Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction

<!DOCTYPE html> <html> <head> <meta charset="utf-8"> <meta name="viewport" content="width=device-width, initial-scale=1"> <title>Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction</title> <meta name="keywords" content="Adrenaline; Anaesthetic; Cardiovascular disease; Lidocaine; Tooth extraction"> <meta name="description" content="Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction, Shehab Ahmed Hamad*, Ranj Nadhim Salai, "> <meta name="citation_publisher" content="Walsh Medical Media"/> <meta name="citation_journal_title" content="Journal of Clinical & Experimental Pharmacology"> <meta name="citation_title" content="Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction"> <meta name="citation_author" content="Shehab Ahmed Hamad"/> <meta name="citation_author" content="Ranj Nadhim Salai"/> <meta name="citation_author" content="Avinash N"/> <meta name="citation_author" content="an"/> <meta name="citation_year" content="2024"> <meta name="citation_volume" content="14"> <meta name="citation_issue" content="2"> <meta name="citation_doi" content="10.35248/2161-1459.24.14.410"> <meta name="citation_issn" content="2161-1459"> <meta name="citation_publication_date" content="2024/03/11"/> <meta name="citation_firstpage" content="1"> <meta name="citation_lastpage" content="5"> <meta name="citation_abstract" content="Objective: To assess the effect of vasoconstrictor in dental local anaesthetic on hemodynamic parameters in patients with cardiovascular disease following tooth extraction. Methods: This prospective study was conducted at Al-Manara college for medical sciences, Amarah, Iraq. The sample of the study included 50 patients with cardiovascular disease who were presented for extraction of a single mandibular molar under local anaesthesia. The local anaesthesia was achieved with inferior alveolar nerve block using single cartridge of 2% lidocaine with 1:100,000 adrenaline. Systolic and diastolic blood pressure, heart rate, and oxygen saturation were measured before injection, immediately after injection, and after 5 and 15 minutes of injection. Results: Although the systolic blood pressure and heart rate were elevated, the diastolic blood pressure was decreased and no change was seen in the oxygen saturation. Conclusion: The local anaesthetic injection of lidocaine with adrenaline, along with the surgical procedure of tooth extraction, produces significant increase in the systolic blood pressure and heart rate in the patients with cardiovascular diseases."> <meta name="citation_fulltext_html_url" content="https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html"> <meta name="citation_pdf_url" content="https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-t.pdf"> <meta name="citation_abstract_html_url" content="https://www.walshmedicalmedia.com/abstract/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-t-126110.html"> <script type="text/javascript"> function openimage( theURL, winName, features ) { window.open( theURL, winName, features ); } </script> <meta itemprop="name" content="Walsh Medical Media" /> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <meta name="google-site-verification" content="YjHsSGOfJVjTiVTf6S4LqoaspPRh3ErDWaq1RaXtrAY" /> <meta name="ROBOTS" content="INDEX,FOLLOW"> <meta name="googlebot" content="INDEX,FOLLOW"> <link rel="shortcut icon" href="/assets/images/ico.png" /> <link rel="canonical" href="https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html"> <link rel="alternate" href="https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" hreflang="en-us"/> <link rel="stylesheet" type="text/css" href="/assets/lib/css/bootstrap.min.css"> <link rel="stylesheet" type="text/css" href="/assets/css/style.css"> <link rel="stylesheet" type="text/css" href="/assets/css/responsive.css"> <link rel="stylesheet" type="text/css" href="/assets/css/journalpage.css"> <link rel="stylesheet" href="https://pro.fontawesome.com/releases/v5.10.0/css/all.css" crossorigin="anonymous"/> <link href="/assets/lib/css/font/font.css" rel="stylesheet"> <script src="/assets/lib/js/jquery.min.js"></script> <script src="/assets/lib/js/bootstrap.bundle.min.js"></script>  <script src="/assets/lib/js/popper.min.js"></script> <script src="/assets/lib/js/bootstrap.min.js"></script>  <script async src="https://www.googletagmanager.com/gtag/js?id=G-82GJ3LQ7V6"></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-82GJ3LQ7V6'); </script> <script type="application/ld+json"> { "@context": "https://schema.org", "@type": "Organization", "url": "https://www.walshmedicalmedia.com/", "logo": "https://www.walshmedicalmedia.com/assets/images/walsh-medical-media-logo.png" } </script> <meta property="og:title" content="walsh medical media | journals | open access journals" /> <meta property="og:type" content="open access journals" /> <meta property="og:url" content="https://www.walshmedicalmedia.com/" /> <meta property="og:image" content="https://www.walshmedicalmedia.com/assets/images/walsh-medical-media-logo.png" /> <meta name="twitter:card" content="summary"> <meta name="twitter:site" content="@WalshMedical"> <meta name="twitter:title" content="Walsh Medical Media | Journals | Open Access Journals"> <meta name="twitter:description" content="Walsh Medical Media. is one of the leading international open access journals publishers covering clinical, medical, biological, pharmaceutical sciences, engineering, as well as management and technol"> <meta name="twitter:image" content="https://www.walshmedicalmedia.com/assets/images/walsh-medical-media-logo.png">  <script> !function(f,b,e,v,n,t,s){if(f.fbq)return;n=f.fbq=function(){n.callMethod? n.callMethod.apply(n,arguments):n.queue.push(arguments)};if(!f._fbq)f._fbq=n; n.push=n;n.loaded=!0;n.version='2.0';n.queue=[];t=b.createElement(e);t.async=!0; t.src=v;s=b.getElementsByTagName(e)[0];s.parentNode.insertBefore(t,s)}(window, document,'script','//connect.facebook.net/en_US/fbevents.js'); fbq('init', '297919997051754'); fbq('track', "PageView"); </script> </head> <body> <header class="header-view"> <div class="container"> <div class="row"> <div class="col-lg-12 col-md-12 d-flex flex-column justify-content-center"> <nav class="navbar navbar-expand-lg p-0"> <a href="https://www.walshmedicalmedia.com/" title="Walsh Medical Media"><img src="/assets/images/walsh-medical-media-logo.png" alt="Walsh Medical Media"></a> <button class="navbar-toggler toggle-view" type="button" data-bs-toggle="collapse" data-bs-target="#mainNavbar"> <i class="fa fa-bars" aria-hidden="true"></i> </button> <div class="collapse navbar-collapse justify-content-end" id="mainNavbar"> <ul class="navbar-nav header-links"> <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/" title="Click here">Home</a> </li> <li class="nav-item dropdown"> <a class="nav-link dropdown-toggle own-journal" href="#" id="navbarDropdownMenuLink" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false"> Journals </a> <ul class="dropdown-menu custom-dropdown" aria-labelledby="navbarDropdownMenuLink"> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/scientific-journals-list.html" title="Click here">A-Z Journals</a></li> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/open-access-journals-list.html" title="Click here">Browse By Subject</a></li> </ul> </li> <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/publish-with-us.html" title="Click here">Publish With Us</a> </li> <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/contact-us.html" title="Click here">Contact Us</a> </li> </ul> <ul class="navbar-nav manuscript"> <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/submissions/clinical-experimental-pharmacology.html" title="Click