Changes in Blood Pressure and Pulse Rate of Patients without Systemic Diseases Following the Injection of 2% Lidocaine Plus Epinephrine 1:80000 in an Inferior Alveolar Nerve Block - A Prospective Study

Ehsan Aliabadi; Vahid Divanpour; Mohsen Mardani

doi:10.4103/ams.ams_187_19

Changes in Blood Pressure and Pulse Rate of Patients without Systemic Diseases Following the Injection of 2% Lidocaine Plus Epinephrine 1:80000 in an Inferior Alveolar Nerve Block - A Prospective Study

Ann Maxillofac Surg. 2020 Jul-Dec;10(2):361-364. doi: 10.4103/ams.ams_187_19. Epub 2020 Dec 23.

Authors

Ehsan Aliabadi¹, Vahid Divanpour², Mohsen Mardani¹

Affiliations

¹ Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
² Department of Operative Dentistry, Bushehr University of Medical Sciences, Iran.

Abstract

Introduction: An inferior alveolar nerve block is dental anesthesia produced by the local injection of lidocaine plus epinephrine; however, its administration could cause cardiovascular side effects. We aimed to assess the changes in blood pressure and pulse rate following the injection of 2% lidocaine with epinephrine 1:80000 for an inferior alveolar nerve block.

Materials and methods: Seventy-one patients without any systemic disease were enrolled in this study. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate were measured using an automatic digital blood pressure monitor in four stages as follows: at the rest time (Stage 1), prior to injection (Stage 2), immediately after injection (Stage 3), and 10 min after the administration of anesthetic agents (Stage 4). All injections and measurements were carried out by a single operator to minimize the variability.

Results: SBP and DBP in all stages were within the normal range (lower than 130 and 80 mmHg, respectively), and none of the patients showed evidence of arterial hypertension. Although the pulse rate increased significantly at Stages 2, 3, and 4 compared with Stage 1 (P < 0.05), no evidence of bradycardia or tachycardia was seen.

Discussion: Local anesthesia with 2% lidocaine plus epinephrine 1:80000 for an inferior alveolar nerve block would be safe for patients without any systemic diseases.

Keywords: Arterial hypertension; epinephrine; inferior alveolar nerve block; lidocaine; pulse rate.