Felypressin increases blood pressure during dental procedures in hypertensive patients.
BACKGROUND
Felypressin has been added to local anesthetic to increase the length of the anesthetic effect and reduce toxicity during dental procedures. However, the effect on blood pressure remains uncertain, and this may be highly relevant in the dental treatment of hypertensive patients.


OBJECTIVE
To investigate the effect of felypressin on blood pressure in hypertensive patients with controlled BP.


METHODS
71 subjects with these characteristics and in need of periodontal treatment were studied. After 10 minutes of rest, local anesthesia (prilocaine) was infiltrated with and without addition of felypressin. Then, a deep subgingival scaling was performed. Blood pressure was measured by an automated oscillometric device (DIXTAL DX2010). Ten minutes after the administration of the anesthetic, peak anesthetic action was recorded. The State-Trait Anxiety Inventory (STAI) was used to assess the patients' trait anxiety.


RESULTS
Systolic blood pressure increased after anesthesia, regardless of association with felypressin, throughout the dental procedure (p<0.05) and this response can be explained, at least in part, by the trait anxiety levels of the subjects. However, a further increase in diastolic blood pressure was observed when prilocaine was associated with felypressin (p<0.05), but this response did not change with trait anxiety levels.


CONCLUSIONS
Felypressin increased the diastolic blood pressure of hypertensive patients with controlled blood pressure. Patients with high trait anxiety presented increases in systolic blood pressure upon some procedures, suggesting that an increase in blood pressure might also be related to fear or anxiety.
Unidade de Hipertensão, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Ana Lúcia Aparecida
AL
Bronzo
Crivaldo Gomes
CG
Cardoso
Kátia Coelho
KC
Ortega
Décio
D
Mion
D000328:Adult; D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000009:adverse effects*; D001007:Anxiety / Q000523:psychology; D001794:Blood Pressure / Q000187:drug effects*; D005259:Felypressin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000628:therapy; D018709:Statistics, Nonparametric; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
D014662:Vasoconstrictor Agents; D005259:Felypressin