Hemodynamic changes comparing 2% lidocaine and 4% articaine with epinephrine 1: 100,000 in lower third molar surgery.

Oral and Maxillofacial Surgery, Pernambuco School of Dentistry, Universidade de Pernambuco-Faculdade de Odontologia de Pernambuco, Camaragibe, Pernambuco, Brazil.
The Journal of craniofacial surgery (Impact Factor: 0.68). 07/2012; 23(4):1204-11. DOI: 10.1097/SCS.0b013e31824f66a0
Source: PubMed

ABSTRACT An increase in blood pressure during dental treatment has been investigated with regard to potential medical risks since previous studies suggest that dental procedures may cause stress to the patient and, consequently, the cardiovascular system. The aim of the present study was to analyze hemodynamic changes following the administration of either 2% lidocaine (L100) or 4% articaine (A100) (both with epinephrine 1:100,000) in the surgical removal of symmetrically positioned lower third molars.
A prospective, randomized, double-blind, clinical trial was carried out involving 47 patients. Each patient underwent 1 surgery at each of 2 appointments--one under local anesthesia with L100 and the other with A100. The following parameters were assessed at 4 different times: systolic, diastolic, and mean blood pressure; heart rate; oxygen saturation; rate pressure product; and pressure rate quotient.
No hypertensive peak was observed in systolic, diastolic, and mean blood pressure at any evaluation time. Moreover, the type of anesthetic solution did not affect diastolic blood pressure, heart rate, or oxygen saturation during the surgeries. The pressure rate quotient was the only parameter to exhibit statistically significant differences between groups at different evaluation times (P < 0.05).
The hemodynamic parameters evaluated in third molar surgery with 2% lidocaine and 4% articaine (both with epinephrine 1:100,000) did not show significant differences.

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    ABSTRACT: The control of hypertensive patients' blood pressure and heart rate using vasoconstrictors during surgical procedures under anesthesia is still a major concern in everyday surgical practice. This clinical trial aimed to evaluate the variation of blood pressure and heart rate in nonhypertensive and controlled hypertensive voluntary subjects undergoing oral surgery under local anesthesia with lidocaine hydrochloride and epinephrine at 1:100,000 (Alphacaine; DFL, Brazil), performed in the Oral Surgery Department, Dentistry School, Fluminense Federal University. In total, 25 voluntary subjects were divided into 2 groups: nonhypertensive (n = 15) and controlled hypertensives (n = 10). Blood pressure and heart rate were measured at 4 different times: T0, in the waiting room; T1, after placement of the surgical drapes; T2, 10 minutes after anesthesia injection; and T3, at the end of the surgical procedure. A statistically significant difference (P < 0.05) between the groups was found at times T0 and T2 for the systolic pressure but only at time T0 for the diastolic pressure. The assessment of the heart rate of both groups showed a statistically significant difference (P < 0.05) at time T1. An analysis of the employed anesthetic volume indicated no statistically significant difference (P > 0.05) between the amount administered to nonhypertensive and hypertensive subjects. It was concluded that the local anesthetics studied could safely be used in controlled hypertensive and nonhypertensive patients in compliance with the maximum recommended doses.
    The Journal of craniofacial surgery 05/2014; · 0.68 Impact Factor


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May 21, 2014