title: Clinical study of hemodynamic changes comparing 4% articaine hydrochloride with 1:100,000 and 1:200,000 epinephrine.
abstract: OBJECTIVE
  To evaluate hemodynamic changes with the use of 4% articaine and 2 different concentrations of epinephrine (1:100,000 and 1:200,000) in the surgical removal of symmetrically positioned lower third molars.
  
  
  METHODS
  A prospective, randomized, double-blind clinical trial was carried out involving 42 patients each undergoing 2 surgeries on separate occasions under local anesthesia with 4% articaine and either epinephrine 1:100,000 or 1:200,000. The following parameters were assessed at 4 different moments: systolic, diastolic, and mean blood pressure; heart rate; oxygen saturation; rate pressure product (RPP); and pressure rate quotient (PRQ).
  
  
  RESULTS
  The concentration of epinephrine did not affect diastolic blood pressure or oxygen saturation during the surgeries. Significant differences between were detected for heart rate, RPP, and PRQ (P < .05).
  
  
  CONCLUSIONS
  The epinephrine concentration (1:100,000 or 1:200,000) in a 4% articaine solution influences hemodynamic parameters without perceptible clinical changes in healthy patients undergoing lower third molar removal.
authors: Faculdade de Odontologia de Pernambuco, University of Pernambuco, Pernambuco, Brazil. thiago.ctbmf@yahoo.com.br
authors: Hécio Henrique Araújo
authors: HH
authors: de Morais
authors: Ricardo José
authors: RJ
authors: Holanda Vasconcellos
authors: Thiago
authors: T
authors: de Santana Santos
authors: Nelson Studart
authors: NS
authors: Rocha
authors: Fábio Andrey
authors: FA
authors: da Costa Araújo
authors: Ricardo Wathson Feitosa
authors: RW
authors: de Carvalho
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods; D000779:Anesthetics, Local / Q000494:pharmacology*; D001794:Blood Pressure; D002355:Carticaine / Q000494:pharmacology*; D004311:Double-Blind Method; D004837:Epinephrine / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D014081:Tooth Extraction; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D002355:Carticaine; D010100:Oxygen; D004837:Epinephrine