here">Submit Manuscript <i class="fa fa-long-arrow-right px-2" aria-hidden="true"></i></a> </li> </ul> <div id="google_translate_element"></div> </div> </nav> </div> </div> </div> </header> <section class="journal-navbar" id="sticky-navbar"> <div class="container"> <div class="col-md-12 py-4"> <div class="journal-heading-issn"> <h1>Journal of Clinical & Experimental Pharmacology</h1> <p>ISSN: 2161-1459</p> </div> </div> </div>  <header class="journal-navbar"> <div class="container"> <div class="row"> <div class="col-lg-12 col-md-12"> <nav class="navbar navbar-expand-lg p-0"> <button class="navbar-toggler journal-toggle-view" type="button" data-bs-toggle="collapse" data-bs-target="#customNavbar"> <i class="fa fa-bars" aria-hidden="true"></i> </button> <div class="collapse navbar-collapse" id="customNavbar"> <ul class="navbar-nav journal-navbar-list"> <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology.html" title="Click here">Journal Home</a> </li> <li class="nav-item dropdown"> <a class="nav-link dropdown-toggle" href="#" id="navbarDropdownMenuLink" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false"> Editorial panel </a> <ul class="dropdown-menu journal-custom-dropdown" aria-labelledby="navbarDropdownMenuLink"> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/editor-in-chief.html" title="Click here">Editor-in-chief</a></li> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/editorial-board.html" title="Click here">Editor Board</a></li> </ul> </li> <li class="nav-item dropdown"> <a class="nav-link dropdown-toggle" href="#" id="navbarDropdownMenuLink" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false"> Instructions for Authors </a> <ul class="dropdown-menu journal-custom-dropdown" aria-labelledby="navbarDropdownMenuLink"> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/instructionsforauthors.html" title="Click here">Instructions for Authors</a></li> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/ethical-malpractices.html" title="Click here">Publication ethics & malpractice statement</a></li> </ul> </li> <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/submit-manuscript.html" title="Click here">Submit Manuscript</a> </li> <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/inpress.html" title="Articles in process" style="text-transform:inherit;">Articles in process</a> </li>  <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/archive.html" title="Click here">Archive</a> </li> <li class="nav-item dropdown"> <a class="nav-link dropdown-toggle" href="#" id="navbarDropdownMenuLink" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false"> Special Issues </a> <ul class="dropdown-menu journal-custom-dropdown" aria-labelledby="navbarDropdownMenuLink"> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/guidelines.html" title="Click here">Guidelines</a></li> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/upcoming-special-issues.html" title="Click here">Upcoming Special Issues</a></li> </ul> </li> <li class="nav-item"> <a class="nav-link" href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/contact.html" title="Click here">Contact</a> </li> <li class="nav-item dropdown"> <a class="nav-link dropdown-toggle" href="#" id="navbarDropdownMenuLink" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false"> Our Services </a> <ul class="dropdown-menu journal-custom-dropdown" aria-labelledby="navbarDropdownMenuLink"> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/advertise.html" title="Click here">Advertise</a></li> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/reprints.html" title="Click here">Reprints</a></li> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/membership.html" title="Click here">Membership</a></li> <li><a class="dropdown-item" href="https://www.walshmedicalmedia.com/subscription.html" title="Click here">Subscription</a></li> </ul> </li> </ul> </div> </nav> </div> </div> </div> </header> </section> <script type="text/javascript"> function googleTranslateElementInit() { new google.translate.TranslateElement({pageLanguage: 'en'}, 'google_translate_element'); } </script> <script type="text/javascript" src="//translate.google.com/translate_a/element.js?cb=googleTranslateElementInit"></script>  <section class="py-2"> <div class="container"> <div class="row"> <div class="col-lg-3 pt-3 order-last order-sm-first"> <a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/awards-nomination.html" class="btn btn-info btn-block mb-3 border-0 border-left-4 border-info font-size-4 awards_link" ><i class="fa-light fa-award-simple"></i> Awards Nomination </a> <a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology-online-visitors-readers-17.html" class="btn btn-warning btn-block mb-3 border-0 border-left-4 border-info font-size-4 reader_link"><i class="fas fa-book-reader"></i> 20+ Million Readerbase</a>  <div class="card shadow-sm sidebar mb-3"> <div class="list-group list-group-flush qr_code_image"> <img title="QR" src="https://chart.googleapis.com/chart?chs=185x185&cht=qr&chl=https%3A%2F%2Fwww.walshmedicalmedia.com%2Fopen-access%2Fhemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html&chld=M|0&icqrf=00b1e4" alt="Walsh Medical Media"/>  <nav class="nav nav-pills social-icons-footer sidebar_social_icons a-pl-0"> <a title="Share This Article" target="_blank" class="nav-link" rel="noopener" href="https://www.facebook.com/sharer.php?s=100&p[title]=Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction&p[url]=https%3A%2F%2Fwww.walshmedicalmedia.com%2Fopen-access%2Fhemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html"><img src="https://www.walshmedicalmedia.com/assets/socials/facebook.png" alt="Walsh Medical Media" /></a> <a title="Share This Article" target="_blank" class="nav-link" rel="noopener" href="https://web.whatsapp.com/send?text=https%3A%2F%2Fwww.walshmedicalmedia.com%2Fopen-access%2Fhemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" title="Share This Article" target="_blank" class="nav-link"><img src="https://www.walshmedicalmedia.com/assets/socials/whatsapp.png" alt="Walsh Medical Media"/></a> <a title="Share This Article" target="_blank" class="nav-link" rel="noopener" href="https://www.linkedin.com/sharing/share-offsite/?url=https%3A%2F%2Fwww.walshmedicalmedia.com%2Fopen-access%2Fhemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" title="Share This Article" target="_blank" class="nav-link"><img src="https://www.walshmedicalmedia.com/assets/socials/linkedin.png" alt="Walsh Medical Media"/></a> <a title="Share This Article" target="_blank" class="nav-link" rel="noopener" href="https://twitter.com/share?text=Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction&url=https%3A%2F%2Fwww.walshmedicalmedia.com%2Fopen-access%2Fhemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" class="nav-link"><img src="https://www.walshmedicalmedia.com/assets/socials/twitter.png" alt="Walsh Medical Media" /></a> </nav>  </div> </div>  <div class="card mb-3"> <div class="card-header custom-header"> <h6><a target="_blank" href="https://scholar.google.com/citations?hl=en&user=Jj_wdWYAAAAJ" title="Click here">Google Scholar citation report</a></h6> </div> <div class="card-body custom-body"> <h6 style="font-weight:bold;">Citations : 1547</h6> <p><a target="_blank" href="https://scholar.google.com/citations?hl=en&user=Jj_wdWYAAAAJ" title="Click here">Journal of Clinical & Experimental Pharmacology received 1547 citations as per Google Scholar report</a></p> <div class="card shadow-sm sidebar mb-3"> <a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/citations.html" title="Click here"><img