Cardiovascular responses to epinephrine-containing local anesthetics for dental use: A comparison of hemodynamic responses to infiltration anesthesiaand ergometer-stress testing

Objective. Cardiovascular effects of infiltration anesthesia have been docu mented in numerous studies. However, few studies have been carried out to c ompare the effects of infiltration anesthesia with the effects of exercise- stress testing. The purpose of this study was to examine this issue. Study design. Eight young and 13 older subjects were given infusions of epi nephrine to produce cardiovascular responses comparable with those found in subjects undergoing infiltration anesthesia with 3.6 mL of lidocaine with 1:80,000 epinephrine (L-E). Cardiovascular responses to this drug treatment were evaluated with echocardiography and compared with those produced by e rgometer exercise. Results. The hemodynamic effects of L-E infiltration anesthesia were less t han those produced by ergometer-stress testing at 25 watts (W) in young sub jects and at 15 W in the older subjects. The workload of this ergometer-str ess testing was about 4 metabolic equivalents (METS), which is approximatel y equivalent to the workload of walking 4.8 km/hr, doing light yard work (i e, raking leaves, weeding, or pushing a power mower), painting, or doing li ght carpentry. Conclusion. With the exception of some specific pathologic conditions, such as serious arrhythmia, infiltration anesthesia with 3.6 mL of L-E can be c arried out safely on the patients who have exercise capacity of more than 4 METS.