ACTIVATION of the pituitary-adrenocortical system normally occurs in response to a variety of alterations in the environment of the organism(43).
The effects of local anesthesia, routine and surgical tooth extraction on the total urinary 17-hydroxycorticosteroids have been studied in 30 subjects who were apparently healthy young men and women between 20 and 30 years of age.
The subjects were divided into five experimental groups as follow: The ten subjects received injection of 2 per cent lidocaine hydrochloride with epinephrine 1 : 50, 000, were injected with lidocaine hydrochloride with epinephrine 1 : 100, 000, and given distilled water injections respectively; the ten subjects were carried out routine tooth extraction; the ten subjects were undergone surgical. tooth extraction.
Urine samples were collected before injection, after one hour of injection, and after one hour of oral surgery. The activity of the adrenal cortex was estimated by determination of the urine level of 17-hydroxycorticosteroids.
The 17-hydroxycorticoid level in the urine was measured by a modification of the technique of Reddy, ,-enkins, and Thorn(39). Colar was road in microcuvets at 410 milli-microns on a Beckman model B spectrophotometer.
Here are the results of the present study:
1. Changes in the urinary 17-hydrexycorticosteroid levels at 5 minutes before the administration of the anesthetic were 5.01±1.32 to 5.61±1.67μg. /cc. .
2. The different levels of the urinary 17-hydroxycorticosteroids for the postinjection of lidocaineHCl (epinephrine 1 :50,000), lidocaine HCl (epinephrine 1 : 100, 000) and distilled water were suggested that a manifestation of a stress reaction due to the traumatic, psychologic effects of injection itself and a little pharmacologic responses to the injected agents.
3. The urinary 17-hydroxycorticosteroid levels at 5 minutes before the administration of the distilled water was 5.41±1.4μg. /cc. and at one hour after the administration was 6.71±1.71μg. /cc. .
4. The psychic trauma of anticipating oral surgery produced a significant increase in preoperative steroid levels.
5. Simple tooth extraction, per se, was not of sufficient to produce cortical response but the stress of procedure incident to removal of impacted lower third molar worked out a significant additional rise in steroid concentrations.
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