Abstract
Objective
The primary aim of this study was to investigate the effect associated with patients’ factor such as systemic disease on the blood pressure of patients in dental procedure. The secondary aim of this study was to investigate the effect associated with systemic disease and antihypertensive on the blood pressure changes with local anesthesia.
Methods
The blood pressure was measured before and after local anesthesia injection for dental treatment. The effect associated with patients’ factor such as systemic disease on the blood pressure and the effect on blood pressure changes of the type of antihypertensive drugs and the systemic disease were analyzed using a multivariate analysis of variance test.
Results
We analyzed 1306 patients scheduled for the dental procedure. Age and some systemic diseases such as hypertension and angina pectoris affected blood pressure before local anesthesia. On the other hand, age and systemic diseases did not affect blood pressure changes. And, some antihypertensive affected systolic blood pressure changes.
Conclusions
The blood pressure change with local anesthesia was not associated with systemic diseases and age but was associated with antihypertensive agents. In particular, calcium channel blockers, angiotensin II receptor antagonists and alpha-blockers accentuate blood pressure reducing caused by local anesthesia.
Clinical relevance
The blood pressure change with local anesthesia was associated with antihypertensive agents.
This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (number UMIN000030695).
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References
Sproat C, Beheshti S, Harwood AN, Crossbie D (2009) Should we screen for hypertension in general dental practice? Br Dent J 207:275–277. https://doi.org/10.1038/sj.bdj.2009.815
Brand HS, Abraham-Inpijn L (1996) Cardiovascular responses induced by dental treatment. Eur J Oral Sci 104:245–252. https://doi.org/10.1111/j.1600-0722.1996.tb00074.x
Bronzo AL, Cardoso CG Jr, Ortega KC, Mion D Jr (2012) Felypressin increases blood pressure during dental procedures in hypertensive patients. Arq Bras Cardiol 99:724–731. https://doi.org/10.1590/s0066-782x2012005000062
Kubota K, Kyosaka Y, Ueda K, Minakuchi S (2020) Increase in pulse pressure on administration of a dental local anesthetic solution, prilocaine hydrochloride with felypressin in male diabetic patients with coronary heart disease. Clin Oral Investig 24:239–246. https://doi.org/10.1007/s00784-019-02924-x
Kansui Y, Ibaraki A, Goto K, Haga Y, Seki T, Takiguchi T, Ohtsubo T, Kitazono T, Matsumura K (2016) Trends in blood pressure control and medication use during 20 years in a hypertension clinic in Japan. Clin Exp Hypertens 38:299–304. https://doi.org/10.3109/10641963.2015.1107086
Brabant SM, Bertrand M, Eyraud D, Darmon PL, Coriat P (1999) The hemodynamic effects of anesthetic induction in vascular surgical patients chronically treated with angiotensin II receptor antagonists. Anesth Analg 89:1388–1392
Shimamoto K, Ando K, Fujita T, Hasebe N, Higaki J, Horiuchi M, Imai Y, Imaizumi T, Ishimitsu T, Ito M, Ito S, Itoh H, Iwao H, Kai H, Kario K, Kashihara N, Kawano Y, Kim-Mitsuyama S, Kimura G, Kohara K, Komuro I, Kumagai H, Matsuura H, Miura K, Morishita R, Naruse M, Node K, Ohya Y, Rakugi H, Saito I, Saitoh S, Shimada K, Shimosawa T, Suzuki H, Tamura K, Tanahashi N, Tsuchihashi T, Uchiyama M, Ueda S, Umemura S, and Japanese Society of Hypertension Committee for Guidelines for the Management of H (2014) The Japanese Society of hypertension guidelines for the management of hypertension (JSH 2014). Hypertens Res 37:253–390. https://doi.org/10.1038/hr.2014.20
Ouchi K, Sugiyama K (2016) Dexmedetomidine dose dependently enhances the local anesthetic action of lidocaine in inferior alveolar nerve block: a randomized double-blind study. Reg Anesth Pain Med 41:348–355. https://doi.org/10.1097/AAP.0000000000000380
Ouchi K, Koga Y, Nakao S, Sugiyama K (2014) Dexmedetomidine dose-dependently enhances local anesthetic action of lidocaine. J Oral Maxillofac Surg 72:474–480. https://doi.org/10.1016/j.joms.2013.09.038
Ouchi K (2020) Dexmedetomidine 2-ppm shaded blockppm is appropriate for the enhancement effect of local anesthetic action of lidocaine in inferior alveolar nerve block: a randomized crossover study; a study that awaits confirmation in a larger trial. Clin J Pain 36:618–625. https://doi.org/10.1097/AJP.0000000000000839
Daisuke O, Tetsuya N, Yasuyuki T, Sano K (2009) The influence of local anesthetic injected by the pre-administration method on plasma catecholamine and hemodynamic responses. Oral Therap Pharmacol 28:117–123
Moser M (1997) Angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and calcium channel blocking agents: a review of potential benefits and possible adverse reactions. J Am Coll Cardiol 29:1414–1421
Carp H, Vadhera R, Jayaram A, Garvey D (1994) Endogenous vasopressin and renin-angiotensin systems support blood pressure after epidural block in humans. Anesthesiology 80:1000–1007 discussion 27A-28A
Fukusaki M, Maekawa T, Kobayashi I, Hara T, Sumikawa K (1997) Catecholamine and renin-angiotensin response during controlled hypotension induced by prostaglandin E1 combined with hemodilution during isoflurane anesthesia. J Clin Anesth 9:321–327
Inagawa M, Ichinohe T, Kaneko Y (2010) Felypressin, but not epinephrine, reduces myocardial oxygen tension after an injection of dental local anesthetic solution at routine doses. J Oral Maxillofac Surg 68:1013–1017. https://doi.org/10.1016/j.joms.2009.07.080
Ouchi K, Sugiyama K (2015) Required propofol dose for anesthesia and time to emerge are affected by the use of antiepileptics: prospective cohort study. BMC Anesthesiol 15:34. https://doi.org/10.1186/s12871-015-0006-z
Ouchi K (2020) The number and kind of antiepileptics affect propofol dose requirement for anesthesia: observational study. Odontology 108:102–108. https://doi.org/10.1007/s10266-019-00457-z
Acknowledgments
We would like to thank Dr. Hiroki Suzuki, Yoko Ueno and Ken Sasaki for their help with data collection. We would like to thank Assoc. Prof. Junji Kishimoto (statistician) for his help with data analysis.
Funding
This work was supported by the departmental research fund.
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All authors has seen the original study data, reviewed the analysis of the data, approved the final manuscript, and is the author responsible for archiving the study files.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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The authors declare no competing interests.
Additional information
This work was presented, in part; on 2018, 2019 and 2020, at the Annual Japanese Society of Gerodontology, Japan (Oimachi, Tokyo, 2018; Sendai, Miyagi 2019; and on the web, 2020).
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Ouchi, K., Jinnouchi, A. Calcium channel blockers, angiotensin II receptor antagonists and alpha-blockers accentuate blood pressure reducing caused by dental local anesthesia. Clin Oral Invest 25, 4879–4886 (2021). https://doi.org/10.1007/s00784-021-03795-x
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DOI: https://doi.org/10.1007/s00784-021-03795-x