Blood pressure monitoring following individual carpules of anesthetic utilizing computer-controlled anesthetic delivery

Kristi M Soileau,Qingzhao Yu,Adam E Degenova

doi:10.1038/s41405-020-00049-y

Kristi M Soileau, Qingzhao Yu + Show 1 more

Open Access

https://doi.org/10.1038/s41405-020-00049-y

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Abstract

To date, no study has evaluated blood pressure following administration of each carpule given for dental procedures using a computerized dental anesthesia system. Blood pressures taken prior to performing invasive periodontal procedures were compared with those readings measured following delivery of each of up to three consecutive carpules of Marcaine or Xylocaine in varying order. Pressure differences were also adjusted for age, sex, race, and whether a prescribed anxiolytic was taken beforehand. Neither systolic nor diastolic blood pressures changed significantly as compared to initial blood pressure readings. However, compared with Whites, Hispanics, and Middle Easterners, Blacks had significantly higher systolic pressure at the third carpule delivery, the cause being unknown. Blood pressure in patients being anesthetized for root planing and various periodontal surgical procedures will not increase significantly when administering up to three carpules, whether Marcaine or Xylocaine, in varying order, using controlled flow dental anesthesia, and this method may be preferable to syringes in managing dental procedural stress.

Highlights

Anxiety is a barrier to dental attendance.[1]
Comparison of the change in blood pressure while varying the second type of anesthetic carpule when the first carpule was Xylocaine anesthesia delivery system, nor has there been any dental Second carpule type relative to change in blood pressure
The null hypothesis in this study was that blood pressure will not increase significantly during administration of anesthesia as compared to the patients’ initial anesthetic carpule and the change in systolic pressure is not different at a significance level of 0.05

Summary

Introduction

Anxiety is a barrier to dental attendance.[1] It is estimated that approximately half of the people in the United States fear dentistry to some degree, of which ~30 million are termed “phobic,” such that they avoid dental care altogether.[2] Much of this fear stems from the sight of the anesthetic apparatus and the sensation of the operating dental handpiece, these having been listed as the two most fear-eliciting stimuli.[3]. The injection of local anesthesia can inflict discomfort, which may elicit cardiovascular changes such as hypertension or tachycardia.[4] For many patients undergoing dental procedures, pain control is essential, in those with cardiovascular disease. Pain and other stressors can result in a dramatic endogenous release of epinephrine and norepinephrine, which can affect heart disease deleteriously; the importance of good local anesthetic technique cannot be over emphasized.[5]

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