• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.3
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• pp.365-369
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• 2017

Local anesthetics are widely used in clinical dentistry. However, while rare, there have been some reports of true hypersensitivity to local anesthetics. A case of hypersensitivity in a 26-month-old boy is reported. After administering local anesthesia with lidocaine, treatment was performed while the patient was under oral sedation. After treatment, the patient presented with lower lip edema. Treatment with anti-histamines and a steroid successfully reversed his symptoms.

• Restorative Dentistry and Endodontics
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• v.28 no.6
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• pp.475-484
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• 2003

동통조절을 위해 국소마취제는 치과임상에서 광범위하게 사용되어진다. 가장 널리 쓰이는 국소마취제는 리도카인이고 이는 마취효과의 지속 및 지혈효과 등의 목적으로 혈관수축제를 포함하고 있다. 대표적 혈관수축제인 에피네프린은 임상에서 1:300,000에서부터 1:50,000의 농도로 다양하게 사용되어진다. 수복치료를 위해서는 통상적으로 1:100.000농도의 에피네프린이 사용되고 있고 외과적 근관치료시 지혈효과를 위해서는 1:50,000농도의 에피네프린이 추천되고 있다. 이들 농도의 에피네프린을 포함한 리도카인으로 국소마취시 에피네프린의 농도가 치수의 혈류 및 치은의 혈류에 미치는 영향을 이해할 필요가 있고 그 영향이 전기치수검사에 대한 치수의 반응성에 미치는 영향도 이해할 필요가 있다. 따라서 혈관수축제를 포함한 국소마취제에 의한 치수혈류의 변화와 치수신경의 반응성을 이해하는 것은 중요하다 하겠다. 본 연구의 목적은 두 가지 농도의 에피네프린을 포함한 국소마취제로 마취시 나타나는 치수 및 치은의 혈류 변화를 치수신경의 반응성과 비교, 관찰함으로써 국소마취제가 치수 및 치은에 미치는 영향을 파악하고자 함에 있다. 24세에서 27세까지의 10명의 피검자의 건전한 상악중절치를 시험에 이용하였다. Laser Doppler flowmeter의 probe을 고정하기 위한 splint를 간접법으로 인상용 putty를 이용하여 제작하고 치수 및 치은의 혈류량, 그리고 전기치수검사에 대한 반응성을 측정하기 위한 3개의 구멍을 만들었다. 피검자를 10분간 안정시킨 후 마취 전 10분간 정상 혈류량과 전기검사치를 측정하고 1:50,000 epinephrine과 1:100,00 epinephrine이 각각 함유된 2% 리도카인 용액 0.9 ml를 상악 좌측 중절치 치근단부위 협점막에 침윤마취하였다. 마취 후 70분간 치수 및 치은 혈류량을 laser Doppler flowmeter를 이용해 연속적으로 측정하여 그 수치를 컴퓨터에 저장하였고, 매 5분 간격으로 전기치수검사를 시행하여 그 측정치를 기록하였다. 매 시간 간격의 평균 혈류량을 정상 혈류량에 대한 백분율로 나타내고, 각각의 농도에서 최소 치수 및 치은 혈류량을 Paired t-test, Wilcoxon's signed rank test. Duncan's multiple range test. Fisher's exact test등을 이용. 통계분석 하여 다음과 같은 결과를 얻었다. 에피네프린이 함유되어 있지 않은 리도카인을 협점막에 주사시 혈류변화가 거의 나타나지 않았으나 1:50,000 및 1:100.000 에피네프린이 함유된 2% 리도카인을 협점막에 침윤마취시 치수 및 치은 혈류 공히 현저히 감소하였다(p<0.01). 1:50,000 에피네프린군은 1:100,000 에피네프린군에 비해 치수 혈류량이 현저히 억제되어 나타났으나(p<0.01), 치은 혈류량에서는 유의성 있는 차이를 나타내지 않았다(p>0.05). 두 농도의 에피네프린 군 공히 치은혈류는 치수혈류에 비해 유의하게 많은 감소를 나타내었다(p<0.05). 1:100,000 에피네프린 군에서 마취액 주입 후 치수혈류 최대감소가 가장 먼저 나타났고 이어서 전기검사에 대한 치수의 반응성 소실 및 치은혈류 최대 감소의 순으로 나타났다(p<0.05). 1:50,000 에피네프린군의 경우가 1:100,000 에피네프린군의 경우에 비해 마취지속시간이 길게 나타났으나 유의성은 없었다(p>0.05).

