Glycemic effect of administration of epinephrine-containing local anaesthesia in patients undergoing dental extraction, a comparison between healthy and diabetic patients.
OBJECTIVE
To compare the effect of administration of epinephrine (in the dental local anesthetic solution) on blood glucose concentration in healthy and diabetic dental patients after extraction. To determine if there is any correlation between blood glucose level changes and the number of carpules injected, number of teeth extracted and the gender of the patient.


METHODS
An open study of 60 patients (30 healthy and 30 diabetics) visiting the Oral Surgery clinic of Ajman University of Science and Technology. A drop of blood was taken from the tip of the patient's finger and placed on a glucometer strip to determine the pre-operative blood glucose level. Dental local anaesthesia (1.8 ml carpule each) containing 1:80,000 epinephrine was injected either through infiltration or block. Extraction was carried out atraumatically and 10 minutes post-extraction the glucose measurement was taken.


RESULTS
The difference in the blood glucose levels pre- and post operatively were not significantly different (p > 0.05) when a comparison was made between the healthy and diabetic groups. Comparison of glucose changes in diabetics who had taken their hypoglycaemic medication and those who had not, showed a significant difference (p < 0.05). Statistical analysis showed no correlation between the blood glucose level changes and the number of carpules used, number of teeth extracted and gender.


CONCLUSIONS
Dental local anaesthetic solution containing epinephrine is safe to use in all healthy and diabetic patients (irrespective of their gender), excepting those diabetics who have not taken their pre-operative hypoglycaemic medication. There is no relation between the post-extraction glucose changes and the number of carpules used, number of teeth extracted or gender.
Tily
Fatima Ebrahim
FE
Department of Surgical Science, Faculty of Dentistry, Ajman University of Science & Technology, Dubai, UAE.
Thomas
Sam
S
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D014081:Tooth Extraction; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D000779:Anesthetics, Local; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D004837:Epinephrine