src="https://www.walshmedicalmedia.com/admin/citation-images/journal-of-clinical--experimental-pharmacology-citation.PNG" alt="Journal of Clinical & Experimental Pharmacology" class="img-fluid p_rel" /></a> </div> </div> </div> <div class="card mb-3"> <div class="card-header custom-header"> <h6><a href="https://publons.com/journal/81757/journal-of-clinical-experimental-pharmacology/" target="_blank" title="Click here">Journal of Clinical & Experimental Pharmacology peer review process verified at publons</a></h6> </div> <div class="card-body custom-body"> <a href="https://publons.com/journal/81757/journal-of-clinical-experimental-pharmacology/" target="_blank" title="Click here"><img src="https://www.walshmedicalmedia.com/admin/publon-images/journal-of-clinical--experimental-pharmacology-publon.png" alt="Flyer image" class="p_rel w-100" height="250px"/></a> </div> </div> <div class="card mb-3"> <div class="card-body custom-body p-0"> <div> <a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/advertising.html" title="Click here"><img src="https://www.walshmedicalmedia.com/assets/images/tower-banner.jpg" alt="Flyer image" class="img-fluid p_rel" width="100%" /> <span class="p_abo cu_roundchip"> <span> <h5><span>25+</span> Million Website Visitors</h5> </span> </span> </a> </div> </div> </div>   <div class="card mb-3"> <div class="card-header custom-header"> <h6>Indexed In</h6> </div> <div class="card-body custom-body card-scroll"> <ul class="list-unstyled index-list"> <li><i class="fa fa-angle-right"></i> Open J Gate </li> <li><i class="fa fa-angle-right"></i> Genamics JournalSeek </li> <li><i class="fa fa-angle-right"></i> China National Knowledge Infrastructure (CNKI) </li> <li><i class="fa fa-angle-right"></i> Ulrich's Periodicals Directory </li> <li><i class="fa fa-angle-right"></i> RefSeek </li> <li><i class="fa fa-angle-right"></i> Hamdard University </li> <li><i class="fa fa-angle-right"></i> EBSCO A-Z </li> <li><i class="fa fa-angle-right"></i> OCLC- WorldCat </li> <li><i class="fa fa-angle-right"></i> Publons </li> <li><i class="fa fa-angle-right"></i> Google Scholar </li> </ul> </div> <div class="card-footer custom-card-footer text-end"> <a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/indexing.html">View More <i class="fa fa-long-arrow-right" aria-hidden="true"></i></a> </div> </div> <div class="card mb-3"> <div class="card-header custom-header"> <h6>Useful Links</h6> </div> <div class="card-body custom-body card-scroll"> <ul class="list-unstyled index-list"> <li><a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/aim-and-scope.html" title="Click Here"><i class="fa fa-angle-right"></i> Aim and Scope</a></li> <li><a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/peer-review-process.html" title="Click Here"><i class="fa fa-angle-right"></i> Peer Review Process</a></li>   <li><a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/citations.html" title="Click Here"><i class="fa fa-angle-right"></i> Citations Report</a></li> <li><a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/indexing.html" title="Click Here"><i class="fa fa-angle-right"></i> Indexing and Archiving</a></li> <li><a href="https://www.walshmedicalmedia.com/clinical-experimental-pharmacology/archive.html" title="Click Here"><i class="fa fa-angle-right"></i> Table of Contents</a></li> <li><a href="https://www.walshmedicalmedia.com/submissions/clinical-experimental-pharmacology.html" title="Click Here"><i class="fa fa-angle-right"></i> Submit Paper</a></li> <li><a href="https://www.walshmedicalmedia.com/peer-review-tracking/" title="Click Here"><i class="fa fa-angle-right"></i> Track Your Paper</a></li> <li><a href="https://www.walshmedicalmedia.com/funded-articles.html" title="Click Here"><i class="fa fa-angle-right"></i> Funded Work</a></li> </ul> </div> </div> <div class="card mb-3"> <div class="card-header custom-header"> <h6>Share This Page</h6> </div> <div class="card-body left-bar-social-links"> <ul class="nav"> <li><a class="nav-link" rel="noopener" href="https://www.facebook.com/sharer.php?u=https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" target="_blank" title="Share with Facebook"><i class="fab fa-facebook-f"></i></a></li> <li><a class="nav-link" rel="noopener" href="https://twitter.com/share?url=https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" target="_blank" title="Share with Twiter"><i class="fab fa-twitter"></i></a></li> <li><a class="nav-link" rel="noopener" href="https://www.linkedin.com/shareArticle?mini=true&url=https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" target="_blank" title="Share with Linkedin"><i class="fab fa-linkedin-in"></i></a></li> <li><a class="nav-link" rel="noopener" href="https://pinterest.com/pin/create/button/?url=https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" target="_blank" title="Share with Pinterest"><i class="fab fa-pinterest-p"></i></a></li> <li><a class="nav-link" rel="noopener" href="https://www.blogger.com/blog-this.g?u=https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-tooth-extra-126110.html" target="_blank" title="Share with Blogger"><i class="fab fa-blogger-b"></i></a></li> </ul> </div> </div>   <div class="card mb-3"> <div class="card-header custom-header"> <h6>Journal Flyer</h6> </div> <div class="card-body custom-body"> <div> <img src="https://www.walshmedicalmedia.com/admin/flyers/journal-of-clinical--experimental-pharmacology-flyer.jpg" alt="Journal of Clinical & Experimental Pharmacology" class="img-fluid" width='100%'/> </div> </div> </div>  <div class="card mb-3" align="center"> <a class="twitter-timeline" href="https://x.com/ClinExpPharma" data-width="450" data-height="300">Tweets by </a> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script> </div>  <div class="card mb-3"> <div class="card-header custom-header"> <h6>Open Access Journals</h6> </div> <div class="card-body custom-body card-scroll"> <ul class="list-unstyled index-list"> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/agri-and-aquaculture-journals.html" title="Click here"> Agri and Aquaculture </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/biochemistry-journals.html" title="Click here"> Biochemistry </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/bioinformatics-and-systems-biology-journals.html" title="Click here"> Bioinformatics & Systems Biology </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/business-and-management-journals.html" title="Click here"> Business & Management </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/chemistry-journals.html" title="Click here"> Chemistry </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/clinical-sciences-journals.html" title="Click here"> Clinical Sciences </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/engineering-journals.html" title="Click here"> Engineering </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/food-and-nutrition-journals.html" title="Click here"> Food & Nutrition </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/general-science-journals.html" title="Click here"> General Science </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/genetics-and-molecular-biology-journals.html" title="Click here"> Genetics & Molecular Biology </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/immunology-and-microbiology-journals.html" title="Click here"> Immunology & Microbiology </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/medical-sciences-journals.html" title="Click here"> Medical Sciences </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/neuroscience-and-psychology-journals.html" title="Click here"> Neuroscience & Psychology </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/nursing-and-health-care-journals.html" title="Click here"> Nursing & Health Care </a></li> <li><i class="fa fa-angle-right"></i><a href="https://www.walshmedicalmedia.com/pharmaceutical-sciences-journals.html" title="Click here"> Pharmaceutical Sciences </a></li> </ul> </div> <div class="card-footer custom-card-footer text-end"> <a href="https://www.walshmedicalmedia.com/open-access-journals-list.html">View More <i class="fa fa-long-arrow-right" aria-hidden="true"></i></a> </div> </div>  </div> <div class="col-lg-9"> <div class="row align-items-center justify-content-between"> <div class="col-12 col-sm-6"> <p class="text-muted mb-0"> Research Article - (2024) Volume 14, Issue 2 </p> </div> <div class="col-12 col-sm-6 text-end"> <ul class="list-unstyled abtract-view justify-content-end"> <li> <a href="https://www.walshmedicalmedia.com/open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-t.pdf" title="View PDF" class="btn btn-sm bg-green-600 rounded-50"><i class="fas fa-file-pdf"></i> View PDF</a> </li> <li> <a href="https://www.walshmedicalmedia.com/pdfdownload.php?download=open-access/hemodynamic-effect-of-2-lidocaine-with-a-1100000-adrenaline-in-patients-with-cardiovascular-diseases-undergoing-single-t.pdf&aid=126110" title="Download PDF" class="btn btn-sm bg-green-600 rounded-50"><i class="fas fa-download"></i> Download PDF</a> </li> </ul> </div> </div> <h5 class="font-size-7 mt-2">Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction</h5> <a href='https://www.walshmedicalmedia.com/author/shehab-ahmed-hamad-55967' title='Shehab Ahmed Hamad' style='color:#555; border-bottom:1px dotted #CCC;'>Shehab Ahmed Hamad</a><sup><a href='#a1'>1</a></sup><sup><a href='#Shehab_Ahmed_Hamad'>*</a></sup>, <a href='https://www.walshmedicalmedia.com/author/ranj-nadhim-salai-55968' title='Ranj Nadhim Salai' style='color:#555; border-bottom:1px dotted #CCC;'>Ranj Nadhim Salai</a><sup><a href='#a2'>2</a></sup> and <a href='https://www.walshmedicalmedia.com/author/avinash-nandan-55969' title='Avinash Nandan' style='color:#555; border-bottom:1px dotted #CCC;'>Avinash Nandan</a><sup><a href='#a2'>2</a></sup> <div> </div> <a id="a1"></a><sup>1</sup>Department of Oral and Maxillofacial Surgery, Kurdistan Higher Council of Medical Specialties, Erbil, Iraq<br> <a id="a2"></a><sup>2</sup>Department of Dentistry, Tishik International University, Erbil, Iraq<br> <div> </div> <a id="Shehab_Ahmed_Hamad"></a> <strong><sup>*</sup>Correspondence:</strong> Shehab Ahmed Hamad, Department of Oral and Maxillofacial Surgery, Kurdistan Higher Council of Medical Specialties, Erbil, Iraq, <strong>Tel:</strong> 7503478636, <strong>Email:</strong> <i class='fa fa-envelope' aria-hidden='true' title='shehab.ahmed@khcms.edu.krd'></i> <p> <strong>Received: </strong>14-Jun-2023, Manuscript No. CPECR-23-21869; <strong>Editor assigned: </strong>16-Jun-2023, Pre QC No. CPECR-23-21869 (PQ); <strong>Reviewed: </strong>30-Jun-2023, QC No. CPECR-23-21869 ; <strong>Revised: </strong>04-Mar-2024, Manuscript No. CPECR-23-21869 (R); <strong>Published:</strong> 11-Mar-2024, DOI: 10.35248/2161-1459.24.14.410</p> <div class="card bg-light mb-3"> <div class="card-body px-3 pb-0"> <h2 class="font-size-5">Abstract</h2> <p><strong>Objective: </strong>To assess the effect of vasoconstrictor in dental local anaesthetic on hemodynamic parameters in patients with cardiovascular disease following tooth extraction.</p> <p><strong>Methods: </strong>This prospective study was conducted at Al-Manara college for medical sciences, Amarah, Iraq. The sample of the study included 50 patients with cardiovascular disease who were presented for extraction of a single mandibular molar under local anaesthesia. The local anaesthesia was achieved with inferior alveolar nerve block using single cartridge of 2% lidocaine with 1:100,000 adrenaline. Systolic and diastolic blood pressure, heart rate, and oxygen saturation were measured before injection, immediately after injection, and after 5 and 15 minutes of injection.</p> <p><strong>Results: </strong>Although the systolic blood pressure and heart rate were elevated, the diastolic blood pressure was decreased and no change was seen in the oxygen saturation.</p> <p><strong>Conclusion: </strong>The local anaesthetic injection of lidocaine with adrenaline, along with the surgical procedure of tooth extraction, produces significant increase in the systolic blood pressure and heart rate in the patients with cardiovascular diseases.</p> <h4 class="font-size-4">Keywords</h4> <p>Adrenaline; Anaesthetic; Cardiovascular disease; Lidocaine; Tooth extraction</p> </div> </div> <h4>Introduction</h4> <p>In minor oral surgical procedures, Local Anesthetics (LA) are frequently employed for safe and efficient intraoperative and perioperative pain management. The nerve impulse from the teeth and the surrounding soft tissues is irreversibly interrupted by LA. The most commonly used local anesthetics nowadays are the combination of lidocaine, the most popular amide, and adrenaline, the most popular vasoconstrictor. Without a vasoconstrictor, lidocaine does not provide a sufficient duration of anesthetic activity, which can result in intraoperative pain, systemic endogenous catecholamine release, and detrimental cardiovascular problems like an increase in blood pressure and heart rate and possibly even arrhythmia [<a href="#1" title="1">1</a>]. Adrenaline is the most commonly used vasoconstrictor that has both local and systemic effects at the injection site. Adrenaline stimulates 1 receptors in peripheral blood arteries, which causes vasoconstriction [<a href="#2" title="2">2</a>]. Stimulation of β1 receptors by adrenaline increases the heart rate and raises the blood pressure [<a href="#3" title="3">3</a>]. When mixed with adrenaline, a vasoconstrictor, lidocaine, a vasodilator when given alone, creates a combination that tends to counteract the effects of the former. It is generally recognized that this combination can increase anesthesia's clinical depth while also reducing systemic lidocaine toxicity and minimizing blood loss during tooth extraction [<a href="#4" title="4">4</a>,<a href="#5" title="5">5</a>].</p> <p>Adrenaline's potential adverse effects include dose-dependent cardio-vascular consequences. Cardiovascular Diseases (CVD) affect a wide range of patients, with essential hypertension, ischaemic heart disease, rheumatic heart disease, valvular heart disease, congenital heart disease, arrhythmias, heart failure, transient ischemic attacks, and cerebrovascular diseases among the most prevalent [<a href="#6" title="6">6</a>]. Lidocaine and adrenaline combination used for oral surgery may cause intraoperative hemodynamic changes during surgery [<a href="#7" title="7">7</a>]. These systemic side effects are primarily caused by poor technique, such as administering nerve block injections without adequate aspiration, injecting a high dose, interfering with other medications, or allowing the anesthetic ingredient to immediately take effect when injected into a highly vascular location [<a href="#8" title="8">8</a>,<a href="#9" title="9">9</a>]. The surgeon can operate more safely by keeping track of these patients' hemodynamic changes because it can help avoid emergencies [<a href="#10" title="10">10</a>].</p> <p>The use of local anesthetics with adrenaline has drawn criticism since, even with correct technique, there is a conceivable chance of systemic absorption, which could have negative cardiovascular effects, especially in individuals with cardiovascular disorders [<a href="#11" title="11">11</a>]. It is also widely believed that the use of local anesthetics combined with adrenaline puts patients with heart illness, particularly those who have undiscovered cardio-vascular conditions, at risk for life-threatening medical problems [<a href="#12" title="12">12</a>].