title: Comparing hemodynamic and glycemic response to local anesthesia with epinephrine and without epinephrine in patients undergoing tooth extractions.
abstract: BACKGROUND
  Lignocaine with epinephrine as local anesthetic (LA) provides hemostasis and decreases the risk of systemic toxicity. The purpose of the present study was to investigate and compare the response of lignocaine with and without epinephrine to evaluate hemodynamic and metabolic response in normotensive and type II controlled diabetic patients.
  
  
  METHODS
  A total of 50 patients (25 healthy and 25 controlled type II diabetics) undergoing multiple tooth extractions (age group of 20-80 years) were included in this prospective, randomised, clinical study. On their first visit, the patients were given 2% lignocaine HCl with 1:200,000 epinephrine, and 2% lignocaine HCl was given on the second visit, to carry out tooth extractions. Blood pressure (BP), pulse rate, oxygen saturation, and blood glucose estimations were done at definite intervals (before, immediately after, and 20 min after the administration of LA) on both the visits.
  
  
  RESULTS
  The increase in blood glucose concentration following the administration of 2% lignocaine HCl with 1:200,000 epinephrine was statistically significant (P< 0.05) in controlled diabetic patients. Statistically significant variability in diastolic BP (DBP) was also noted in controlled diabetic patients. Both systolic BP and DBPs were statistically significantly elevated after the administration of 2% lignocaine HCl.
  
  
  CONCLUSIONS
  2% lignocaine HCl with 1:200,000 epinephrine in type II diabetics and 2% lignocaine HCl should be used with caution in normotensive as well as type II controlled diabetic patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Baba Jaswant Singh Dental College and Research Institute, Ludhiana, Punjab, India.
authors.forename: Paramjot
authors.initials: P
authors.lastname: Kaur
authors.affiliation: Department of Oral and Maxillofacial Surgery, Baba Jaswant Singh Dental College and Research Institute, Ludhiana, Punjab, India.
authors.forename: Rashi
authors.initials: R
authors.lastname: Bahl
authors.affiliation: Department of Oral and Maxillofacial Surgery, Baba Jaswant Singh Dental College and Research Institute, Ludhiana, Punjab, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Kaura
authors.affiliation: Department of Oral and Maxillofacial Surgery, Baba Jaswant Singh Dental College and Research Institute, Ludhiana, Punjab, India.
authors.forename: Sumit
authors.initials: S
authors.lastname: Bansal
keywords: Epinephrine; lignocaine HCl; local anesthesia; normotensive; tooth extractions; type II diabetes