Effects of vasoconstrictors in dentistry upon systolic and diastolic arterial pressure

Vasoconstrictors associated to local anesthetics habitually used in dental practice have been reported to influence arterial pressure, in the same way as other factors such as patient anxiety or stress.

The present study investigates the variations in systolic and diastolic arterial pressure in three groups of patients subjected to conventional dental treatment in the form of molar extraction, with the aim of determining whether such variations are attributable to the use of a vasoconstrictor or to other factors such as patient anxiety.

A total of 43 healthy males with normal blood pressure readings were grouped according to the type of anesthetic solution employed: Group I (2% lidocaine with epinephrine 1:80,000), Group 2 (3% mepivacaine with epinephrine 1:100,000) and Group 3 (3% mepivacaine with no associated vasoconstrictor). In all cases the Hamilton Anxiety Scale was applied, with blood pressure recordings before and after anesthetic injection, during dental extraction, and at the end of treatment.

No statistically significant differences were observed in the blood pressure variations among the groups according to whether or not a vasoconstrictor was associated to the anesthetic solution in these healthy subjects. In increased systolic pressure was observed during extraction in all three study groups.

Our findings suggest that the use of a vasoconstrictor in association to the local anesthetic solution does not substantially modify blood pressure. On the other hand, the observed increase in systolic pressure in all three treatment groups may be attributed to patient anxiety.