felypressin and Arrhythmias--Cardiac

The routine use of local anesthetics associated to vasoconstrictors for the dental treatment of patients with cardiopathies is still controversial, due to the risk of adverse cardiovascular effects.. To evaluate and compare the hemodynamic effects of the use of local anesthetics with a non-adrenergic vasoconstrictor in patients with ventricular arrhythmia, when compared to the use of anesthetics without vasoconstrictor.. A prospective randomized study evaluated 33 patients with positive serology for Chagas' disease and 32 patients with coronary artery disease that presented complex ventricular arrhythmia at Holter monitoring (>10 EV/h and NSVT), of which 21 were females, aged 54.73 + 7.94 years, submitted to routine dental treatment with pterygomandibular anesthesia. These patients were divided in two groups: group I received prilocaine 3% associated with felypressin 0.03 IU/ml and group II received lidocaine 2% without vasoconstrictor. The number and complexity of extrasystoles were analyzed, as well as the heart rate and systemic arterial pressure of the patients on the day before, one hour before, during the procedure and one hour after the dental procedure.. No hemodynamic alterations or increase in the number and complexity of the ventricular arrhythmia related to the anesthetic used in the dental procedure were observed in either group.. The results suggest that prilocaine 3% associated to a felypressin 0.03 IU/ml can be safely used in patients with Chagas' disease or coronariopathy with complex ventricular arrhythmia.

Topics: Adolescent; Adult; Aged; Anesthesia, Dental; Anesthetics, Local; Arrhythmias, Cardiac; Blood Pressure; Chagas Cardiomyopathy; Electrocardiography, Ambulatory; Felypressin; Female; Heart Rate; Humans; Lidocaine; Male; Middle Aged; Prilocaine; Prospective Studies; Time Factors; Vasoconstrictor Agents; Young Adult

The incidence of cardiac dysrhythmias and adequacy of haemostasis during nasal surgery under deep halothane anaesthesia were studied following nasal infiltration with 10 ml of either 1.5% lignocaine with adrenaline 1:200,000 or prilocaine 1.5% with octapressin 0.03 IU per ml. There was a significant difference in the incidence of cardiac dysrhythmias between patients given octapressin 2% and patients given adrenaline infiltration (18%) p greater than 0.01. Adequate haemostasis was observed in 84% of patients who received octapressin with no adverse effects compared to 94% of the group which received adrenaline (p greater than 0.01). We suggest for the use of lignocaine-adrenaline during halothane anaesthesia that adequate ventilation is assured, deep halothane anaesthesia given, the infiltration delayed 10 minutes after tracheal intubation, the rate of injection adjusted to 10 ml in a 10-minute period and a total dose of adrenaline does not exceed 0.6 microgram/kg.

Topics: Administration, Intranasal; Adolescent; Adult; Anesthesia, Inhalation; Arrhythmias, Cardiac; Drug Interactions; Epinephrine; Felypressin; Female; Halothane; Humans; Lidocaine; Male; Nose; Prilocaine

A healthy 82-year-old woman presented for dacryocystorhinostomy under general anaesthesia. Following the application of intranasal cocaine and subcutaneous injection of felypressin she developed severe hypertension, multiple ventricular ectopic beats and depression of the ST segment on the electrocardiogram. A drug interaction is suspected.

Topics: Aged; Arrhythmias, Cardiac; Cocaine; Drug Hypersensitivity; Drug Interactions; Felypressin; Female; Humans; Hypertension; Intraoperative Complications; Lacrimal Apparatus; Lypressin; Nasal Cavity

Topics: Animals; Arrhythmias, Cardiac; Blood Pressure; Cats; Cyclopropanes; Electrocardiography; Felypressin; Female; Halothane; Heart; Heart Ventricles; Humans; Injections, Intravenous; Nasal Decongestants; Vasopressins