Type to search

Supporting Your Practice

Which vasoconstrictors are used in dentistry and what are their properties?


Dental SyringeThe addition of vasoconstrictors to anesthetic solutions assists in hemostasis and duration of the anesthesia action.

Properties of Adrenaline or Epinephrine

  • Prolongs duration of action for lidocaine and enhances margin of safety
  • Beta-adrenergic activity which may cause blood pressure to rise
  • Alpha actions, such as vasoconstriction of blood vessels in skin and mucosa
  • Cardiac effects may be minimal but can be significant
  • Increases cardiac output in healthy as well as cardiac patients
  • Debate as to whether to avoid epinephrine in cardiac patients or those taking beta-blockers
  • May induce a decrease in plasma levels of potassium or increases in glucose levels but not clinically significant
  • Contraindicated in patients intoxicated with cocaine
  • Local anesthetics with epinephrine may cause delayed wound healing and increased incidence of dry sockets
  • Epinephrine is metabolized in the liver and metabolites are largely excreted in the urine


  • A synthetic analogue of vasopressin
  • Does not have oxytocin-like actions or anti-diuretic actions of vasopressin
  • Minimal toxic effects even if delivered intravenously
  • No evidence that prilocaine with felypressin is safer than lidocaine with epinephrine

Source: Anesthesia Complications in the Dental Office, Wiley Blackwell 2015.

Leave a Comment

Your email address will not be published. Required fields are marked *

%d bloggers like this: