title: A prospective randomized clinical trial compared the effect of various types of local anesthetics cartridges on hypertensive patients during dental extraction.
abstract: OBJECTIVE
  To evaluate hemodynamic changes of blood pressure and heart rate on hypertensive patients undergoing tooth extraction using various types of local anesthesia (LA).
  
  
  METHODS
  A prospective randomized clinical trial was conducted on 45 hypertensive patients who were divided equally into 3 parallel groups according to LA received. Group 1: Lidociane 2% with epinephrine 1: 80,000. Group 2: Prilocaine 3% with Felypressin 0.03 IU/ml. Group 3: Mepivacaine 3% plain.
  
  
  METHODS
  hypertensive patients, under medical management with blood pressure ≤ 159/99.
  
  
  METHODS
  Blood pressure ≥160 /100 and patients receiving β blockers. Negative aspiration was mandatory before the injection of 2 cartridges of LA. Blood pressure and heart rate were evaluated by Electronic Sphygmomanometer and Pulse Oximeters in 3 different time-points; 3 minutes before LA, three minutes after LA and three minutes after extraction.
  
  
  RESULTS
  The mean of systolic blood pressure (SBP) had increased after LA injection, and then decreased after extraction in the 3 groups of patients. Increase of SBP after extraction with (Mepivacaine plain) was higher than (Lidociane with Epinephrine) and the difference was statistically significant using ANOVA (p=0.037). The differences in the mean heart rates and mean diastolic blood pressures in the 3 groups were not significant.
  
  
  CONCLUSIONS
  The increase of blood pressure with Epinephrine and Felypressin is negligible. Therefore, it is safe to use 2 cartridges of Lidociane 2% with Epinephrine 1:80,000 or Prilocaine 3% with Felypressin 0.03 IU/ml for hypertensive patients whose blood pressure ≤ 159/99 provided negative aspiration is verified before injection. Key words:Local anesthesia, tooth extraction, hypertensive patients, vasoconstrictors, epinephrine, Felypressin.
authors: BDs, MSc, Lecturer in Oral and Maxillofacial Surgery. Riyadh Colleges of Dentistry and Pharmacy, Oral and Maxillofacial Surgery and Diagnostic Science Department, Dental Hospital (Munessya) Riyadh, Kingdom of Saudi Arabia.
authors: Nedal
authors: N
authors: Abu-Mostafa
authors: BDS. Riyadh Colleges of Dentistry and Pharmacy, Oral and Maxillofacial Surgery and Diagnostic Science Department, Dental Hospital (Munessya) Riyadh, Kingdom of Saudi Arabia.
authors: Abdullah
authors: A
authors: Aldawssary
authors: BDS. Riyadh Colleges of Dentistry and Pharmacy, Oral and Maxillofacial Surgery and Diagnostic Science Department, Dental Hospital (Munessya) Riyadh, Kingdom of Saudi Arabia.
authors: Ahmad
authors: A
authors: Assari
authors: BDS. Riyadh Colleges of Dentistry and Pharmacy, Oral and Maxillofacial Surgery and Diagnostic Science Department, Dental Hospital (Munessya) Riyadh, Kingdom of Saudi Arabia.
authors: Suliman
authors: S
authors: Alnujaidy
authors: BDS. Riyadh Colleges of Dentistry and Pharmacy, Oral and Maxillofacial Surgery and Diagnostic Science Department, Dental Hospital (Munessya) Riyadh, Kingdom of Saudi Arabia.
authors: Almutlaq
authors: A
authors: Almutlaq