title: Clinical study of hemodynamic changes during extraction in controlled hypertensive patients.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of the vasoconstrictor used in local anesthesia during dental extraction in controlled hypertensive patients.
  
  
  METHODS
  A prospective observational study was carried out in hypertensive patients (n=97) with a mean age of 60.45±9.60 years. The following parameters were monitored at three different timepoints (before the procedure, 3 minutes after local anesthesia infiltration, and 3 minutes after the operation): blood pressure (diastolic and systolic), heart rate, and oxygen saturation. Anesthesia (1-3 carpules) was provided in the form of articaine with 4% epinephrine as vasoconstrictor in one group, while another group received 3% mepivacaine without vasoconstrictor.
  
  
  RESULTS
  All patients presented primary hypertension (n=97)(grade I in 57.7% of the cases and grade II in 42.3%). The most widely used antihypertensive drugs were angiotensin II receptor antagonists (ARA II). The only significant differences observed corresponded to systolic blood pressure measured before and after dental extraction in the group of hypertensive patients anesthetized with vasoconstrictor.
  
  
  CONCLUSIONS
  In procedures such as dental extraction, no significant hemodynamic changes in well controlled hypertensive patients are seen attributable to anesthetic use with a vasoconstrictor, when fewer than three local anesthetic carpules are administered.
authors.affiliation: Department of Stomatology, Valencia University Dental School, Stomatology Unit, Dr. Peset University Hospital, Juan de Garay s/n, 46017 Valencia, Spain. francisco.silvestre@uv.es
authors.forename: Francisco-Javier
authors.initials: FJ
authors.lastname: Silvestre
authors.forename: Isabel
authors.initials: I
authors.lastname: Salvador-Martínez
authors.forename: Daniel
authors.initials: D
authors.lastname: Bautista
authors.forename: Javier
authors.initials: J
authors.lastname: Silvestre-Rangil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014081:Tooth Extraction; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents