The study and analysis of the prognosis criteria for a safe local anesthesia in patients with arterial hypertension

Abstract

Relevance. To develop the algorithm for a safe and effective local anesthesia in dental outpatients with arterial hypertension.Materials and methods. The study was conducted in the laboratory of functional and clinical studies of Moscow State University of Medicine and Dentistry. Electric pulp testing (µA) was performed and pulp microcirculation (PU) was assessed in the intact teeth of patients with hypertension before and 5, 10, 15, 30 and 60 minutes after the administration of local anesthesia. We used 4% articaine solutions without a vasoconstrictor and with its minimal concentration 1:200 000 and 1:400 000, and 3% mepivacaine solution. The safety of the administered local anesthetic was assessed by the continuous hemodynamic monitoring.Results. 4% articaine solution without epinephrine had a shallow anesthetic effect in the maxilla and anterior mandible. 1:400 000 and 1:200 000 vasoconstrictor concentrations in 4% articaine solution increase the depth and duration of the anesthesia from 20 to 30 minutes respectively. Changes in the pulp sensibility but not in blood microcirculation were demonstrated by the functional parameters of the intact dental pulp in patients with hypertension after the administration of 3% mepivacaine solution at the mandibular foramen. The continuous hemodynamic monitoring data showed no changes in arterial blood pressure, heart rate, oxygen saturation on administration of either of the studied local anesthetic solutions or techniques.Conclusion. The analysis of the prognosis criteria for a safe local anesthesia allowed us to ground the choice of anesthetic in dental outpatients with arterial hypertension.