Assessment of patient’s anxiety and expectation associated with hemodynamic changes during surgical procedure under local anesthesia

• Main Authors: Marcos Vinícius Mendes DANTAS, Bianca NESSO, Daniel Sagawa MITUUTI, Marisa Aparecida Cabrini GABRIELLI
• Format: Article
• Language: English
• Published: Universidade Estadual Paulista
• Series: Revista de Odontologia da UNESP
• Subjects: Anxiety; fear; vital signs; blood pressure; local anesthetic
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-25772017000500299&lng=en&tlng=en

Abstract Introduction The dental patient’s anxiety and expectation may significantly alter their vital signs. The use of local anesthetics associated with a vasoconstrictor may also alter the vital signs of these patients, promoting hemodynamic changes that may result in emergency situations. Objective To evaluate the influence of anxiety of patients submitted to third molar extraction and the use of different anesthetic substances with adrenaline on their vital signs (oxygen saturation, heart rate, and systolic and diastolic blood pressure) in different moments. Material and method Forty patients answered the questionnaire of the Dental Anxiety Scale (Corah’s Scale) and fear (KleinKnecht’s Scale) and were submitted to third molar extraction in two surgical times for the use of articaine or mepivacaine, both associated with adrenaline. The results were analyzed by ANOVA followed by Tukey post hoc test, Student's t test, and Pearson's correlation coefficients (α=0.05). Result There was no significant differences in saturation or heart rate. The blood pressure showed significant variations during time for both anesthetics, however mepivacaine resulted in a longer postoperative time to restore blood pressure. Patients with high or moderate anxiety and high fear index were those who had positive correlations with the highest blood pressure values. Conclusion Anxiety and fear positively influence the increase in blood pressure. Mepivacaine promoted a greater resistance to the return of normal vital signs, especially blood pressure levels.