Cardiovascular response to dental treatment with use of local anesthesia

Increases in blood pressure and heart rate are observed during dental treatment and are influenced by many factors, such as psychological and physical stress, painful stimuli, and the action of catecholamines present in local anesthetic solutions. Epinephrine present in local anesthetic causes an increase in heart rate; however, the in- crease in blood pressure is slight. The most important factor to influence the increase in blood pressure during dental treatment seems to be the age of the patients. Older patients showed a greater increase in systolic blood pressure than younger patients. The sympathetic nervous system is activated by local anesthesia and dental treatment, resulting in increases in blood pressure and heart rate. Responses of cardiac sympathetic and parasympathetic nervous systems, which have been evaluated by power spectral analysis of R-R variability, are different in younger and older patients, suggesting that the two age groups have different regulatory mechanisms for cardiac autonomic function. The rate pressure product, which has been used to estimate myocardial oxygen consumption, increases during dental treatment. Therefore, careful electrocardiographic monitoring during dental treatment is recommended in patients with coronary artery disease. (C) 2000 by CVR and R, Inc.