Hemodynamic changes during exodontia in hypertensive and normotensive patients following injection of local anesthetics with and without epinephrine: a prospective comparative study

Introduction: patients encountered in practice and exodontia procedures. Possibility of cardiovascular complications can be anticipated in these patients. This study compares blood pressure, heart rate, and peripheral capillary oxygen saturation, in normotensive and hypertensive patients prior to, during and after dental extractions. Patients and methods: A prospective comparative study was carried out in 100 (N = 100) patients between the age group of 40-70 years. 50 patients diagnosed with Stage I hypertension and 50 patients who were normotensives, requiring extraction of tooth were recruited. They were further divided into four groups namely, A, B, C and D, each consisting of 25 (n = 25). Group A included patients with controlled hypertension who were administered local anesthesia with epinephrine, while Group B had patients with controlled hypertension who were administered local anesthesia without epinephrine. Group C had normotensive patients who were administered local anesthesia with epinephrine and normotensive patients who were administered local anesthesia without epinephrine were under group D. The patients were evaluated at preoperative, intra operatively and post-operative interval for blood pressure, heart rate and peripheral oxygen saturation. Results: The sample consisted of 42 males and 58 females with a mean age of 42.6, 49.9, 40.6 and 31.6 years in group A, B, C and D respectively. Both systolic and diastolic blood pressure was increased after administration of anesthetic in all four group and decreased lower than baseline level after the surgical procedure. Heart rate was also found to be increased in all groups. A significant difference in peripheral oxygen saturation levels between group A and group B was observed post operatively. Conclusion: The use of epinephrine in local anesthetics have no significant role in altering the blood pressure and heart rate of hypertensive as well as normotensive patients .