossRefPubMed

23.

Bromage PR. Concentrations of lignocaine in the blood after intravenous, intramuscular epidural and endotracheal administration. Anaesthesia. 1961;16:461–78. https://doi.org/10.1111/j.1365-2044.1961.tb13426.x.CrossRefPubMed

24.

Scott DB, Littlewood DG, Covino BG, Drummond GB. Plasma lignocaine concentrations following endotracheal spraying with an aerosol. Br J Anaesth. 1976;48:899–902. https://doi.org/10.1093/bja/48.9.899.CrossRefPubMed

25.

Viegas O, Stoelting RK. Lidocaine in arterial blood after laryngotracheal administration. Anesthesiology. 1975;43:491–3. https://doi.org/10.1097/00000542-197510000-00019.CrossRefPubMed

26.

Adriani J, Campbell D. Fatalities following topical application of local anesthetics to mucous membranes. JAMA. 1956;162:1527–30. https://doi.org/10.1001/jama.1956.02970340017006.CrossRef

27.

Scott DB. Evaluation of clinical tolerance of local anaesthetic agents. Br J Anaesth. 1975;47(suppl):328–33.PubMed

28.

Trapp L, Will J. Acquired Methemoglobinemia Revisited. Dent Clin N Am. 2010;54:665–75. https://doi.org/10.1016/j.cden.2010.06.007.CrossRefPubMed

29.

Nakamura S, Matsuura N, Ichinohe T. A new method of topical anesthesia by using anesthetic solution in a patch. J Endod. 2013;39:1369–73. https://doi.org/10.1016/j.joen.2013.07.019.CrossRefPubMed

Title: Effect of epinephrine on the absorption of lidocaine following application to the oral mucosa in rats
Authors: Rui Sasaki
Katsuhisa Sunada
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Anesthetics
Anesthetics
Published in: BMC Oral Health / Issue 1/2021
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-021-01691-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of epinephrine on the absorption of lidocaine following application to the oral mucosa in rats

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

Perceived general health in relation to oral health status in a rural Kenyan elderly population

Factors affecting dental self-confidence and satisfaction with dental appearance among adolescents in Saudi Arabia: a cross sectional study

Associations between mental health problems and risky oral and sexual behaviour in adolescents in a sub-urban community in Southwest Nigeria

Curcumin upregulates transforming growth factor-β1, its receptors, and vascular endothelial growth factor expressions in an in vitro human gingival fibroblast wound healing model

Hydrogeogenic fluoride in groundwater and dental fluorosis in Thai agrarian communities: a prevalence survey and case–control study

Women’s awareness regarding the use of dental imaging during pregnancy