The Effect of Local Anesthesia (Lidocaine 2%) with Epinephrine (1:100,000) On Blood Pressure Level of Hypertensive Patients Reported To a Tertiary Care Hospital, Peshawar, Pakistan
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 6
Abstract
Objective: The objective of the study was to evaluate the effect of local anesthesia (Lidocaine) with epinephrine (1:100000) on blood pressure level and medicine used by hypertensive patients having Prehypertension, stage I and stage II hypertension. Methodology: This randomized controlled trial study was carried out in the department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar, Pakistan from February 2016 to August 2016. A total of 88 male and female hypertensive patients were selected and were divide into two groups through lottery method: Group A: Having 28 patients who receive 3 cartridges of Lidocaine 2% with epinephrine (1:100,000).Group B: Having 22 patients who receive 3 cartridges of lidocaine 2% without epinephrine (1:100,000). The blood pressure was measured prior to injection, 5minutes after injection, during extraction and after extraction of the tooth. Aspiration was carried out prior to injecting the local anesthesia. Statistical analysis was performed using SPSS 22. P ≤ 0.05 was considered as significant. Discussion: No significant increase in SBP and decrease in DBP were seen 5 minutes after injection, during extraction and after extraction of the tooth. The most commonly medicine taken by patients were β-blockers n=42 (47.72%). Pearson correlation revealed that increasing the duration of tooth extraction will decrease SBP (-.204) and DBP (-.106). ANOVA showed that the increase or decrease in SBP and DBP was statistically not significant (P=.698) between intergroup. Chi-square statistics exhibit that hypertension is highly associated with 40-49 years age group (X2=21.286, P=0.000). Regression analysis showed no significant relationship between β-blockers and local anesthesia with epinephrine 1:100,000. Hypertension is the systolic blood pressure (SBP) of ≥ 140mmHg or diastolic blood pressure (DBP) of ≥90mm Hg [1]. More than 90% of causes of hypertension are not clear but there are certain regulatory systems of blood pressure as well as environmental factors which contribute in regulation of blood pressure [2]. Blood pressure is also regulated by cardiac output and heart rate [3]. Over expression of the genes which controlled these regulatory systems may contribute in high blood pressure [4]. Due to high prevalence of hypertension globally, it is one of the most frequent disease seen in the patients who are visiting the dental hospitals and clinics [5,6]. In Pakistan approximately 33% of adult population suffers from hypertension and is the most common amongst cardiovascular diseases [7]. One utmost apprehension of dental treatment for hypertensive patients is the unexpected and marked increase in blood pressure that could lead to life-threatening complications therefore thesepatients contribute a major risk group in the dental treatment [5,8]. Local anesthetics combined with vasoconstrictors are used in most of the dental procedures [9]. Vasoconstrictors in the local anesthesia are added to enhance duration of local anesthesia, to halt systemic toxicity and to assist in hemostasis [10]. The most frequently used local anesthesia in many countries is Lidocaine and it was the first local anesthetic to be marketed in 1948 [5,11]. Epinephrine is the leading vasoconstrictor used in dental practices today [6,9]. Epinephrine acts on both α and β receptors but dominate on β. Acting on α1 epinephrine causing vasoconstriction in the peripheral blood vessels [12] while increase in the heart rate and blood pressure is due to the effect of epinephrine on β1 receptors [13]. There is controversy exists among different studies. Some believe that local anesthesia with epinephrine increases blood pressure as well as heart and should be contraindicated in hypertensive patients [5,11,14,15]. While some studies showed that the use of local anesthesia with epinephrine has no substantial effect on blood pressure and heart rate when one-three dental catridges are used as the amount of epinephrine is very low [16- 18]. Daubländer et al. [19] and Meechan et al. [20] demonstrate that it is obligatory for dental professionals to be cautious in proper use of local anesthesia with vasoconstrictor and care is needed when selecting and administrating these anesthetics to avoid systemic complications. The objective of the study is to evaluate the effect of local anesthesia (Lidocaine) with epinephrine (1:100000) on blood pressure level and medicine used by hypertensive patients having Prehypertension, stage I and stage II hypertension.
Authors and Affiliations
Muhammad Ilyas, Zupash Ali Khan, Ibrahim Khan, Akif Zamir, Kainat Ijaz, Jawad Ahmad Kundi
Keywords
Related Articles
- EP ID EP578608
- DOI 10.26717/BJSTR.2017.01.000513
- Views 158
- Downloads 0
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