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


METHODS
Sixty-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.


RESULTS
The 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.


CONCLUSIONS
Lidocaine, 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.
Ezmek
Bahadir
B
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.
Arslan
Ahmet
A
Delilbasi
Cagri
C
Sencift
Kemal
K
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001641:Bicuspid / Q000601:surgery; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002610:Cheek / Q000294:innervation; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008340:Mandibular Nerve / Q000187:drug effects; D008619:Mepivacaine / Q000008:administration & dosage*; D008875:Middle Aged; D008963:Molar / Q000601:surgery; D009407:Nerve Block / Q000379:methods; D010100:Oxygen / Q000097:blood; D011318:Prilocaine / Q000008:administration & dosage*; D014081:Tooth Extraction; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D000319:Adrenergic beta-Antagonists; D000779:Anesthetics, Local; D002121:Calcium Channel Blockers; D014662:Vasoconstrictor Agents; D011318:Prilocaine; D008012:Lidocaine; D008619:Mepivacaine; D010100:Oxygen