Changes in blood pressure, heart rate, and electrocardiogram during dental treatment with use of local anesthesia

Abraham-Inpijn, L.; Borgmeijer-Hoelen, A; Gortzak, Richmond A. Th.

doi:10.14219/jada.archive.1988.0318

Cited by 68 publications

(45 citation statements)

References 7 publications

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“…17 Generally, local anesthesia such as epinephrine is used in the clinical setting of dental procedures, and this can lead to an increase in blood pressure. 19,20 It may be advisable to delay the administration of local anesthesia with epinephrine until an appropriate time is reached after the start of the Dex maintenance infusion following a loading dose of 6 mcg/kg/h. Both MAP and HR still showed a significant decrease at 60 minutes after the end of the Dex infusion.…”

Section: Circulationmentioning

confidence: 99%

Intravenous Sedation with Low-Dose Dexmedetomidine: Its Potential for Use in Dentistry

Ogawa

Seino

et al. 2008

Anesthesia Progress

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This study investigated the physiologic and sedative parameters associated with a low-dose infusion of dexmedetomidine ( Dex). Thirteen healthy volunteers were sedated with Dex at a loading dose of 6 mcg/kg/h for 5 minutes and a continuous infusion dose of 0.2 mcg/kg/h for 25 minutes. The recovery process was observed for 60 minutes post infusion. The tidal volume decreased significantly despite nonsignificant changes in respiratory rate, minute ventilation, oxygen saturation, and end-tidal carbon dioxide. The mean arterial pressure and heart rate also decreased significantly but within clinically acceptable levels. Amnesia to pin prick was present in 69% of subjects. A Trieger dot test plot error ratio did not show a significant change at 30 minutes post infusion despite a continued significant decrease in bispectral index. We conclude that sedation with a low dose of Dex appears to be safe and potentially efficacious for young healthy patients undergoing dental procedures.

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Section: Circulationmentioning

confidence: 99%

Intravenous Sedation with Low-Dose Dexmedetomidine: Its Potential for Use in Dentistry

Ogawa

Seino

et al. 2008

Anesthesia Progress

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“…Abnormal patient behavior is often reported during these procedures, as a result of psychological factors, physical stress, painful stimuli and the action of anesthetic solutions (Abraham-Inpijn et al, 1988;Gortzak et al, 1992;Meiller et al, 1993;Tsuchihashi et al, 1996;Laragnoit et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

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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“…The increase in heart rate and blood pressure after the adrenergic activation by epinephrine are undesired cardiovascular side effects. Inpijn et al have reported that after injection of 2% lidocaine containing 1:80.000 epinephrine, a more evident increase in blood pressure occurred in hypertensive patients compared to normotensive patients, and the same dose of local anesthetic led to arrhythmias in 7.5% of the hypertensive patients [21]. Hersch et al reported that the increase in pulse and SBP related to articaine with 1:100.000 epinephrine was greater than that associated with an articaine/1:200.000 mixture [22], while Daublander et al reported that an articaine/1:200.000 mixture caused fewer sympathomimetic effects than articaine/1:100.000 [4].…”

Section: Discussionmentioning

confidence: 99%

Do Local Anesthetics Containing Epinephrine Affect Blood Pressure in the Elderly?

Arpacı¹,

Işık²,

Kadioğlu³

et al. 2016

Ann Clin Anal Med

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Anahtar KelimelerDental; Lokal Anestezik; Epinefrin; Yaşlı; Kan Basıncı Abstract Aim: Dental procedures are often performed under local anesthesia. Vasoconstrictors added to local anesthetics might have unwanted effects in the elderly and in patients with comorbid diseases. The aim of this study was to evaluate the effects of local anesthetics containing epinephrine on blood pressure in elderly patients undergoing dental procedures. Material and Method: The study included 479 patients (age, 67.37±6.62) who underwent tooth extraction. Patient demographics, current health conditions, and blood pressure values were recorded before local anesthesia and at 5 minutes after anesthesia administration. Patients were divided into 4 groups: Group I (n=272) received 40 mg articaine/0.012 mg epinephrine (Ultracain® D-S Forte); Group II (n=196) received 40 mg articaine/0.01 mg epinephrine (Maxicaine FORT); Group III (n=6) received 40 mg articaine/0.006 mg epinephrine (Ultracain® D-S); and Group IV (n=5) received 40 mg articaine/0.005 mg epinephrine (Maxicaine). Statistical analyses were performed using SPSS version 20.0. Results: A total of 479 patients were included in the analysis. Hypertension and diabetes were the most frequently reported comorbidities among these patients. Blood pressure values after administration of anesthesia were higher than those recorded before the procedure in all groups. Discussion: Local anesthetics containing epinephrine are not associated with a significant increase in blood pressure in elderly patients undergoing dental procedures. Obtaining a detailed clinical history may reduce the risk of procedure-related morbidity.

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Changes in blood pressure, heart rate, and electrocardiogram during dental treatment with use of local anesthesia

Cited by 68 publications

References 7 publications

Intravenous Sedation with Low-Dose Dexmedetomidine: Its Potential for Use in Dentistry

Intravenous Sedation with Low-Dose Dexmedetomidine: Its Potential for Use in Dentistry

Hemodynamic Behavior in Third Molar Surgeries Using Lidocaine or Articaine

Do Local Anesthetics Containing Epinephrine Affect Blood Pressure in the Elderly?

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