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Epinephrine dose in cardiac disease — NDEB AFK MCQ

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ModerateBiomedical SciencesEpinephrine dose in cardiac diseaseNDEB AFK

A 70-year-old with stable angina needs restorative treatment. The plan is 2% lidocaine with epinephrine, and the patient is anxious but medically stable. What is the most important consideration?

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Correct answer: A — Limit vasoconstrictor dose and aspirate carefully

In stable cardiovascular disease, local anaesthesia with limited epinephrine and careful aspiration is commonly safer than pain-driven endogenous catecholamine release. Epinephrine-impregnated retraction cord can deliver higher systemic exposure and should be used cautiously. The pearl is to reduce stress, aspirate, inject slowly, and keep emergency nitroglycerin and oxygen available.

Reference: Canadian dental pharmacology references; NDEB KSAs 2024