Cortisol Level and Hemodynamic Changes During Tooth Extraction at Hypertensive and Normotensive Patients

Agani, Zana; Benedetti, A; Krasniqi, Vjosa Hamiti; Ahmedi, Jehona; Sejfija, Zana; Loxha, Mergime Prekazi; Murtezani, Arben; Rexhepi, Aida; Ibraimi, Zana

doi:10.5455/medarh.2015.117-122

Cited by 16 publications

(18 citation statements)

References 17 publications

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“…Agani et al reported a significant correlation between extraction of teeth and hemodynamic changes including both the blood pressure and pulse rate, regardless of the presence or absence of a vasoconstrictor in the local anaesthesia. These findings have to be evaluated further in future studies due to inconsistent evidence ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…The stress before the injection of anaesthetic produces more fear than the actual injection. Previous studies have shown, the increase in systolic and diastolic blood pressure among individuals who underwent extraction regardless of the anaesthetic used, with or without vasoconstrictor, while no significant difference was seen with respect to pulse rate ( 8 ).…”

Section: Introductionmentioning

confidence: 94%

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Estimation of salivary cortisol among subjects undergoing dental extraction

et al. 2018

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BackgroundDental procedures can be stressful and studies have shown that salivary cortisol is elevated during such procedures. Our study aimed to evaluate saliva cortisol levels among the subjects who underwent dental extractions and to compare it with that of the controls. The secondary objective of the study was to evaluate any correlation between salivary cortisol and hemodynamic parameters.Material and MethodsWe conducted this clinical study among subjects, who were indicated for dental extraction. Saliva samples from the subjects in the study group were collected before and after (10 mins) the dental extraction. Hemodynamic parameters like heart rate, systolic (SBP) and diastolic blood pressure (DBP) and oxygen saturation (Sp O2) were measured 10 minutes prior to the dental extraction and after completion of the extraction by a single trained examiner. Salivary cortisol was estimated by solid phase enzyme-linked immunosorbent assay (ELISA).ResultsA total of 31 subjects in the study group and 24 subjects in control group have participated in this study. The mean salivary cortisol concentration was significantly higher after extraction (27.94±7.94) than before extraction (24.67±8.31) in the study group (P<0.001). No significant correlations were seen between salivary cortisol concentration and hemodynamic parameters except for diastolic blood pressure after extraction.ConclusionsDental extractions and local anaesthetic procedures can induce stress in subjects. Dental care providers should try to minimise the subject’s anxiety and stress to the maximum extent. Key words:Cortisol, dental, extraction, saliva, stress.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Estimation of salivary cortisol among subjects undergoing dental extraction

et al. 2018

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“…Previous studies have described increases in blood pressure (BP) and heart rate (HR) following the infiltration of local anesthesia with VC ( 6 , 7 ). Electrocardiographic (ECG) alterations have also been associated with patient anxiety in the context of dental treatment ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Influence of anxiety and anesthetic vasoconstrictors upon hemodynamic parameters during dental procedures in controlled hypertensive and non-hypertensive patients

et al. 2021

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Background To determine the influence of dental anxiety and the vasoconstrictor used in local anesthesia upon different hemodynamic parameters - systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR) and peripheral oxygen saturation (SatO2) - during dental extraction and oral hygiene. The safety of local anesthesia with vasoconstrictor in patients with medically controlled hypertension was also assessed. Material and Methods A total of 159 patients were divided into two groups according to the dental treatment received: tooth extraction (n = 106) and oral hygiene (n = 53). The hemodynamic parameters (SBP, DBP, HR and SatO2) were recorded throughout dental treatment. Patient anxiety was assessed using the Beck Anxiety Inventory (BAI), the Modified Corah’s Dental Anxiety Scale (MDAS) and the Hamilton test. Results The HR increased after anesthetic infiltration with vasoconstrictor and decreased after the tooth extraction. However, HR remained stable in the oral hygiene group, in both hypertensive and non-hypertensive patients. The SatO2 values decreased after anesthetic infiltration with vasoconstrictor. These slight changes associated with the vasoconstrictor agent were observed in patients without anxiety, but not in patients with mild or moderate anxiety. Both SBP and DBP remained constant after local anesthetic infiltration with vasoconstrictor, regardless of whether the patients presented hypertension or moderate anxiety. Conclusions The vasoconstrictor used in local anesthesia may induce a very subtle increase in HR, with no significant increase in patients who experience anxiety. Key words: Tooth extraction, dental anesthesia, vasoconstrictor agents, dental anxiety, hypertension.

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“…In literature, various scales are documented to measure the anxiety of dental patients, of which Corah's Dental Anxiety Scale is the most often used. Other scales such as the Modified Corah Dental Scale, Charles Spielberger Psychologist Scale, KDFS, ISAR, Modified Dental Anxiety Scale,[ 9 ] and Gatchel's Anxiety Scale have also been used. In previous studies conducted by Gatchel's[ 10 ] Chanpong et al .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of presurgical serum cortisol level in patients undergoing major maxillofacial surgery

Aher

Waknis

Shah

et al. 2020

Ann Maxillofac Surg

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Background: Stress is an integral part of life. Anxiety levels may increase when it comes to being treated surgically due to road traffic accidents causing facial trauma, other pathologies or burns. The stress that is caused during a surgical procedure as well as during the treatment in debilitated patients or traumatic conditions is bound to cause disturbance in the metabolic and physiologic levels of cortisol. Therefore, a study was carried out to determine the cortisol levels just prior to surgery on the day of operation to quantify the stress levels and also aid in any preanesthetic medication changes for the patient undergoing maxillofacial surgery. Aim: To evaluate and compare pre-surgical serum cortisol levels in patients undergoing major maxillofacial surgery under general anaesthesia. Objective: To evaluate the serum cortisol level of patient 3 days prior to surgery, on the day of surgery and to compare and evaluate the difference seen in both the obtained values. Methods: A prospective, randomized, in- vivo study was carried out in the Department of Oral and Maxillofacial Surgery at a teaching dental hospital. A total of 32 patients were included in this study. Inclusion and Exculsion criteria was made along with pre-opertive assessment of the patient, informed consent was obtained from all patients involved in the study. Patient blood sample, at 8 am three days prior to surgery and on the day of surgery and sent for laboratory investigations. Result: Participants in this clinical study underwent treatment of various ailments like facial trauma, and miscellaneous pathologies like Dentigerous Cyst, Oral submucosa fibrosis, Osteomyelitis, Benign Tumor and Orthognathic surgery. The anxiety of the patients were assessed by serum cortisol level preoperatively and on the day of operation. A total of 32 patients, 26 male and 06 female were included in the study. There was statistically highly significant difference seen between the mean values obtained three days prior to surgery and on the day of surgery. Conclusion: We have concluded from this study that the serum cortisol level shows significant increase on the day of surgery. A future study can focus on association between increased levels of serum cortisol and postoperative wound healing where patients can be divided into two groups one receiving pre-operative stress reduction protocol and other not receiving the same.

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Cortisol Level and Hemodynamic Changes During Tooth Extraction at Hypertensive and Normotensive Patients

Cited by 16 publications

References 17 publications

Estimation of salivary cortisol among subjects undergoing dental extraction

Estimation of salivary cortisol among subjects undergoing dental extraction

Influence of anxiety and anesthetic vasoconstrictors upon hemodynamic parameters during dental procedures in controlled hypertensive and non-hypertensive patients

Evaluation of presurgical serum cortisol level in patients undergoing major maxillofacial surgery

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