Influence of local anesthethics with adrenalina 1:100.000 in basic vital constants during third molar surgery.

OBJECTIVE The present study consists of a double-blind randomized clinical trial of paired samples. The purpose of the present study was thus to examine the effect of four different local anesthetics of the amida group (2% lidocaine with 1:100.000 adrenaline; 3% prilocaine with 0.30 IU felipressine; 2% mepivacaine with 1:100.000 adrenaline; and 4% articaine with 1:100.100 adrenaline) in patients undergoing extraction of lower third molars and verify the changes in systolic, diastolic and mean blood pressures, heart rate (HR) and oxygen saturation (SpO2). STUDY DESIGN The sample comprised 168 extractions of lower third molars performed on 84 patients, divided into three groups, in whom lidocaine was the control anesthetic. The anesthetic solution applied differed from one side of the mouth to the other (control and experimental) in the same patient at different time periods. RESULTS The following significant variations were observed: increase in systolic blood pressure with mepivacaine and articaine; decrease in diastolic blood pressure with lidocaine; increase in heart rate with all the anesthetics, but with no statistical significance in the case of prilocaine. The variations in mean blood pressure and oxygen saturation were not statistically significant. All the hemodynamic changes returned to normal with no need for any further treatment. No complications were observed in any of the 168 procedures performed. CONCLUSION All the anesthetics studied behaved, in relation to lidocaine, within the parameters of hemodynamic safety, although the best performance was that of prilocaine, followed by lidocaine. The measurement of systolic blood pressure, diastolic blood pressure and heart rate are appropriate monitoring methods for patients under the effects of local anesthetic, even healthy ones.