</p> <p>This study evaluated the safety of adrenaline in local anaesthesia on cardiovascular events in patients with CVD.</p> <h4>Materials and Methods</h4> <p>This prospective study was conducted at the faculty of dentistry at Al-Manara college of medical sciences, Amarah, Iraq, from September 29<sup>th</sup> 2022 to April 1<sup>st </sup>2023. Fifty patients with cardiovascular disease, who needed single tooth extraction, were included in the study. All patients were anaesthetized with one cartridges of 1.8 ml Local Anaesthesia (LA), containing 2% lidocaine with 1:100,000 adrenaline. Four hemodynamic parameters were measured, including systolic blood pressure, diastolic blood pressure, heart rate and oxygen saturation. The parameters were measured immediately before local anaesthetic injection, immediately after injection, and after 5 and 15 minutes of injection. Inclusion criteria: Patients who were diagnosed with hypertension and other cardiovascular diseases. Patients were excluded if they need surgical removal of the tooth, or the tooth was fractured at the time of extraction.</p> <p>The inferior alveolar nerve was administered using aspirating dental syringe. If the blood was encountered in the cartridge during aspiration, the needle was pulled out of the injection site and the cartridge was replaced with a new one.</p> <p>All procedures were performed in morning sessions with relaxed atmosphere and without having been prescribed any preoperative anxiolytic medications. On the dental chair, a pulse oximeter (merlin medical<sup>®</sup> pulse oximeter) was applied to the left index finger to measure the oxygen saturation. The blood pressure and heart rate were measured by an electronic sphygmomanometer (OMRON<sup>®</sup> automatic blood pressure monitor).</p> <p>Statistical analysis was performed using SPSS software (IBM corp. released 2017. IBM SPSS statistics for windows, version 25.0. Armonk, NY: IMB Corp). Comparisons between the groups was carried out using a dependent t test. The significance level was set at P ≤ 0.05.</p> <h4>Results</h4> <p>The sample size of the study was 50 patients, 29 (58%) females and 21 (42%) males with a mean age of 47 ± 18 years (range 38-77 years). Hypertensive patients was 41 (82%), 4 (8%) patients had angina pectoris and 5 (10%) patients suffered from arrhythmias.</p> <p>The systolic blood pressure showed no significant changes immediately after injection; however, after five minutes of the injection there was a statistically significant increase in the systolic blood pressure from 130.4 mmHg to 134.6 mmHg (p=0.006). The systolic blood pressure return back to its nearly normal value 15 minutes after injection (<strong>Table 1</strong>). The diastolic blood pressure showed a statistically significant reduction immediately after injection, from 69.1 mmHg to 65.8 mmHg (p<0.001). At 5 and 15 minutes after injection the diastolic blood pressure is significantly different from the baseline measurement (<strong>Table 2</strong>).</p> <div class="table-responsive"> <table class="table table-striped"> <thead> <tr> <th rowspan="3"> </th> <th colspan="6">                          Systolic blood pressure (mmHg)</th> </tr> <tr> <th colspan="2">                Pair 1</th> <th colspan="2">           Pair 2</th> <th colspan="2">           Pair 3</th> </tr> <tr> <th>Before</th> <th>Immediately after</th> <th>Before</th> <th>After 5 mins.</th> <th>Before </th> <th>After 15 mins.</th> </tr> </thead> <tbody> <tr> <td>Maximum </td> <td>154 </td> <td>155 </td> <td>154 </td> <td>160 </td> <td>154 </td> <td>159 </td> </tr> <tr> <td>Minimum </td> <td>123 </td> <td>128 </td> <td>123 </td> <td>130 </td> <td>123 </td> <td>136 </td> </tr> <tr> <td>Mean </td> <td>130.4 </td> <td>131.9 </td> <td>130.4 </td> <td>134.7 </td> <td>130.4 </td> <td>130.1 </td> </tr> <tr> <td>SD </td> <td>15.7 </td> <td>14.9 </td> <td>15.7 </td> <td>15.2 </td> <td>15.7 </td> <td>14.8 </td> </tr> <tr> <td>T-value</td> <td colspan="2">1.4 </td> <td colspan="2">2.9 </td> <td colspan="2">0.3 </td> </tr> <tr> <td>P-value</td> <td colspan="2">0.16 </td> <td colspan="2">0.006 </td> <td colspan="2">0.788 </td> </tr> </tbody> </table> </div> <p> <strong>Table 1:</strong> Comparison of systolic blood pressure at different time points after injection.</p> <div class="table-responsive"> <table class="table table-striped"> <thead> <tr> <th rowspan="3">  </th> <th colspan="6">                                  Diastolic blood pressure (mmHg)</th> </tr> <tr> <th colspan="2">                Pair 1</th> <th colspan="2">           Pair 2</th> <th colspan="2">           Pair 3</th> </tr> <tr> <th>Before</th> <th>Immediately      after</th> <th>Before</th> <th>After 5 minutes</th> <th>Before </th> <th>After 15 minutes</th> </tr> </thead> <tbody> <tr> <td>Maximum </td> <td>90 </td> <td>88 </td> <td>90 </td> <td>102 </td> <td>90 </td> <td>88 </td> </tr> <tr> <td>Minimum </td> <td>67 </td> <td>64 </td> <td>67 </td> <td>65 </td> <td>67 </td> <td>66 </td> </tr> <tr> <td>Mean </td> <td>69.1 </td> <td>65.8 </td> <td>69.1 </td> <td>67.5 </td> <td>69.1 </td> <td>68.3 </td> </tr> <tr> <td>SD </td> <td>13.3 </td> <td>12.8 </td> <td>13.3 </td> <td>15.4 </td> <td>13.3 </td> <td>12 </td> </tr> <tr> <td>T-value</td> <td colspan="2">6.4 </td> <td colspan="2">1.1 </td> <td colspan="2">1.4 </td> </tr> <tr> <td>P-value</td> <td colspan="2">0 </td> <td colspan="2">0.275 </td> <td colspan="2">0.167 </td> </tr> </tbody> </table> </div> <p> <strong>Table 2:</strong> Comparison of diastolic blood pressure at different time points after injection.</p> <p>The heart rate showed a statistically significant increase from the baseline, immediately after injection (91.4 <em>vs</em>. 94.9, p=0.007) and after 5 minutes of injection (91.4 <em>vs</em>. 95.1, p=0.004) (<strong>Table 3</strong>).</p> <p>After 15 minutes, the heart rate returned back to its pre-injection value. There was no a significant change in the oxygen saturation at the three time points after injection (<strong>Table 4</strong>).</p> <div class="table-responsive"> <table class="table table-striped"> <thead> <tr> <th rowspan="3">  </th> <th colspan="6">                          Heart rate (beat/minute)</th> </tr> <tr> <th colspan="2">                Pair 1</th> <th colspan="2">           Pair 2</th> <th colspan="2">           Pair 3</th> </tr> <tr> <th>Before</th> <th>Immediately after</th> <th>Before</th> <th>After 5 minutes</th> <th>Before </th> <th>After 15 minutes</th> </tr> </thead> <tbody> <tr> <td>Maximum </td> <td>115 </td> <td>118 </td> <td>115 </td> <td>160 </td> <td>115 </td> <td>159 </td> </tr> <tr> <td>Minimum </td> <td>65 </td> <td>72 </td> <td>65 </td> <td>130 </td> <td>65 </td> <td>136 </td> </tr> <tr> <td>Mean </td> <td>91.4 </td> <td>94.9 </td> <td>91.4 </td> <td>95.1 </td> <td>91.4 </td> <td>91.3 </td> </tr> <tr> <td>SD </td> <td>10.9 </td> <td>11.1 </td> <td>10.9 </td> <td>10.8 </td> <td>10.9 </td> <td>10.8 </td> </tr> <tr> <td>T-value</td> <td colspan="2">2.8 </td> <td colspan="2">3.1 </td> <td colspan="2">0.08 </td> </tr> <tr> <td>P-value</td> <td colspan="2">0.007 </td> <td colspan="2">0.004 </td> <td colspan="2">0.935 </td> </tr> </tbody> </table> </div> <p> <strong>Table 3: </strong>Comparison of heart rate at different time points after injection.