• 대한치과마취과학회:학술대회논문집
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• 2003.06a
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• pp.45-46
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• 2003

• The Korean Journal of Pharmacology
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• v.23 no.2
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• pp.113-121
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• 1987

Local anesthetics were investigated for their effects on mitochondrial electron transport system, production of superoxide radical from submitochondrial particles and malondialdehyde production through lipid per oxidation. Local anesthetics had various effects on activities of enzymes in electron transport chain. The activities of NADH dehydrogenase, NADH oxidase and NADH-ubiquinone oxidoreductase were effectively inhibited by lidocaine, procaine and dibucaine but slightly influenced by cocaine. The activities of succinate dehydrogenase, succinate-cytochrome c oxidoreductase and succinate-ubiquinone oxidoreductase were inhibited by lidocaine and dibucaine, but the succinate oxidase activity was stimulated by local anesthetics. Both dihydroubiquinone-cytochrome c oxidoreductase and cytochrome c oxidase activities were inhibited by local anesthetics. In these reactions, the response of Complex I segment to local anesthetics was greater than other Complex segments. Local anesthetics inhibited both the superoxide production from submitochondrial particles supplemented with succinate or NADH and the enhanced production of superoxide radicals by antimycin. The malondialdehyde production by oxygen free radicals was inhibited by local anesthetics. These results suggest that the inhibition of superoxide and malondialdehyde production caused by local anesthetics may be brought by suppression of the electron transport in mitochondria at sites in or near complex I segment.

• Journal of Life Science
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• v.2 no.2
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• pp.97-107
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• 1992

Strichartz and Richie have suggested that the mechanism of sodium donductance block of local anesthetics involves their interaction with a specific binding site within the sodium channel. However, there is evidence that local anesthetics can interact electrostatically with membrane proteins as well as membrane lipids. Whether or not all actions of local anesthetics are mediated by common site remains unclear. Thus, it can not be ruled out that local anesthetics concurrently interact with neuronal membrane lipids since sodium channels were found to be tightly associated with membrane lipids through covalent or noncovalent bonds. In summary, it is strongly postulated that local anesthetics, in addition to their direct interaction with sodium channels, concurrently interact with membrane lipids, fluidize the membrane, and thus induce conformational changes of sodium channels, which are known to be tightly associated with membrane lipids.

• Journal of The Korean Dental Society of Anesthesiology
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• v.3 no.2 s.5
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• pp.80-83
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• 2003

• 대한치과마취과학회:학술대회논문집
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• 2006.06a
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• pp.26-28
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• 2006

• The Journal of the Korean dental association
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• v.37 no.5 s.360
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• pp.335-342
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• 1999

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.7
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• pp.200-206
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• 2018

The aim of this study was to evaluate the effect of Ropivacaine on pain following laparoscopic surgery. Between March 2015 and June 2017, all 97 patients with renal mass who elected to receive laparoscopic nephrectomy were reviewed, retrospectively. Normal saline (0.9%) was used as a control in 45 patients while Ropivacaine was used for local anesthesia in the instillation group (n=52). Pain score (visual analog scale) of the shoulder and upper abdominal area between the two groups was significantly different between recovery time and 24 h (p<0.05), with no significant differences between 48 and 72 h (both p>0.05). In the instillation group, pain score of shoulder and abdominal pain in the two groups according to the amount of CO2 used was not significantly different between recovery time and 24, 48, and 72 h (all p>0.05). Ropivacaine reduced shoulder and upper abdominal pain that occurred within 24 h after surgery. Effective pain control with Ropivacaine is needed in the early postoperative period when a large amount of CO2 is used in laparoscopic surgery.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.39-39
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• 2009