Medial rectus muscle palsy after dental anesthesia.

A 42-year-old woman developed a transient partial third cranial nerve palsy after a supraperiosteal injection in the area of the middle superior alveolar nerve with mepivacaine HCl for dental anesthesia. This effect may have been caused by direct extension through a bony defect rather than by inadvertent intravascular injection of the anesthetic. Dentists and ophthalmologists should be aware of this phenomenon, which can result in permanent ocular palsy and even amaurosis.

Influence of dietary sodium on renin activity and arterial pressure during anesthesia.

The effect of pentobarbital anesthesia on plasma renin activity (PRA) and mean arterial pressure (MAP) was studied in chronically catheterized dogs maintained on normal or low-sodium intake. Within 1 min of administration, pentobarbital caused a rapid fall in MAP which was followed by a restoration of MAP toward control within 5 min. Thirty minutes after induction of anesthesia, PRA was unchanged in sodium-replete dogs and elevated two-fold in sodium-depleted dogs. MAP was significantly lowered (20 mmHg) in normal salt dogs and only slightly decreased in low-salt dogs 30 min after pentobarbital. MAP returned to preanesthetic control value in dogs given converting enzyme inhibitor before anesthesia. Surgical stress or cutaneous electrical stimulation causey hexamethonium. These results indicate that change in PRA and MAP of pentobarbital-anesthetized dogs is significantly influenced by the sodium intake of the animal and by the degree of surgical stress.