</p> <div class="table-responsive"> <table class="table table-striped"> <thead> <tr> <th rowspan="3">  </th> <th colspan="6">                          Oxygen saturation (%)</th> </tr> <tr> <th colspan="2">                Pair 1</th> <th colspan="2">           Pair 2</th> <th colspan="2">           Pair 3</th> </tr> <tr> <th>Before</th> <th>Immediately after</th> <th>Before</th> <th>After 5 minutes</th> <th>Before </th> <th>After 15 minutes</th> </tr> </thead> <tbody> <tr> <td>Maximum </td> <td>100 </td> <td>100 </td> <td>100 </td> <td>100 </td> <td>100 </td> <td>100 </td> </tr> <tr> <td>Minimum </td> <td>85 </td> <td>83 </td> <td>85 </td> <td>86 </td> <td>85 </td> <td>87 </td> </tr> <tr> <td>Mean </td> <td>94.1 </td> <td>94.6 </td> <td>94.1 </td> <td>94.1 </td> <td>94.1 </td> <td>94.8 </td> </tr> <tr> <td>SD </td> <td>4.8 </td> <td>3.4 </td> <td>4.8 </td> <td>3.3 </td> <td>4.7 </td> <td>2.9 </td> </tr> <tr> <td>T-value</td> <td colspan="2">1.1 </td> <td colspan="2">0.07 </td> <td colspan="2">1.2 </td> </tr> <tr> <td>P-value</td> <td colspan="2">0.293 </td> <td colspan="2">0.943 </td> <td colspan="2">0.248 </td> </tr> </tbody> </table> </div> <p> <strong>Table 4:</strong> Comparison of oxygen saturation at different time points after injection.</p> <h4>Discussion</h4> <p>This study examined the impact of a local anesthetic combining lidocaine (2%) and adrenaline (1:100,000) on the heart rate, oxygen saturation, systolic blood pressure, and diastolic blood pressure in patients with cardiovascular disorders undergoing single tooth extractions. The measurements of these variables were carried out before, immediately after, and at five and fifteen minutes after the injection of local anesthetic.</p> <p>This study indicated that in individuals with cardiovascular illness, systolic blood pressure significantly increased 5 minutes after injection. In addition, the heart rate significantly increased immediately following injection and lasted for 5 minutes. Immediately following injection, the diastolic blood pressure statistically significantly decreased before returning to almost pre-injection levels.</p> <p>The tension and apprehension during tooth extraction and the impact of exogenous adrenaline may be responsible for the hemodynamic alterations [<a href="#13" title="13">13</a>]. The stimulation of peripheral alpha-1 receptors, which predominantly raises blood pressure through induced vasoconstriction and contraction of vascular smooth muscles, may be responsible for an increase in systolic blood pressure. The stimulation of beta-2 receptors, which results in dilatation of blood arteries in skeletal muscles, may be the cause of the drop in diastolic blood pressure. The beta-1 receptors in the heart are responsible for mediating the rise in heart rate [<a href="#14" title="14">14</a>].</p> <p>The sympathomimetic catecholamine adrenaline has pharmacologic effects on both alpha and beta-adrenergic receptors. In modest doses, it has a stronger affinity for beta receptors. Large doses, however, have a selective effect on alpha receptors. Adrenaline causes enhanced vascular smooth muscle contraction, pupillary dilator muscle contraction, and intestinal sphincter muscle contraction through its impact on alpha-1 receptors. Increased heart rate, myocardial contractility, and renin release <em>via</em> beta-1 receptors are additional major effects [<a href="#15" title="15">15</a>].</p> <p>The American heart association recommended that the maximum dose of adrenaline in local anesthesia for a healthy individual is 0.2 mg however, if the patient has serious cardiovascular disease, this should be reduced to 0.04 mg. In comparison to the maximal dose in healthy people, which is 0.2 mg, a local anesthetic cartridge containing adrenaline at a concentration of 1:100,000 have 0.018 mg of adrenaline. This amount of adrenaline is present in 11 cartridges of 1.8 ml. The maximum recommended dose of adrenaline for local anesthetic injections given to individuals with cardiovascular disease is 0.04 mg, which only includes 2.2 cartridges containing 1.8 ml [<a href="#16" title="16">16</a>].</p> <p>Abraham, et al., endings on cardiovascular problems expected after normal dental care and our study are consistent [<a href="#17" title="17">17</a>]. They discovered that intraoral injection of 2% lidocaine with 1:100,000 adrenaline resulted in a higher rise in blood pressure in hypertensive patients undergoing tooth extraction. The results of our investigation are likewise consistent with those of Niwa, et al., who assessed the safety of using local anesthesia including adrenaline in patients with cardiovascular disease. Impedance cardiography was used to monitor the hemodynamic response to an intraoral injection of 1.8 ml of 2% lidocaine and 1:80,000 adrenaline [<a href="#18" title="18">18</a>]. Ten minutes after the injection, they saw substantial cardiovascular changes and theorized that these changes were minor and within normal limits. Additionally, it was noted that the heart rate and systolic blood pressure elevated from the baseline by 5.1% and 4.1% respectively, while diastolic blood pressure decreased by approximately 10%.</p> <p>Our study group's drop in diastolic blood pressure is comparable to that of Chaudhry, et al., who discovered that prehypertensives and stages I and II hypertensives saw drops in mean diastolic blood pressure five minutes after receiving local anesthesia injections [<a href="#19" title="19">19</a>]. Chaudhry, et al., also discovered that after two minutes of injection of two cartridges containing 2% Lidocaine with 1:100,000 adrenaline, the mean systolic blood pressure increased in pre-hypertensive, hypertensive stage I and II patients. Systolic blood pressure recovered to normal in all groups after the injections lasted for five minutes, and in hypertension stage II patients, it even decreased somewhat.</p> <p>Santos, et al., examined the usage of local anesthetics used in the removal of lower third molars that included 4% articaine combined with 1:100,000 (10 mug/mL) or 1:200,000 (5 mug/mL) adrenaline [<a href="#20" title="20">20</a>]. In two sessions, fifty healthy patients underwent local anesthesia using either 1:100,000 or 1:200,000 adreanaline to remove their symmetrically positioned lower third molars. They did not discover a significant difference in the measurements of systolic and diastolic blood pressure with injection, in contrast to our findings.</p> <p>2% lidocaine and epinephrine 1:100,000 (L100) or 4% articaine and epinephrine 1:200,000 (L200) were the local anesthetics used in the study by de Morais, et al., to analyze hemodynamic changes following the surgical removal of symmetrically positioned lower third molars. Systolic, diastolic, and mean blood pressure measurements at any evaluation time showed no hypertensive peak. Additionally, neither oxygen saturation nor diastolic blood pressures were impacted by the anesthetic solution type. Kammerer, et al., conducted a study to compare and assess the clinical anaesthetic efficacy of five different 4% adrenergic articaine solutions in pulpal anesthesia following infiltration. They emphasized that these solutions' infiltration anesthesia had no impact on heart rate, blood pressure, or oxygen saturation.</p> <p>To evaluate the pharmacokinetics and cardiovascular effects of 11.9 ml of 4% articaine Hydrochloride (HCl) plus 1:100,000 adrenaline with those of 11.9 ml of 4% articaine HCl plus 1:200,000 adrenaline, Hersh, et al., conducted a randomized, double-blind, two-way crossover clinical experiment. According to the study's findings, there were no appreciable changes between the two adrenaline concentrations.</p> <p>In our investigation, there was no statistically significant difference in the oxygen saturation. However, in their respective trials, Santos, et al.; de Morais, et al., both noted an increase in oxygen saturation following the injection of adrenaline into local anesthesia.