Main Article Content

Abstract

Background


Local anesthesia (LA) is the most common form of anesthesia that is used in most dental procedures. It is almost unavoidable in many dental treatments. Lidocaine is usually used with epinephrine in a single cartridge. Epinephrine is added to lidocaine to reduce toxicity, prolong duration of anesthesia and control bleeding. A common belief in medicine, dentistry and even among the patients is that the use of epinephrine is contraindicated in cardiovascular patients as epinephrine suddenly raises the blood pressure (BP) and hearth rate (HR).


Objective


The aim of this research is to study the effects of Local Anaesthesia containing adrenaline (vasoconstrictor) on Blood pressure and pulse rate in hypertensive patients and to ascertain the safety of using Local Anaesthesia with adrenaline in such patients.


Design


A prospective cross sectional study to analyze the effects of Local Anaesthesia containing adrenaline (vasoconstrictor) on Blood pressure and pulse rate in hypertensive patients


Duration


October 2016 to December 2017.


Setting


Osmania General Hospital, Hyderabad.


Participants


The study was conducted on 200 patients who underwent dental extraction at Osmania General Hospital, Hyderabad.


Methods


Out of 200 patients, 100 patients were normotensive patients with systolic blood pressure of <120 mm of Hg and diastolic blood pressure of < 80 mm of Hg and remaining 100 patients were Hypertensive patients out of which 50 patients had Stage I Hypertension (SBP 140 – 159 mm of Hg & DBP 90 – 99 mm of Hg) and 50 patients had Stage II Hypertension (SBP >160 mm Hg & DBP >100 mm Hg). All patients were given Inferior Alveolar Nerve Block followed by Lingual & Long Buccal Nerve Blocks with 2% Lignocaine with 1:2, 00,000 Adrenaline. The Blood pressure and pulse rate were recorded 6 times.


Results


All patients showed a considerable increase in Systolic and Diastolic BP recorded at 2 minutes but gradually showed a reduction until 60 minutes post-operatively. The pulse rate also demonstrated a sudden increase followed by gradual reduction to preoperative level.


Conclusion


All patients demonstrated a considerable increase in blood pressure and pulse rate but not significantly which may be attributed to stress induced due to dental extraction.

Keywords

Local Anesthesia Adrenaline Hemodynamic Changes Blood Pressure Pulse Rate

Article Details

How to Cite
Dr. P. Srujana, & Dr. Syed Arshaduddin Ahmed. (2021). Effects of local anesthesia with adrenaline on blood pressure and pulse rate of healthy and hypertensive patients undergoing tooth extraction. International Journal of Research in Pharmacology & Pharmacotherapeutics, 7(4), 336-339. Retrieved from https://ijrpp.com/ijrpp/article/view/305

References

  1. [1]. Reeve LW. Modern pharmacodynamic concepts of local anesthesia. Dent Clin North Am 14, 1970, 783-804.
  2. [2]. Pascuet E, Donnelly RF, Garceau D, Vaillancourt R. Buffered lidocaine hydrochloride solution with and without epinephrine: Stability in polypropylene syringes. Can J Hosp Pharm 62, 2009, 375-80.
  3. [3]. Cousins MJ, Bridenbaugh PO. Neural Blockade in Clinical Anesthesia and Management of Pain. Philadelphia: Lippincott Williams & Wilkins; 4, 2008.
  4. [4]. Facts & Comparisons. Drug Facts and Comparisons 2011. St. Louis: Lippincott Williams & Wilkins; 65, 2010.
  5. [5]. Keesling GR, Hinds EC. Optimal concentration of epinephrine in lidocaine solutions. J Am Dent Assoc 66, 1963, 337-40.
  6. [6]. Hoffman BB. Catecholamines, sympathomimetic drugs, and adrenergic receptor antagonists. In: Hardman JG, Limbird LE, Gilman AG, editors. Goodman and Gilman's The Pharmacological Basis of Therapeutics. New York, NY: McGraw-Hill; 10, 2001.
  7. [7]. Cassidy JP, Phero JC, Grau WH. Epinephrine: Systemic effects and varying concentrations in local anesthesia. AnesthProg 33, 1986c, 289-97.
  8. [8]. Malamed S. Handbook of Local Anesthesia. St. Louis: CV Mosby Pub. Co.; 1, 1980, 27-35.
  9. [9]. Milam SB, Giovannitti JA Jr. Local anesthetics in dental practice. Dent Clin North Am 28, 1984, 493-508.
  10. [10]. Roberts DN, Sowray JH. Local Analgesia in Dentistry. Bristol:
  11. [11]. John Wright & Sons, Ltd.; 1970.
  12. [12]. Tófoli GR, Ramacciato JC, de Oliveira PC, Volpato MC, Groppo FC, Ranali J. Comparison of effectiveness of 4% articaine associated with 1: 100,000 or 1: 200,000 epinephrine in inferior alveolar nerve block. AnesthProg 50, 2003, 164-8.
  13. [13]. Jastak JT, Yagiela JA, Donaldson D. Local Anesthesia of the Oral Cavity. Philadelphia: Saunders; 3, 1995.
  14. [14]. Yagiela JA. Adverse drug interactions in dental practice: Interactions associated with vasoconstrictors. Part V of a series. J Am Dent Assoc 130, 1999, 701-9.
  15. [15]. Einhorn A. Text Book of Clinical Pharmacology in Dental Practice. Saint Louis: CV Mosby Company; 1974.
  16. [16]. Stewart JH, Cole GW, Klein JA. Neutralized lidocaine with epinephrine for local anesthesia. J DermatolSurgOncol 15, 1989, 1081-3.
  17. [17]. Cowan A. Local anaesthetics and vasoconstrictors. J Ir Dent Assoc 20, 1974, 156-62.
  18. [18]. Aberg G. Studies on the duration of local anesthesia: A possible mechanism for the prolonging effect of "vasoconstrictors" on the duration of infiltration anesthesia. Int J Oral Surg 9, 1980, 144-7.
  19. [19]. Roberts DH, Sowray LH. Local Analgesia in Dentistry. Bristol: Wright PSG; 2, 1979.
  20. [20]. Howe GL, Whitehead FI. Local Anaesthesia in Dentistry. Bristol: Wright PSG; 2, 1981.
  21. [21]. Monheim LM. Local Anesthetic and Pain Control in Dental Practice. 4 th ed. St. Louis: Mosby Co; 1978, 162-6.
  22. [22]. Van den Berg AA, Montoya-Pelaez LF. Comparison of lignocaine 2% with adrenaline, bupivacaine 0.5% with or without hyaluronidase and a mixture of bupivacaine, lignocaine and hyaluronidase for peribulbar block analgesia. ActaAnaesthesiolScand 45, 2001, 961-6.