• The Korean Journal of Pain
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• v.9 no.1
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• pp.46-56
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• 1996

Many surgeons and anesthesiologists prefer using vasoconstrictor mixed with local anesthetic agent to reduce the incidence of side effects and prolong the duration of analgesia because most local anesthetic agents, except cocaine, were believed to possess vasodilating effect. However, some investigators recently reported vasoconstricting effect of local anesthetic agents. There is still controversy on the vasoactive effect of local anesthetic agents. So this study is aimed to clarify the vasoactive effect of local anesthetics in the animal model resembling clinical settings. Rabbits were anesthesized with ketamine and haloghane, and respirations were controlled with Harvard animal ventilator. Lidocaine (0.5%, 1.0%, 1.5%) and bupivacaine (0.125%, 0.25% and 0.5%) with or without 1:100,000 epinephrine were subdermaly injected on the femoral bupivacaine of the femoral artery were measured with Doppler flow meter in vivo. The mean arterial pressure, pulse rate, arterial blood gases, pH and level of serum electrolytes were measured at every 2 minute interval for 30 minutes. Results were as follows: 1) There was no significant vasoconstriction with 0.5% lidocaine and 0.125% bupivacaine. 2) Statistically significant (p<0.05) vasodilations were observed with lidocaine (1.0~2.0%) and bupivacaine (0.25~0.5%). 3) There were no changes on the duration of vasodilation induced by local anesthetic agents of various concentrations. 4) Onset of vasodilation induced by local anesthetic agents of high concentration were faster than that of lower concentrations. 5) In the mixed injection group of epinephrine and local anesthetic agent, the vasoconstriction induced by epinephrine was completely reversed by local anesthetics, approximately 5 minutes later. In conclusion, local anesthetic agents at dose exceeding 1.0% lidocaine and 0.25% bupivacaine increase local blood flow significantly in animal study in vivo which is applicable in human clinical settings. The increase blood flow may be due to dilatation of blood vessel. Further study on the analysis of association between amount of absorbed local anesthetics in blood vessels and dilatation of blood vessels is needed.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.223-233
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• 2018

Topical anesthetics are commonly used in oral & maxillofacial surgery to control pain in the oral cavity mucosa before local anesthetic injection. These anesthetic agents come in many forms, developed for different usages, to minimize adverse reactions, and for optimal anesthetic efficiency. Earlier studies have revealed that these agents may also limit the growth of microorganisms in the area of anesthetic application. Many topical anesthetic agents show different levels of antimicrobial activity against various bacterial strains and Candida. The dosage of local anesthetic agent used in some clinical preparations is too low to show a significant effect on microbial activity. Efficiency of antimicrobial activity depends on the local anesthetic agent's properties of diffusion within the bloodstream and binding efficiency with cytoplasmic membrane, which is followed by disruption of the bacterial cell membrane. The antimicrobial properties of these agents may extend their usage in patients to both control pain and infection. To develop the topical local anesthetic optimal usage and antimicrobial effect, a collaborating antiseptic agent may be used to benefit the local anesthetic. However, more research is required regarding minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of topical local anesthetic agents with drug interaction between anesthetics and antiseptic agents.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.4
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• pp.179-188
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• 2013

Background: Today, there are computer controlled local anesthesia devices used clinically. The main principle is to control injection speed by computer aided system, and it relieves pain. However, there are few objective data considering this subject. In this literature review, we researched studies about computer controlled anesthetic delivery. We compared pain control effect of computer controlled to conventional local anesthetic syringe system. Methods: A bibliographic search in PubMed was performed and we reviewed original articles. Results: There were 18 publications that compared pain control effect of computer controlled to conventional system. There were 8 articles reported of children, similar pain control effect was found in 7 of them. One study showed superior pain control effect of computer controlled anesthetic delivery. For adults, 10 studies showed superior pain control effect in computer aided system. Conclusions: Computer controlled anesthetic delivery has similar or superior pain control effect compared to conventional local anesthetic syringe system. For both children and adults, computer controlled anesthetic delivery could be clinically useful, still it may be more effective for adults.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.1
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• pp.41-46
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• 2018

