BEHAVIOR OF BLOOD PRESSURE IN PATIENTS IN THE DENTAL CHAIR

Keywords: Blood pressure – Dental infiltration anesthesia.        
Blood pressure is affected by acute increases in cardiac output and peripheral resistance which are mediated by the sympathetic system. Stimulation of the latter, following infiltration anesthesia, triggers a cascade of events, whose outcome may be reflected in increased blood pressure (BP) and heart rate (HR). OBJECTIVE: To determine whether a protocolized dental treatment under infiltration anesthesia causes changes in BP and HR in patients with controlled hypertension versus normal subjects. METHODS: A prospective longitudinal comparative study involving repeated determinations of BP and HR was performed. The patients were divided into two groups: 1) controlled hypertensive and 2) non-hypertensive patients. Patients presenting mild to moderate periodontal disease and normal basal BP values (systolic < 140 or diastolic < 90 mmHg) were included. Under local infiltration anesthesia (LIA) (carticaine 4% with 1:100000 adrenaline), all patients underwent removal of superficial tartar using ultrasound material and scaling and root planing with curettes. BP and HR were recorded at admission, prior to the procedure, post-anesthesia, on finishing the procedure, and at release. RESULTS: The study was conducted on 60 patients, average age 53 ± 15 years, 52% of whom were women. The hypertensive group accounted for 59% of the total population. The highest systolic BP values were recorded post LIA administration and were statistically significant in both groups (p < 0.01). There were no significant differences between systolic BP values at baseline and at release.  No significant differences in diastolic BP or HR were observed among the different treatment stages or between groups. CONCLUSIONS: The highest BP values were observed post-administration of local infiltration anesthesia. The behavior of BP was similar in controlled hypertensive patients and non-hypertensive patients. There were no significant differences in heart rate among the different treatment stages.