Cardiovascular response to epinephrine-containing local anesthesia in patients with cardiovascular disease

Niwa, Hitoshi; Sugimura, Mitsutaka; Satoh, Yuu; Tanimoto, Ai

doi:10.1067/moe.2001.118903

Cited by 70 publications

(42 citation statements)

References 28 publications

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“…3). HR values varied significantly in a number of earlier studies (Salonen et al, 1998;Niwa et al, 2001;Vasconcellos et al), which was not the case in the present study or in other previous studies (Mestre Aspa et al; de Morais et al, 2012b), in which no alterations to HR were correlated with the use of anesthetic solutions (Fig. 4).…”

Section: Discussioncontrasting

confidence: 45%

Hemodynamic Behavior in Third Molar Surgeries Using Lidocaine or Articaine

Stella

Falci

Coelho

et al. 2018

Int. J. Odontostomat.

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STELLA, P. E. M.; FALCI, S. G. M.; COELHO, V. S. & DOS SANTOS, C. R. R.Hemodynamic behavior in third molar surgeries using lidocaine or articaine. Int. J. Odontostomat., 12(1):76-85, 2018. SUMMARY:The aim of this research was to assess the hemodynamic variations during the extraction of impacted lower third molars using lidocaine 2 % or articaine 4 %, as local anesthetics. Fourteen patients with a mean age of 22.4 (SD=3.25), were submitted to the bilateral extraction of lower third molars, with an interval of three to four weeks between the two extractions. Systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate and oxygen saturation in the blood were assessed at seven specific time points: baseline; anesthetic puncture; two minutes after anesthesia; osteotomy; suture and five minutes after the procedure had been completed. The statistical analysis involved descriptive analysis, the Shapiro-Wilk test, the Mann-Whitney test, the t-test and the repeated measurements test. No significant differences were found for any of the hemodynamic behavior variables when comparing lidocaine 2 % and articaine 4 %. Significant differences were found between the time points assessed within each group, particularly in relation to the variable heart rate. In the articaine group, systolic blood pressure exhibited a significant decrease five minutes after the procedure. There were no significant variations in hemodynamic behavior between the two different anesthetic groups (articaine 4 % and lidocaine 2 %).

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Section: Discussioncontrasting

confidence: 45%

Hemodynamic Behavior in Third Molar Surgeries Using Lidocaine or Articaine

Stella

Falci

Coelho

et al. 2018

Int. J. Odontostomat.

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“…However an increase in systolic blood pressure was detected immediately after epinephrine injection, attributed such an increase to the stress-induced release of excessive endogenous catecholamine's, as Niwa et al mentioned in their study (Niwa et al, 2001). In fact, since the epinephrine concentration induced by exogenous resources peaks three-five minutes after the injection, the observed elevation is not a pharmacological effect (Lipp, Dick, Daublander, Fuder, & Stanton Hicks, 1993).…”

Section: Discussionmentioning

confidence: 85%

“…Despite controversies over the administration of epinephrine for hypertensive patients in dental clinics (Bader et al, 2002), a number of researchers have recommended its safety at permissible doses (Torres-Lagares et al, 2012;Silvestre, Salvador-Martinez, Bautista, & Silvestre-Rangil, 2011;Ezmek, Asra, Delibasi, & Sencift, 2010;Elad et al, 2008;Niwa, Sugimura, Satoh, & Tanimoto, 2001). On the other hand, even though epinephrine generally contraindicated in ASA III&IV hypertensive patients, and those with blood pressure above 200/115 mmHg (Hupp, Ellis, & Tcker, 2008), but many dentists try to replace the routine lidocaine-epinephrine combination with alternative anesthetics in the treatment of patients with a history of hypertension.…”

Section: Introductionmentioning

confidence: 99%

Comparative Assessment of the Effects of Three Local Anesthetics: Lidocaine, Prilocaine, and Mepivacaine on Blood Pressure Changes in Patients with Controlled Hypertension

Hashemi¹,

Ladez²,

Moghadam³

2016

GJHS

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Background: Given large number of patients with hypertension attending dental clinics and the profound effects of local anesthetics containing vasoconstrictors, this study aimed to compare the effects of lidocaine 2% + epinephrine, prilocaine 3% + felypressin0.03, and mepivacaine 3% on blood pressure changes. Methods:The current study was carried out from May 2014 to February 2015.Patients with controlled hypertension (systolic blood pressure<159.94 mmHg before the injection) who attended Zahedan dental school (Zahedan , Iran) for the extraction of a mandibular tooth were selected and randomly allocated to three groups of 20. Groups 1-3 received lidocaine 2% + epinephrine, prilocaine 3% + felypressin 0.03 units, and mepivacaine3%, respectively. Patients were only included if they were injected with a maximum of two 1.8 ml cartridges (3.6 ml) for tooth extraction (maximum epinephrine dose of 0.04 mg was maintained in systemic patients).The collected data were analyzed using the analysis of variance (ANOVA) in SPSS 19.0. (SPSS Inc., Chicago, IL, USA)Results: No significant differences were observed between the systolic and diastolic blood pressure of the three groups. The three evaluated local anesthetic solutions had similar effects in patients with controlled hypertension. Conclusion:While no significant changes in blood pressure were observed in three groups, all dental procedures on the mentioned group of patients have to be performed under careful monitoring and aspiration. Moreover, the maximum epinephrine dose (0.04mg) should never be exceeded in these patients.

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“…En 1998, 2001 et 2008, trois études ont inclus respectivement 40, 27 et 50 patients atteints de diverses cardiopathies, chez lesquels l'adrénaline a été utilisée pour l'anesthésie locale [7][8][9] ; aucun effet cardiovasculaire sévère n'a été observé. En 2002, une synthèse réalisée à partir de 6 études a évalué les risques de l'adrénaline chez 325 hypertendus [10] ; une légère augmentation transitoire de la pression artérielle a été constatée lors d'une anesthésie avec vasoconstricteur, mais elle est à peine plus importante que lors d'une anesthésie sans vasoconstricteur.…”

Section: Discussionunclassified