Assessment of cardiovascular parameters during dental procedures under the effect of benzodiazepines: a double blind study

Abstract

The purpose of this study was to evaluate cardiovascular parameters during dental procedures: systolic, diastolic, and mean blood pressures, and heart rate. Nineteen healthy normotensive patients (18-56 years of age) received restorative treatment on three maxillary molars. The patients were continuously monitored by a non-invasive automatic monitor for blood pressure and heart rate during the pre-, trans-, and post-operative periods at the following stages: 15 min prior to anesthesia; during topical anesthesia; during infiltrative anesthesia; for 5 minutes immediately after; during cavity preparation; during restorative procedure; for 10 min after completion. Patients were divided into three groups: A (without pre-medication), B (preceded by 10 mg diazepam), and C (preceded by placebo). All patients received infiltrative anesthesia containing 1.8 mL of 2% lidocaine (36 mg) with epinephrine 1:100,000 (18 microg). There were no changes in the parameters during the clinical procedures. When groups were compared, there were significant differences in diastolic arterial pressures during anesthesia.

Isolated atrial fibrillation (IAF) after local anaesthesia with epinephrine in an anxious dental patient

“…The circulating levels of epinephrine that are achievable after administration of 1.8 ml of local anaesthetic with epinephrine 1:100,000 can yield only minor changes of heart rate and blood pressure. 9,24 Faraco et al 25 and Dionne et al 26 have observed a rise of heart rate in patients undergoing dental treatment by 4-6% and 19-30% respectively. These studies support the general belief that, although LA with epinephrine cannot be the only cause of tachyarrhythmias, many different factors may together cause the development of IAF, as probably in this case.…”

Isolated atrial fibrillation (IAF) after local anaesthesia with epinephrine in an anxious dental patient

“…The circulating levels of epinephrine that are achievable after administration of 1.8 ml of local anaesthetic with epinephrine 1:100,000 can yield only minor changes of heart rate and blood pressure. 9,24 Faraco et al 25 and Dionne et al 26 have observed a rise of heart rate in patients undergoing dental treatment by 4-6% and 19-30% respectively. These studies support the general belief that, although LA with epinephrine cannot be the only cause of tachyarrhythmias, many different factors may together cause the development of IAF, as probably in this case.…”

Does the effect of adrenaline on intraoral 2% lidocaine contribute to haemodynamic instability?: A prospective, randomized double blinded study

“…They also increase the depth and duration of anaesthesia. 6 Adrenaline influences the HR and blood pressure by stimulating the alpha-adrenergic and beta-adrenergic receptors. There are no explanations why epinephrine has different effects on duration of action on different LAs.…”

The Effect of Hypertension and/or Diabetes on Blood Pressure and Heart Rate Changes in Patients Undergoing Oral Surgeries

“…If there is a difference of more than 10 mmHg between the BP values measured at home and measured at the dental clinic, it should be kept in mind that this may be white coat hypertension (22). Factors causing changes in BP during oral surgery include age, gender, individual factors such as body mass index; physiological and psychological stress, fear and anxiety, family history of hypertension, dose of catecholamines in local anesthetics (12)(13)(14)19,23,24). In a study evaluated the effect of anxiety on cardiovascular parameters in hypertensive patients, 1.8 ml of local anesthetic containing 2% lidocaine and 1:200000 epinephrine was used.…”

Isolated atrial fibrillation (IAF) after local anaesthesia with epinephrine in an anxious dental patient

“…The circulating levels of epinephrine that are achievable after administration of 1.8 ml of local anaesthetic with epinephrine 1:100,000 can yield only minor changes of heart rate and blood pressure. 9,24 Faraco et al 25 and Dionne et al 26 have observed a rise of heart rate in patients undergoing dental treatment by 4-6% and 19-30% respectively. These studies support the general belief that, although LA with epinephrine cannot be the only cause of tachyarrhythmias, many different factors may together cause the development of IAF, as probably in this case.…”

Does the effect of adrenaline on intraoral 2% lidocaine contribute to haemodynamic instability?: A prospective, randomized double blinded study

“…They also increase the depth and duration of anaesthesia. 6 Adrenaline influences the HR and blood pressure by stimulating the alpha-adrenergic and beta-adrenergic receptors. There are no explanations why epinephrine has different effects on duration of action on different LAs.…”

The Effect of Hypertension and/or Diabetes on Blood Pressure and Heart Rate Changes in Patients Undergoing Oral Surgeries

“…If there is a difference of more than 10 mmHg between the BP values measured at home and measured at the dental clinic, it should be kept in mind that this may be white coat hypertension (22). Factors causing changes in BP during oral surgery include age, gender, individual factors such as body mass index; physiological and psychological stress, fear and anxiety, family history of hypertension, dose of catecholamines in local anesthetics (12)(13)(14)19,23,24). In a study evaluated the effect of anxiety on cardiovascular parameters in hypertensive patients, 1.8 ml of local anesthetic containing 2% lidocaine and 1:200000 epinephrine was used.…”

Isolated atrial fibrillation (IAF) after local anaesthesia with epinephrine in an anxious dental patient

“…The circulating levels of epinephrine that are achievable after administration of 1.8 ml of local anaesthetic with epinephrine 1:100,000 can yield only minor changes of heart rate and blood pressure. 9,24 Faraco et al 25 and Dionne et al 26 have observed a rise of heart rate in patients undergoing dental treatment by 4-6% and 19-30% respectively. These studies support the general belief that, although LA with epinephrine cannot be the only cause of tachyarrhythmias, many different factors may together cause the development of IAF, as probably in this case.…”

Does the effect of adrenaline on intraoral 2% lidocaine contribute to haemodynamic instability?: A prospective, randomized double blinded study

“…They also increase the depth and duration of anaesthesia. 6 Adrenaline influences the HR and blood pressure by stimulating the alpha-adrenergic and beta-adrenergic receptors. There are no explanations why epinephrine has different effects on duration of action on different LAs.…”

The Effect of Hypertension and/or Diabetes on Blood Pressure and Heart Rate Changes in Patients Undergoing Oral Surgeries

“…If there is a difference of more than 10 mmHg between the BP values measured at home and measured at the dental clinic, it should be kept in mind that this may be white coat hypertension (22). Factors causing changes in BP during oral surgery include age, gender, individual factors such as body mass index; physiological and psychological stress, fear and anxiety, family history of hypertension, dose of catecholamines in local anesthetics (12)(13)(14)19,23,24). In a study evaluated the effect of anxiety on cardiovascular parameters in hypertensive patients, 1.8 ml of local anesthetic containing 2% lidocaine and 1:200000 epinephrine was used.…”