</p> <p>In contrast to the results of our investigation, Meechan, et al. also looked at how heart transplant recipients responded to dental local anesthetic solutions with and without adrenaline. They came to the conclusion that 10 minutes after injection the heart transplant patients suffered a considerable tachycardia. The heart rate did not significantly change following the infusion of an adrenaline-free solution. Blood pressure measurements, both systolic and diastolic, were unaffected. As the tension and fear brought on by the surgical process ended, the measured parameters recovered to baseline readings 15 minutes after the tooth extraction. Our study's findings concur with those of other research that show no appreciable increases in oxygen saturation.</p> <h4>Conclusion</h4> <p>The local anaesthetic injection of lidocaine with adrenaline, along with the surgical procedure of tooth extraction, produces significant increase in the systolic blood pressure and heart rate in the patients with cardiovascular diseases. However, the diastolic blood pressure was significantly reduced and the oxygen saturation shows no significant changes.</p> <h4>References</h4> <ol> <li id='Reference_Title_Link' value='1'><a name="1" id='1'></a>Haas DA. An update on local anesthetics in dentistry. J Can Dent Assoc. 2002;68(9):546-551. <p>[<a href="https://scholar.google.com/scholar?cluster=7311090791635406111&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/12366885/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='2'><a name="2" id='2'></a>Martinez A, Castellon EV, Aytes LB, Escoda CG. <a href="https://www.joms.org/article/S0278-2391(07)01474-7/fulltext">Hemodynamic changes during the surgical removal of lower third molars.</a> J Oral Maxillofac Surg. 2008;66(3):453-461. <p>[<a href="https://doi.org/10.1016/j.joms.2007.06.634">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=16136431466289062522&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18280377/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='3'><a name="3" id='3'></a>Arrigoni J, Lambrecht JT, Filippi A. Cardiovascular monitoring and its consequences in oral surgery. Schweiz Monatsschr Zahnmed. 2005;115(3):208-213. <p>[<a href="https://scholar.google.com/scholar?cluster=10852158400836859648&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15832655/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='4'><a name="4" id='4'></a>Figallo MA, Cayon RT, Lagares D, Flores JR, Portillo G. <a href="http://www.medicinaoral.com/odo/volumenes/v4i2/jcedv4i2p107.pdf">Use of anesthetics associated to vasoconstrictors for dentistry in patients with cardiopathies. Review of the literature published in the last decade</a>. J Clin Exp Dent. 2012;4(2):e107-e111. <p>[<a href="https://doi.org/10.4317/jced.50590">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=4091356212018540586&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24558534/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='5'><a name="5" id='5'></a>Greenwood M, Meechan JG. <a href="https://www.nature.com/articles/4810197">General medicine and surgery for dental practitioners. Part I: Cardiovascular system</a>. Br Dent J. 2003;194(10):537-542. <p>[<a href="https://doi.org/10.1038/sj.bdj.4810197">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=4251770628685262855&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/12819722/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='6'><a name="6" id='6'></a>Jowett NI, Cabot LB. <a href="https://www.nature.com/articles/4800750">Patients with cardiac disease: Considerations for the dental practitioner.</a> Br Dent J. 2000;189(6):297-302. <p>[<a href="https://doi.org/10.1038/sj.bdj.4800750">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=13954682497182443138&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11060950/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='7'><a name="7" id='7'></a>George G, Morgan A, Meechan J, Moles DR, Needleman I, Ng YL, et al. <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006487.pub2/full">Injectable local anaesthetic agents for dental anaesthesia.</a> Cochrane Database Syst Rev. 2018;7(7):Cd006487. <p>[<a href="https://doi.org/10.1002/14651858.cd006487.pub2">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=543647462011322910&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29990391/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='8'><a name="8" id='8'></a>Brown RS, Rhodus NL. <a href="https://www.oooojournal.net/article/S1079-2104(05)00482-8/fulltext">Epinephrine and local anesthesia revisited</a>. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(4):401-408. <p>[<a href="https://doi.org/10.1016/j.tripleo.2005.05.074">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=13296524177303335289&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/16182160/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='9'><a name="9" id='9'></a>Cecanho R, de Luca LA Jr, Ranali J. <a href="https://meridian.allenpress.com/anesthesia-progress">Cardiovascular effects of felypressin</a>. Anesth Prog. 2006;53(4):19-25. <p>[<a href="https://doi.org/10.2344/0003-3006(2006)53%5b119:ceof%5d2.0.co;2">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=2879864467458328388&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17177590/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='10'><a name="10" id='10'></a>Silvestre FJ, Verdu MJ, Sanchis JM, Grau D, Penarrocha M. Effects of vasoconstrictors in dentistry upon systolic and diastolic arterial pressure. Med Oral. 2001;6(1):57-63. <p>[<a href="https://scholar.google.com/scholar?cluster=14623183417557485676&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11488132/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='11'><a name="11" id='11'></a>Dantas MVM, Nesso B, Mituuti DS, Gabrielli MAC. <a href="https://www.scielo.br/j/rounesp/a/tjKGtmnFK4ZJmbYBctVvddh/?lang=en">Assessment of patient’s anxiety and expectation associated with hemodynamic changes during surgical procedure under local anesthesia.</a> Rev Odontol UNESP. 2017;46(5):299-306. <p>[<a href="https://doi.org/10.1590/1807-2577.02917">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=2679664828976884223&hl=en&as_sdt=0,5">Google Scholar</a>]</p> </li> <li id='Reference_Title_Link' value='12'><a name="12" id='12'></a>Bradford SC. <a href="https://journals.sagepub.com/doi/10.3184/003685015X14401543180542">The history of adrenalin.</a> Sci Prog. 2015;98(3):306-308. <p>[<a href="https://doi.org/10.3184/003685015x14401543180542">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=17788228746288733942&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26601344/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='13'><a name="13" id='13'></a>Ball CM, Featherstone PJ. <a href="https://journals.sagepub.com/doi/10.1177/0310057X1704500301">The early history of adrenaline.</a> Anaesth Intensive Care. 2017;45(3):279-281. <p>[<a href="https://doi.org/10.1177/0310057x1704500301">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=17110858405944934439&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28486885/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='14'><a name="14" id='14'></a>Abraham-Inpijn L, Borgmeijer-Hoelen A, Gortzak RT. <a href="https://jada.ada.org/article/S0002-8177(88)64015-3/pdf">Changes in blood pressure, heart rate, and electrocardiogram during dental treatment with use of local anesthesia</a>. J Am Dent Assoc. 