The cardiovascular effect of local anesthesia with articaine plus 1:200,000 adrenalin versus lidocaine plus 1:100,000 adrenalin in medically compromised cardiac patients: a prospective, randomized, double blinded study

Sharon Elad*, Dan Admon, Meirav Kedmi, Eitan Naveh, Esti Benzki, Sharon Ayalon, Alex Tuchband, Haim Lutan, Eliezer Kaufman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Objectives: This study compared cardiovascular safety profiles of 2 local anesthetics (LA): articaine (Ubistesine) versus standard lidocaine solution in cardiovascular patients. Study design: Fifty cardiovascular patients were randomly assigned to dental treatment using 1.8 mL of one of two LA injections: articaine 4% and adrenalin 1:200,000 or lidocaine 2% and adrenalin 1:100,000. A computerized system enabled continuous longitudinal data collection: electrocardiography (ECG), O2-saturation, blood pressure (BP), and heart rate (HR). Patients scored pain level at the end of the LA injection (on a 0 to 10 scale). Results: There were no clinical severe adverse effects. One transient local parasthesia occurred (lidocaine group), which lasted 4 weeks. There were no statistically significant differences between the 2 groups in HR, systolic or diastolic-BP, and O2 saturation. Age, gender, jaw treated, treatment duration, and the pain level did not influence the results of the comparison. In 3 patients asymptomatic ischemic changes were noted on ECG (1 in the lidocaine group and 2 in the articaine group). Conclusions: LA with articaine 4% with adrenalin 1:200,000 was comparably as safe as LA with standard concentrations of lidocaine and adrenalin in cardiovascular patients. Cardiac ischemic changes on ECG did not appear to be related to the LA.

Original languageEnglish
Pages (from-to)725-730
Number of pages6
JournalOral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Volume105
Issue number6
DOIs
StatePublished - Jun 2008
Externally publishedYes

Funding

FundersFunder number
3M
Universidad de las Fuerzas Armadas ESPE

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