Haemodynamic changes under emotional stress following a minor surgical procedure under local anaesthesia

Int J Oral Maxillofac Surg. 1987 Dec;16(6):688-94. doi: 10.1016/s0901-5027(87)80054-1.


The influence of 4 ml lidocaine 2% without vasoconstrictor, and with epinephrine 0.001%, or with norepinephrine 0.005% on the heart rate and blood pressure was investigated in one group of patients (n = 30) during a minor surgical procedure (tooth extraction) and in an age-matched group of volunteers (n = 30) with injection only and without any intervention. The difference between the 2 groups underlines the presence of emotional stress. Lidocaine without and with a vasoconstrictor changes the heart rate and blood pressure differently. These haemodynamic changes are superposed by alterations caused by emotional stress and are similar in all test series. The so-called epinephrine-collapse often seems to have its cause in an abrupt relative deficiency of epinephrine after stress. It is possible to significantly influence the cardiovascular system in connection with a local anaesthesia with the choice of vasoconstrictor.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anesthesia, Dental*
  • Anesthesia, Local*
  • Blood Pressure
  • Epinephrine / pharmacology
  • Heart Rate / drug effects
  • Hemodynamics / drug effects*
  • Humans
  • Lidocaine / pharmacology*
  • Minor Surgical Procedures
  • Norepinephrine / pharmacology
  • Prospective Studies
  • Random Allocation
  • Stress, Psychological*
  • Tooth Extraction / psychology*


  • Lidocaine
  • Norepinephrine
  • Epinephrine