The effects of dental local anaesthetics on blood glucose concentration in healthy volunteers and in patients having third molar surgery.

The effects of adrenaline-containing and adrenaline-free dental local anaesthetic solutions on blood glucose concentration were investigated in single-blind cross-over studies in ten healthy volunteers and in ten patients having lower third molar surgery. The solutions compared were 2% lignocaine containing 1:80,000 adrenaline (Xylocaine) and 3% prilocaine with 0.03 IU/ml felypressin (Citanest). In all cases, 4.4 ml of solution was used. In the volunteer study the blood glucose concentration increased from 4.48 +/- 0.72 mmol/litre immediately before the injection of Xylocaine to 5.07 +/- 0.99 mmol/litre 30 minutes following the injection; with Citanest the pretreatment concentration of 4.56 +/- 0.92 mmol/litre changed to 4.24 +/- 0.62 mmol/litre at 30 minutes. This increase in blood glucose concentration following the administration of Xylocaine was significant (t = 3.39, P less than 0.01), as was the difference between treatments (t = 2.64, P less than 0.05). In the patient study, the blood glucose level prior to the injection of Xylocaine was 4.56 +/- 1.59 mmol/litre and this increased to 5.24 +/- 0.86 mmol/litre 30 minutes after the local anaesthetic was injected. The pretreatment blood glucose level of 4.52 +/- 0.82 mmol/litre in patients when Citanest was used changed to 4.33 +/- 0.71 mmol/litre 30 minutes following the injection. The difference at 30 minutes in the changes in blood glucose concentration between local anaesthetic regimes in patients having third molar surgery was significant (t = 2.60, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)