James D Bader1, Arthur J Bonito, Daniel A Shugars. 1. School of Dentistry, Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC 27599, USA. jim_baderunc.edu
Abstract
OBJECTIVE: A systematic review was conducted to identify any additional risks of adverse cardiovascular outcomes to hypertensive individuals represented by use of epinephrine-containing anesthetic solutions and epinephrine-impregnated retraction cords. STUDY DESIGN: Two searches identified 373 local anesthetic and 33 retraction cord reports; 6 local anesthetic reports met inclusion criteria. RESULTS: Use of epinephrine in uncontrolled hypertensive patients was associated with small, nonsignificant increases in systolic and diastolic blood pressure. No adverse outcomes were reported. Only one study examined effects of epinephrine on controlled hypertensive patients, in whom additional risks due to interactions with antihypertensive medication are possible. Available studies did not address effects of gingival retraction cord on hypertensive patients. CONCLUSIONS: Although the increased risk for adverse events among uncontrolled hypertensive patients was found to be low and the reported occurrence of adverse events in hypertensive patients associated with the use of epinephrine in local anesthetics was minimal, the quantity and quality of the pertinent literature is problematic.
OBJECTIVE: A systematic review was conducted to identify any additional risks of adverse cardiovascular outcomes to hypertensive individuals represented by use of epinephrine-containing anesthetic solutions and epinephrine-impregnated retraction cords. STUDY DESIGN: Two searches identified 373 local anesthetic and 33 retraction cord reports; 6 local anesthetic reports met inclusion criteria. RESULTS: Use of epinephrine in uncontrolled hypertensivepatients was associated with small, nonsignificant increases in systolic and diastolic blood pressure. No adverse outcomes were reported. Only one study examined effects of epinephrine on controlled hypertensivepatients, in whom additional risks due to interactions with antihypertensive medication are possible. Available studies did not address effects of gingival retraction cord on hypertensivepatients. CONCLUSIONS: Although the increased risk for adverse events among uncontrolled hypertensivepatients was found to be low and the reported occurrence of adverse events in hypertensivepatients associated with the use of epinephrine in local anesthetics was minimal, the quantity and quality of the pertinent literature is problematic.
Authors: Caio Chaves Guimaraes; Luciane Cruz Lopes; Cristiane de Cássia Bergamaschi; Juliana Cama Ramacciato; Marcus Tolentino Silva; Jimmy de Oliveira Araújo; Natalia Karol de Andrade; Rogério Heládio Lopes Motta Journal: BMJ Open Date: 2021-07-15 Impact factor: 2.692
Authors: María A Serrera Figallo; Rocío T Velázquez Cayón; Daniel Torres Lagares; Jose R Corcuera Flores; Guillermo Machuca Portillo Journal: J Clin Exp Dent Date: 2012-04-01