1988;116(4):531-536. <p>[<a href="https://doi.org/10.14219/jada.archive.1988.0318">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=5201333305221610064&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/3164019/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='15'><a name="15" id='15'></a>Niwa H, Sugimura M, Satoh Y, Tanimoto A. <a href="https://www.oooojournal.net/article/S1079-2104(01)54218-3/fulltext">Cardiovascular response to epinephrine-containing local anesthesia in patients with cardiovascular disease</a>. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92(6):610-616. <p>[<a href="https://doi.org/10.1067/moe.2001.118903">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=13908466769266653564&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11740477/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='16'><a name="16" id='16'></a>Chaudhry S, Iqbal HA, Izhar F, Mirza KM, Khan NF, Yasmeen R, et al. Effect on blood pressure and pulse rate after administration of an epinephrine containing dental local anaesthetic in hypertensive patients. J Pak Med Assoc. 2011;61(11):1088-1091. <p>[<a href="https://scholar.google.com/scholar?cluster=5074369283620371925&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22125984/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='17'><a name="17" id='17'></a>Santos CF, Modena KC, Giglio FP, Sakai VT, Calvo AM, Colombini BL. <a href="https://www.joms.org/article/S0278-2391(07)00521-6/fulltext">Epinephrine concentration (1:100,000 or 1:200,000) does not affect the clinical efficacy of 4% articaine for lower third molar removal: A double-blind, randomized, crossover study.</a> J Oral Maxillofac Surg. 2007;65(12):2445-2452. <p>[<a href="https://doi.org/10.1016/j.joms.2007.04.020">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=5301433816980123755&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18022467/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='18'><a name="18" id='18'></a>de Morais HH, de Santos T, Araujo FA, Vajgel A, de Vasconcellos RJ. <a href="https://journals.lww.com/jcraniofacialsurgery/abstract/2012/11000/hemodynamic_changes_comparing_lidocaine_hcl_with.29.aspx">Hemodynamic changes comparing lidocaine HCl with epinephrine and articaine HCl with epinephrine</a>. J Craniofac Surg. 2012;23(6):1703-1708. <p>[<a href="https://doi.org/10.1097/scs.0b013e31826bec3b">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=15644248423334653075&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23147329/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='19'><a name="19" id='19'></a>Kammerer PW, Seeling J, Alshihri A, Daublander M. <a href="https://link.springer.com/article/10.1007/s00784-013-1010-7">Comparative clinical evaluation of different epinephrine concentrations in 4% articaine for dental local infiltration anesthesia.</a> Clin Oral Investig. 2014;18(2):415-421. <p>[<a href="https://doi.org/10.1007/s00784-013-1010-7">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=9300367293964710578&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23740321/">PubMed</a>]</p> </li> <li id='Reference_Title_Link' value='20'><a name="20" id='20'></a>Hersh EV, Giannakopoulos H, Levin LM, Secreto S, Moore PA, Peterson C. <a href="https://jada.ada.org/article/S0002-8177(14)64384-1/fulltext">The pharmacokinetics and cardiovascular effects of high dose articaine with 1:100,000 and 1:200,000 epinephrine.</a> J Am Dent Assoc. 2006;137(11):1562-1571. <p>[<a href="https://doi.org/10.14219/jada.archive.2006.0092">Crossref</a>] [<a href="https://scholar.google.com/scholar?cluster=10447394529937565754&hl=en&as_sdt=0,5">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17082283/">PubMed</a>]</p> </li> </ol>   <div class="card bg-light mb-3"> <div class="card-body px-3 pb-0"> <p><strong>Citation:</strong> Hamad SA, Salai RN, Nandan A (2024) Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction. J Clin Exp Pharmacol. 14:410.</p> <p><strong>Copyright: </strong>© 2024 Hamad SA, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</p> </div> </div> </div> </div> </div> </section>   <div class="whatup"> <ul> <li><a href="tel:+44 1687550021">+44 1687550021 <i class="fab fa-whatsapp" aria-hidden="true"></i></a></li> </ul> </div> <section> <footer> <div class="custom-footer"> <div class="container"> <div class="row"> <div class="col-md-3 md-margin-bottom-40"> <a download="" href="/"><img id="logo-footer" src="/assets/images/footer-logo.png" alt="Walsh Medical Media" width="220px;"></a> <p class="py-3">Walsh Medical Media is a global leader in open access publishing, dedicated to advancing the frontiers of science and technology. We specialize in publishing peer-reviewed, high-impact journals across diverse fields including clinical research, life sciences, biomedical technology, and emerging areas of scientific innovation. </br>It is dedicated to connecting research with real-world practice, helping scientists, clinicians, and technologists share their knowledge and make advancements that positively impact society.</p> </div> <div class="col-md-3 md-margin-bottom-40"> <div class="headline"> <h2>Useful Links</h2> </div> <ul class="list-unstyled link-list"> <li><a href="https://www.walshmedicalmedia.com/" title="Click here">Home</a><i class="fa fa-angle-right"></i></li> <li><a href="https://www.walshmedicalmedia.com/open-access-journals-list.html" title="Click here">Journals</a><i class="fa fa-angle-right"></i></li> <li><a href="https://www.walshmedicalmedia.com/publish-with-us.html" title="Click here">Publish With Us</a><i class="fa fa-angle-right"></i></li> <li><a href="https://www.walshmedicalmedia.com/contact-us.html" title="Click here">Contact Us</a><i class="fa fa-angle-right"></i></li> </ul> </div> <div class="col-md-4 map-img md-margin-bottom-40"> <div class="headline"> <h2>Contact Us</h2> </div> <address> Address:<br> Office 317 Boundary House ,<br> Cricket Field Road, Uxbridge,<br> UB8 1QG, London UK<br> E-mail: <a href="mailto:wwwmanuscripts@journalsci.org">wwwmanuscripts@journalsci.org</a><br> Whatsapp No: +44 1687550021 / +44 7389645281 </address> </div> <div class="col-md-2 md-margin-bottom-40"> <div class="headline"> <h2>Connect</h2> </div> <ul class="list-unstyled link-list1"> <li><a target="_blank" href="https://www.facebook.com/walshmedicalmedia/" title="Click here"><i class="fab fa-facebook"></i> facebook</a></li> <li><i class="fab fa-twitter"></i><a target="_blank" href="https://twitter.com/WalshMedical" title="Click here"> Twitter</a></li> <li><a target="_blank" href="https://www.instagram.com/walsh.medicalmedia/" title="Click here"><i class="fab fa-instagram"></i> Instagram</a></li> <li><a target="_blank" href="https://www.linkedin.com/company/walsh-medical-media/" title="Click here"><i class="fab fa-linkedin" aria-hidden="true"></i>LinkedIn</a></li> </ul> </div> </div> </div> </div> <div class="copyright"> <div class="container"> <div class="row"> <div class="col-md-12"> <p> Copyright © 2024 <a href="https://www.walshmedicalmedia.com/" title="Click here">Walsh Medical Media</a> </p> </div> </div> </div> </div> </footer> <a download="" id="back-to-top" href="#" class="btn btn-dark btn-lg back-to-top text-white" role="button"> <i class="fa fa-chevron-up"></i> </a> </section> <script type="text/javascript"> $(document).ready(function() { $(window).scroll(function() { if ($(this).scrollTop() > 100) { $("#back-to-top").fadeIn(); $("#sticky-navbar").addClass('sticky'); } else { $("#back-to-top").fadeOut(); $("#sticky-navbar").removeClass('sticky') } }); // scroll body to 0px on click $("#back-to-top").click(function() { $("body,html").animate({ scrollTop: 0, }, 400 ); return false; }); }); </script>   <script> $('[data-toggle="popover"]').popover(); </script>   </body> </html>

CINXE.COM

Hemodynamic Effect of 2% Lidocaine with a 1:100,000 Adrenaline in Patients with Cardiovascular Diseases Undergoing Single Tooth Extraction