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Hemodynamic and Glycemic Safety of two Local Anaesthetic Agents during Intra-Alveolar Tooth Extraction: A Comparison

Emmanuel A Adelusi*, Olatokunbo B Abiose, Olalere O Gbolahan

Introduction: There have been some controversies in the literature about the effect of Local Anesthetic (LA) solutions with and without adrenaline on plasma glucose and hemodynamics during dental treatment. The purpose of this study was to investigate and compare the hemodynamic and metabolic effects of two local anesthetic agents in patients undergoing intra-alveolar tooth extraction.

Methods: All medically fit normotensive and nondiabetic patients were included and randomized into two groups. Participants had breakfast before coming in for tooth extraction. The blood pressure, pulse rate, respiratory rate, and temperature were measured pre-anesthesia and 10 and 15 minutes post administration of local anesthesia and blood glucose was measured before and 30 min after administration of local anesthetic agents.

Results: Both groups showed a modest increase in their blood glucose and systolic pressure post administration of local anesthesia, while there was neither statistically significant increase nor decrease in the pulse rate, respiratory rate, and temperature in both groups. There was an increase in the systolic pressure at 10 minutes post extraction, after which a gradual downward trend towards the baseline value was observed in both.

Conclusion: Adrenaline containing bupivacaine and lidocaine appears to have minimal hemodynamic and glycemic effect when used as LA agents in patients undergoing intra-alveolar tooth extraction.