Plasma mepivacaine concentrations in patients undergoing third molar surgery
| Autor: | Csr Fonteles, Ea Dos Santos Filho, Thyciana Rodrigues Ribeiro, F.W.G. Costa, T.P. Bezerra, H C Scarparo, N R Romero, E.C.S. Soares, R N Maia |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Molar Adolescent Epinephrine Anesthesia Dental Mepivacaine Injections Young Adult 03 medical and health sciences 0302 clinical medicine Third molar surgery Heart Rate 030202 anesthesiology Heart rate Humans Medicine In patient Anesthetics Local General Dentistry Dose-Response Relationship Drug business.industry 030206 dentistry Plasma levels Dente Serotino Anesthesia Toxicity Female Molar Third business medicine.drug |
| Zdroj: | Repositório Institucional da Universidade Federal do Ceará (UFC) Universidade Federal do Ceará (UFC) instacron:UFC |
| Popis: | Background Local anaesthetic-related systemic toxicity mainly results from elevated plasma concentrations of these drugs. We hypothesized that intraoral injection of submaximal doses of mepivacaine does not lead to toxic levels of this drug in blood. This study evaluated the plasma levels of mepivacaine in third molars surgeries. Methods Twenty-one patients were randomly assigned into two groups: group I (two unilateral third molars; submaximal dose of mepivacaine 108 mg with epinephrine 54 μg) and group II (four third molars; submaximal dose of mepivacaine 216 mg with epinephrine 108 μg). Blood samples were collected before anaesthesia, and 5, 10, 15, 20, 30, 40, 60, 90 and 120 min after anaesthesia. Results Individual peak plasma concentrations ranged 0.77–8.31 μg/mL (group I) and from 2.36–7.72 μg/mL (group II). An increase in the average dose of mepivacaine from 1.88 ± 0.12 mg/kg (group I) to 3.35 ± 0.17 mg/kg (group II) increased the mean mepivacaine peak plasma levels from 2.33 ± 0.58 to 4.01 ± 0.69 μg/mL, respectively. Four patients obtained plasma levels of mepivacaine above the threshold for toxicity (5 μg/mL). Conclusions Toxic levels of mepivacaine are possible, even when a submaximal dose is used. A twofold increase in the dose of mepivacaine caused the mean peak plasma concentration to increase proportionally, indicating that they may be predicted based on the relation of dose per bodyweight. |
| Databáze: | OpenAIRE |
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