{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:51:08Z","timestamp":1787017868839,"version":"build-2736575974"},"reference-count":68,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":165,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Dentistry"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>\n                    The aim was to investigate the vector\u2010cardiographic effects in patients submitted to dental extraction under local anesthesia. Twenty\u2010one patients aged 36.6\u2009\u00b1\u200912.4 years with a clinical and radiographic indication of mandibular or maxillary tooth extraction were enrolled. The intervention was a local or mandibular nerve block anesthesia with 4% articaine hydrochloride containing epinephrine (1\u2009:\u2009100,000; 40\u2009mg\/ml\u2009+\u200910\u2009\n                    <jats:italic>\u03bc<\/jats:italic>\n                    g\/ml). Blood pressure (BP), heart rate (HR), pulse wave transit time, and vector\u2010cardiography data were recorded throughout 3\u2009min before and 5\u2009min after injection.\n                    <jats:italic>QRS<\/jats:italic>\n                    \u2010 and\n                    <jats:italic>T<\/jats:italic>\n                    \u2010wave area under the curve (\n                    <jats:italic>QRS<\/jats:italic>\n                    <jats:sub>AUC<\/jats:sub>\n                    \/\n                    <jats:italic>T<\/jats:italic>\n                    <jats:sub>AUC<\/jats:sub>\n                    ) were calculated from the\n                    <jats:italic>X<\/jats:italic>\n                    \/\n                    <jats:italic>Y<\/jats:italic>\n                    \/\n                    <jats:italic>Z QRS<\/jats:italic>\n                    \u2010vector or\n                    <jats:italic>T<\/jats:italic>\n                    \u2010vector.\n                    <jats:italic>T<\/jats:italic>\n                    \u2010wave amplitude (\n                    <jats:italic>T<\/jats:italic>\n                    <jats:sub>AM<\/jats:sub>\n                    ),\n                    <jats:italic>T<\/jats:italic>\n                    <jats:sub>AUC<\/jats:sub>\n                    values, and diastolic BP decreased, and HR significantly increased 4\u2009min after injection. A transient moderate HR drop and a corresponding small increase in\n                    <jats:italic>T<\/jats:italic>\n                    <jats:sub>AM<\/jats:sub>\n                    and\n                    <jats:italic>T<\/jats:italic>\n                    <jats:sub>AUC<\/jats:sub>\n                    immediately after the injection procedure may be explained by a decreased sympathetic tone due to psychological relief. In dental anesthesia, the systemic epinephrine effects are represented by a decrease in\n                    <jats:italic>T<\/jats:italic>\n                    <jats:sub>AUC<\/jats:sub>\n                    . These effects are most pronounced in the\n                    <jats:italic>X<\/jats:italic>\n                    \u2010 and\n                    <jats:italic>Y<\/jats:italic>\n                    \u2010leads. The 3D determination of vector planes or amplitudes is a simple method to register the sympathetic tone in local anesthesia independently of possible effects on\n                    <jats:italic>T<\/jats:italic>\n                    \u2010wave characteristics in single leads. In conclusion,\n                    <jats:italic>T<\/jats:italic>\n                    \u2010wave determination may help to detect even small increases in systemic adrenaline concentration in case of accidental intravascular injection. At the same time, full rhythm and spatial ischemia control is provided.\n                  <\/jats:p>","DOI":"10.1155\/2024\/8610423","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T06:32:57Z","timestamp":1718346777000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiovascular and Vector\u2010Cardiographic Effects of Articaine Anesthesia with Epinephrine"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0795-9072","authenticated-orcid":false,"given":"Christoph","family":"P\u00f6kel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6793-4399","authenticated-orcid":false,"given":"Antina","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1794-4636","authenticated-orcid":false,"given":"Martin","family":"Busse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2006.0092"},{"key":"e_1_2_9_2_2","first-page":"6","article-title":"Exogenous and endogenous plasma levels of epinephrine during dental treatment under local anesthesia","volume":"18","author":"Lipp M.","year":"1993","journal-title":"Regional Anesthesia and Pain Medicine"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-198207000-00004"},{"key":"e_1_2_9_4_2","first-page":"234","article-title":"Changes in heart rate and blood pressure during dental procedures with local anesthesia","volume":"36","author":"Mochizuki M.","year":"1989","journal-title":"Anesthesia Progress"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1966.0339"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1970.tb00158.x"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1986.0245"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.1989.0048"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5831.7"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1067\/moe.2002.123866"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2013.05.010"},{"key":"e_1_2_9_12_2","first-page":"232","article-title":"Diplopia as a complication of local anesthesia: a case report","volume":"32","author":"Koumoura F.","year":"2001","journal-title":"Quintessence International"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9290.62798"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1590\/s0066-782x2007000500008"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2011.10.045"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1807-59322009000300005"},{"key":"e_1_2_9_17_2","first-page":"132","article-title":"The incidence of complications associated with local anesthesia in dentistry","volume":"44","author":"Daubl\u00e4nder M.","year":"1997","journal-title":"Anesthesia Progress"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-11-12"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI105051"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.7.Suppl.145"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2005.00146.x"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.13.5.737"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-73143-8"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02219670"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199733060-00002"},{"key":"e_1_2_9_26_2","first-page":"52","article-title":"[Pharmacokinetics of articaine in mandibular nerve block]","volume":"14","author":"M\u00fcller W. 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