Abstract
BackgroundWe investigated the role of epinephrine in prolonging the localization of lidocaine on the oral mucosa and inhibiting its absorption in the blood of rats.MethodsWe 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.ResultsInitially, 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.ConclusionEpinephrine 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.
Highlights
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
There was no significant difference in the lidocaine levels in the first 2 min between the lidocaine group and the lidocaine with epinephrine groups
After 40 min, the lidocaine level was significantly higher in the lidocaine with epinephrine group than in the other group (Table 1)
Summary
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. Tetracaine and cocaine with added epinephrine were widely used as topical anesthetics for the skin [11, 12]. A topical anesthetic containing lidocaine, tetracaine, and epinephrine was developed, and studies were conducted to determine its efficacy and safety [13, 14]. The efficacy of other cutaneous topical anesthetics has been studied [15, 16], and the addition of epinephrine has been regarded as an effective method of obtaining a sufficient anesthetic effect [17]. We hypothesized that epinephrine prolongs the anesthetic effect of topical lidocaine on the oral mucosa. The primary outcome of this study was the amount of lidocaine in the oral mucosa and in the serum of rats when topical anesthetic was used with added epinephrine
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