The Effects of Different Local Anesthetics on Hemodynamic After Injection for Endodontictherapy: A Randomized Clinical Trial



Dadgar F¹ ; Aminifard MN² ; Salarpoor M¹ ; Jalalian M³ Show Affiliations
Source: Acta Medica Mediterranea Published:2015

Abstract

Background: The main question during routine dental procedures is selection of the safest and most effective anesthetic agent for the patient. Local anesthesia is an inseparable component of most endodontic procedures. These solutions have the various cardiovascular effects. Objectives: The aim of this study was to determine the effects of four local anesthetic agents on the cardiovascular systems of patients who require endodontic treatment in different periods of injection. Design, Setting, Participants: A blinded clinical trial was conducted among 80 participants who were referred for root canal therapy to the Endodontic Department of Zahedan University of Medical Sciences, School of Dentistry in Zahedan, Iran in 2011. Interventions: The standard inferior alveolar nerve block was performed for every patient using one cartridge of one of the four local anesthetic agents: Lidocaine 2% + Epinephrine 1:80000; Mepivacaine 3%; Prilocaine 3% + 0.03 IU/ml Felypressin and Articaine 4% + Epinephrine 1:100000. Main Outcome Measure: The hemodynamic parameters, including systolic and diastolic blood pressure (BP) and heart rate (HR), were recorded at seven stages: Stage 1: Upon entrance into the office, Stage 2: 15 minutes after the patient was seated, Stage 3: immediately before the injection, Stages 4-7: immediately and 5, 10, and 15 minutes after the injection. Changes in the hemodynamic parameters in each drug group and between the groups at different intervals. Results: Heart rates, systolic blood pressures, diastolic blood pressures, and arrhythmia variations in the ECG were compared for the four different local anesthetics at seven different time periods. No significant differences were indicated by the ANOVA tests, but the drug-time contrasts were significant (F (14.361, 359.3) = 2.350, P = 0.004, Effect size = 0.086). The results of the repeated measures tests of each two drugs showed that the effects on the subjects for the different time periods were not significant for any of drugs and dependent variables. Conclusion: According to our study, the four local anesthetic agents that were studied altered certain cardiovascular parameters, such as systolic and diastolic blood pressure and heart rate, to varying degrees, but the variations may not be significant. Trial registeration: The clinical trial is registered by Iranian Registry of Clinical Trials #IRCT2014011316210N1. Fund: Funding for study was provided by The Research Deputy of Zahedan University of Medical Sciences (2871).