• Oral Surg Oral Med Oral Pathol Oral Radiol Endod · Jun 2008

    Randomized Controlled Trial

    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, and Eliezer Kaufman.
    • Oral Medicine Service, Hadassah University Hospital, Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel. eladhome@md.huji.ac.il
    • Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Jun 1;105(6):725-30.

    ObjectivesThis study compared cardiovascular safety profiles of 2 local anesthetics (LA): articaine (Ubistesine) versus standard lidocaine solution in cardiovascular patients.Study DesignFifty 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), O(2)-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).ResultsThere 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 O(2) 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).ConclusionsLA 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.

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