Cardiovascular effects of local anesthesia with epinephrine in periodontal treatment

To assess if the association of epinephrine with local anesthesia involves cardiovascular risks, 14 patients undergoing treatment were observed. Systolic and diastolic blood pressures and mean and maximal heart rates were analyzed. The comparison of basal and postanesthetic periods revealed a trend (nonsignificant) toward an increase in systolic blood pressure and a small, statistically significant increase in diastolic blood pressure; the heart rate increased in only a few patients, and never by more than 10 beats/min. The whole group showed a statistically significant reduction in mean and maximal heart rates from the basal period to an end-session period. Thus, in these patients, the given epinephrine doses resulted in negligible changes in heart rate and blood pressure. The reduction in heart rates at the end of treatment underlines the important role of the autonomic nervous system in the modulation of the cardiovascular response during dental sessions