A 45-year-old patient is taking the antidepressant amitriptyline (Elavil). He is scheduled for periodontal surgery. Which of the following local anesthetic regimens is safe for this patient?
a. mepivicaine 2% with 1:20,000 levonordefrin
b. maximum of two cartridges of lidocaine 2% with 1:100,000 EPI
c. one to two cartridges of lidocaine 2% with 1:50,000 EPI
d. no special precautions are needed so any anesthetic is adequate
b. The end result is the accumulation of EPI resulting in cardiac arrhythmias and hypertension. Use a maximum of two cartridges of 1:100,000 EPI and avoid levonordefrin.
Health Professions
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