Background: The purpose of this prospective randomized single-blind clinical trial was to evaluate the effect of tilting the head on the anesthetic efficacy of inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis. Methods: Ninety-two patients were divided into two groups: the first group received IANB and the head was tilted in the direction of the block for 15 min, whereas the second group received IANB and the head was tilted to the opposite side. Access cavity preparation was initiated after 15 min. Success was defined as no pain or faint/weak/mild pain during endodontic access preparation and instrumentation. The anesthetic success rates were analyzed by Pearson chi-square test at 5% significance levels. Results: The same side position and opposite side position yielded 41% and 30% anesthetic success rates, respectively; there was no significant difference between the two sides. Conclusions: Relative head position has no effect on the anesthetic success rate of IANB.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.3
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• pp.143-149
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• 2018

Background: We evaluated the changes in mean arterial pressure (MAP) and heart rate (HR), and the anesthetic and hemostatic effects, after injection of 2% lidocaine containing various concentrations of epinephrine in rats and mice to determine the appropriate concentration of epinephrine in various anesthetic mixtures. Methods: Rats and mice were randomly allocated to experimental groups: 2% lidocaine without epinephrine (L0), 2% lidocaine with epinephrine 1:200,000 (L200), 1:100,000 (L100), and 1:80,000 (L80). Changes in MAP and HR after administration of the anesthetic mixture were evaluated using a physiological recording system in rats. Onset and duration of local anesthesia was evaluated by pricking the hind paw of mice. A spectrophotometric hemoglobin assay was used to quantify the hemostatic effect. Results: MAP increased in response to epinephrine in a dose-dependent manner; it was significantly higher in the L80 group than in the L0 group at 5 min post-administration. The HR was relatively lower in the L0 group than in the L80 group. The time required for onset of action was < 1 min in all evaluation groups. The duration of action and hemostatic effect of the local anesthetic were significantly better in the L200, L100, and L80 groups than in the L0 group. Conclusion: L200 demonstrated relatively stable MAP and HR values with satisfactory efficacy and hemostatic effect. L200 might be a better local anesthetic for dental patients in terms of anesthetic efficacy and safety.

• Development and Reproduction
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• v.23 no.2
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• pp.183-191
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• 2019

The objective of this study is to evaluate the anesthetic effects of clove oil and tricaine methanesulfonate (MS-222) on the Far Eastern catfish, Silurus asotus, by measuring the times to anesthesia and recovery. Each anesthetic effect of clove oil and MS-222 was tested in two groups of fish with different body sizes: a group of small fish (mean body length: $15.5{\pm}1.58cm$, mean body weight: $50.1{\pm}5.91g$, n=20) and a group of large fish (mean body length: $31.5{\pm}4.19cm$, mean body weight: $302.1{\pm}15.22g$, n=20). The anesthetics were used at concentrations of 200, 300, 400, 500, and 600 ppm. The results showed significant relationships between the concentration of the anesthetic and the body size of the fish. Each of these variables showed statistical significance (p<0.05). The time to anesthesia decreased linearly with increasing concentration in the large fish for both clove oil and MS-222 (p<0.05). Based on an optimal anesthetic time of approximately 1 min, the preferred concentrations of the anesthetics were 500 ppm for clove oil and 600 ppm for MS-222. Both the anesthetic time and the recovery time were shorter for the small fish than for the large fish (p<0.05). Our study showed that the smaller-sized Far Eastern catfish was more easily anesthetized and recovered more rapidly from anesthesia than the larger-sized fish.

• Journal of Korean Biological Nursing Science
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• v.9 no.2
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• pp.143-152
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• 2007

Purpose: The purpose of this study was to ascertain the effects of anesthetic information on preoperative state anxiety, plasma glucose, cortisol and epinephrine for patients under tonsillectomy and to provide generic data with anesthetic nursing intervention. Method: Data were collected from 60 patients who had tonsillectomy from November 1, 2003 to April 30, 2004. The group were divided into experimental group and control group: an experiment group of 30 patients was provided with an anesthetic information prepared by the researchers; a control group of another 30 patients was provided with general information. Data were analyzed through chi-squared test, t-test, repeated measure ANOVA using SPSS Program(version 12.0). Result: There were no significant difference between the experimental group and the control group in pre-operative state anxiety, glucose and cortisol. However, there were statistically significant difference between the above two groups in pre-operative pre-operative blood pressure(p=.001), heart beat(p=.000), and epinephrine(p=.035). Conclusion: The authors, with the results of this study, concluded that the preoperative anesthetic information for patients under tonsillectomy had direct effect on lessening pre-operative anxiety.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.5
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• pp.463-471
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• 2005

