Blood pressure fluctuations in hypertensive patients during oral surgery

Meiller, Timothy F.; Overholser, C. Daniel; Kutcher, Mark J.; Bennett, Robert E.

doi:10.1016/0278-2391(83)90187-8

Cited by 21 publications

(15 citation statements)

References 3 publications

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“…Meiller, et al 23 (1983) in a study on normotensive and hypertensive patients, determined that during local anesthesia and tooth extraction that BP increased continually, though without statistical significance. In the present study, SBP did not show statistically significant differences among the groups, but significant changes were observed in the lidocaine and prilocaine groups in DBP and MAP, though not in increasing fashion.…”

Section: Discussionmentioning

confidence: 99%

Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients

et al. 2010

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ObjectiveLocal anesthetic solutions with vasoconstrictors are not contraindicated in hypertensive patients, but due to their hemodynamic effects, local anesthetics without vasoconstrictors are mainly preferred by the clinicians. The aim of this study was to compare hemodynamic effects of three different local anesthetics without vasoconstrictors during tooth extraction in hypertensive patients.Material and MethodsSixty-five mandibular molars and premolars were extracted in 60 hypertensive patients (29 females and 31 males; mean age: 66.95 ± 10.87 years; range: 38 to 86 years old). Inferior alveolar and buccal nerve blocks were performed with 2% lidocaine hydrochloride (HCl), 2% prilocaine HCl or 3% mepivacaine HCl without vasoconstrictor. Hemodynamic parameters namely systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), saturation rate (SR), rate pressure product (RPP) and pressure rate quotient (PRQ) were investigated before and at different intervals after anesthetic injection.ResultsThe hemodynamic effects of the three agents were similar to each other, although some significance was observed for DBP, MAP, RPP and PRQ values in the lidocaine, prilocaine and mepivacaine groups.ConclusionLidocaine, prilocaine and mepivacaine solutions without vasoconstrictor can be safely used in hypertensive patients. It is advisable that dental practitioners select anesthetic solutions for hypertensive patients considering their cardiovascular effects in order to provide patient comfort and safety.

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Section: Discussionmentioning

confidence: 99%

Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients

et al. 2010

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“…No significant changes in diastolic blood pressure were observed after the injection of a local anesthetic (procaine or lidocaine) without a vasoconstrictor (25-27, 29, 34,35). Most patients displayed a limited decrease in diastolic blood pressure after the injection of lidocaine with 1:100 000 epinephrine (27,28,35,36,41).…”

Section: Cardiovascular Changes During Dental Treatment Local Anesthesiamentioning

confidence: 99%

“…The mean systolic blood pressure increased +3 to +10 mmHg during the injection of a local anesthetic. No significant changes, however, were observed in the diastolic blood pressure during the injection (27, [36][37][38][39]. Immediately after the injection of a local anesthetic without a vasoconstrictor, no alteration was observed in the systolic blood pressure (27,30,33,34,40), or only a limited decrease (25,26,29,35).…”

Section: Cardiovascular Changes During Dental Treatment Local Anesthesiamentioning

confidence: 99%

“…It is not clear whether the mean blood pressure of healthy patients increases immediately before the beginning of the extraction (43,65,61). During the extraction, however, the mean systolic blood pressure shows a marked increase of' 3-24 mmHg (26, 27, 36,38,40,43,60,66). It is unclear whether the diastolic blood pressure changes during extraction: some investigators reported increases in diastolic blood pressure of 4-11 mmHg (26, 40, 43, 60, 66), but others observed no changes (27, [36][37][38].…”

Section: Tooth Extractions and Oral Surgerymentioning

confidence: 99%

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Cardiovascular Responses Induced By Dental Treatment

Brand

1997

Australian Endodontic Newsletter

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Brand HS, Abraham-lnpijn L: Cardiovascular responses induced by dental treatment.Changes in mean heart rate and mean systolic and diastolic blood pressure are induced by both the patient's anticipation of scheduled treatment and the actual dental treatment itself. Significant changes have been observed before application of a local anesthetic, during restorative treatment, during extractions, and when epinephrine-impregnated retraction cords were used. These cardiovascular responses may vary according to the local anesthetic used and the choice of vasoconstrictor. The individual changes in heart rate and blood pressure are affected by pain and such individual factors as age, gender, hypertension, dental experience, and psychological responses. Although for the most part the cardiovascular changes induced by dental treatment are limited and within the normal physiological variation, this review stresses the importance of eliminating pain and minimizing patient anxiety.

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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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Blood pressure fluctuations in hypertensive patients during oral surgery

Cited by 21 publications

References 3 publications

Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients

Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients

Cardiovascular Responses Induced By Dental Treatment

Hemodynamic Behavior in Third Molar Surgeries Using Lidocaine or Articaine

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