Recently, the number of diabetic patients have been increased with westernized living way and meal habitation. The regulation of blood sugar concentration is very important for diabetic patients to keep homeostasis and, to prevent acute or chronic complications. Epinephrine combined with lidocaine is used in dental clinic extensively. And epinephrine combined with lidocaine also effects on decreasing the blood leakage volume by constricting micro vessle and arteriole. But, So far there are few researches about the effect of epinephrine contained in dental local anesthetic agent on the blood sugar of diabetes during minor oral surgery. The purpose of this study was intended to investigate whether epinephrine which combined with dental local anesthetics influence body glucose level in diabetes patients by glucose monitoring. The subject of this study were 38 diabetic patients and 38 normal adults, each patient was checked body glucose after a meal 2 hours later with resting state, and injection 1:100000 epinephrine with dental lidocaine 54 ml or lidocaine 54 ml only. And then the body glucose level was checked 5 minutes and 30 minutes after injection. The results were analyzed by two way ANOVA test (p<0.05). The results were as follows: In the experimental group 1, the mean of the blood sugar level was 180.3 mg/dl before an anesthetic injection, 182.8 mg/dl after 5minutes of the anesthetic injection and 182.2 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the experimental group 2, the mean of the blood sugar level was 237 mg/dl before an anesthetic injection, 234.5 mg/dl after 5minutes of the anesthetic injection and 231.8 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the controlled group 1, the mean of the blood sugar level was 117.6 mg/dl before an anesthetic injection, 119.1 mg/dl after 5minutes of the anesthetic injection and 129.3 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05). In the controlled group 2, the mean of the blood sugar level was 104.2 mg/dl before an anesthetic injection, 102 mg/dl after 5minutes of the anesthetic injection and 105.3 mg/dl after 30minutes of the anesthetic injection. The change of the blood sugar level was not statistically by two-way ANOVA tests (p<0.05).

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.3
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• pp.207-217
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• 2021

Background: This study aimed to observe the effect of internship in a pre-anesthetic clinic on the teaching quality of pre-anesthesia evaluation for undergraduates. Methods: A total of 120 undergraduates from July 2017 to July 2018 in the anesthesia department of our hospital were randomly divided into two groups: pre-anesthetic clinic internship teaching group (n = 60) and traditional teaching group (n = 60). The knowledge in the pre-anesthesia evaluation teaching chapters was evaluated between the two groups of undergraduates. Results: There were no significant differences in the demographic information between the two groups. The scores in the case analysis and theoretical knowledge test in the pre-anesthetic clinic internship teaching group were significantly higher than those in the traditional teaching group. In addition, the students' satisfaction with the curriculum design was significantly higher in the pre-anesthetic clinic internship teaching group than in the traditional teaching group. Conclusion: Pre-anesthetic clinic internships can improve the quality of pre-anesthesia assessment teaching for undergraduates.

• Restorative Dentistry and Endodontics
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• v.44 no.4
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• pp.40.1-40.10
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• 2019

Objectives: This study aimed to assess the effect of DentalVibe on the level of pain experienced during anesthetic injections using 2 different techniques. Materials and Methods: This randomized crossover clinical trial evaluated 60 patients who required 2-session endodontic treatment. Labial infiltration (LI) anesthesia was administered in the anterior maxilla of 30 patients, while inferior alveolar nerve block (IANB) was performed in the remaining 30 patients. 1.8 mL of 2% lidocaine was injected at a rate of 1 mL/min using a 27-gauge needle. DentalVibe was randomly assigned to either the first or second injection session. A visual analog scale was used to determine participants' pain level during needle insertion and the anesthetic injection. The paired t-test was applied to assess the efficacy of DentalVibe for pain reduction. Results: In LI anesthesia, the pain level was 12.0 ± 15.5 and 38.1 ± 21.0 during needle insertion and 19.1 ± 16.1 and 48.9 ± 24.6 during the anesthetic injection using DentalVibe and the conventional method, respectively. In IANB, the pain level was 14.1 ± 15.9 and 35.1 ± 20.8 during needle insertion and 17.3 ± 14.2 and 39.5 ± 20.8 during the anesthetic injection using DentalVibe and the conventional method, respectively. DentalVibe significantly decreased the level of pain experienced during needle insertion and the anesthetic injection in anterior LI and mandibular IANB anesthesia. Conclusions: The results suggest that DentalVibe can be used to reduce the level of pain experienced by adult patients during needle insertion and anesthetic injection.