Anesthesia in the oro-maxillo-facial region in patients with hypertension

Abstract

Introduction. Arterial hypertension (HTN) is a commonly encountered condition in patients requiring dental treatment, which can significantly influence the management of conditions in the oro-maxillo-facial region using local anesthesia. Due to the increased risk of cardiovascular complications in patients with HTN, it is crucial to carefully choose the anesthetic substance, method, and technique that are safest for this patient category. Aim of study. To analyze the specific considerations in choosing the type of anesthetic and to assess their effectiveness in managing patients with arterial hypertension (HTN). Methods and materials. In the present study, 14 patients with arterial hypertension who sought dental intervention with local anesthesia were included. The study was conducted at the Department of Oro-Maxillo-Facial Surgery and Oral Implantology, "Arsenie Gutan." Two types of local anesthetics were used: "Septanest" (active substance articaine 4% with adrenaline concentration 1:200,000) and vasoconstrictor-free anesthetic "Scandonest" (active substance mepivacaine 3% without adrenaline content). Continuous monitoring of blood pressure was performed using the classic automated sphygmomanometer "Microlife." Results. Among the 14 patients with hypertension (HTN) aged between 44 and 71 years, 5 (35.71%) were female, and 9 (64.28%) were male. 4 (28.57%) patients required dental implants, 7 (50.0%) underwent tooth extractions, 2 (14.28%) received endodontic treatment, and 1 (7.14%) underwent a cystectomy for a radicular cyst on tooth 4.6. Regarding the anesthesia technique, infiltrative anesthesia was used in 8 (57.14%) patients, and block anesthesia was used in 6 (42.85%) patients. The anesthetic "Scandonest" was administered in 4 (28.57%) cases, while "Septanest (1:200,000)" was administered in 10 (71.42%) cases. In all cases, both during and after the intervention, the sphygmomanometer did not register changes in the initial blood pressure. None of the patients reported pain during the intervention. Conclusion. Based on this study involving a cohort of 14 patients with hypertension, the use of high-quality anesthetics that ensure operator comfort is recommended. These include "Septanest" (articaine 4% with adrenaline concentration 1:200,000) and vasoconstrictor-free anesthetic "Scandonest" (mepivacaine 3% without adrenaline content) for local anesthesia in patients with hypertension. requiring dental treatment, which can significantly influ ence the management of conditions in the oro-maxillo-facial region using local anesthesia. Due to the i ncreased risk of cardiovascular complications in patients with HTN, it is crucial to carefu lly choose the anesthetic substance, method, and technique that are safest for this patient cat egory. Aim of study. To analyze the specific considerations in choosing the type of anesthetic and to assess their effectiveness in managing patients with ar terial hypertension (HTN). Methods and materials. In the present study, 14 patients with arterial hypertens ion who sought dental intervention with local anesthesia were included. The study was conducted at the Department of Oro-Maxillo-Facial Surgery and Oral Implantolo gy, "Arsenie Gutan." Two types of local anesthetics were used: "Septanest" (active subst ance articaine 4% with adrenaline concentration 1:200,000) and vasoconstrictor-free anesthetic "Scandonest" (active substance mepivacaine 3% without adrenaline content). Continuous monitor ing of blood pressure was performed using the classic automated sphygmomanometer "Micro life." Results. Among the 14 patients with hypertension (HTN) aged between 44 and 71 years, 5 (35.71%) were female, and 9 (64.28%) were male. 4 (28.57%) patient s required dental implants, 7 (50.0%) underwent tooth extractions, 2 (14.28%) received endodont ic treatment, and 1 (7.14%) underwent a cystectomy for a radicular cyst on tooth 4.6. R egarding the anesthesia technique, infiltrative anesthesia was used in 8 (57.14%) patients, an d block anesthesia was used in 6 (42.85%) patients. The anesthetic "Scandonest" was adminis tered in 4 (28.57%) cases, while "Septanest (1:200,000)" was administered in 10 (71.42%) cases. In a ll cases, both during and after the intervention, the sphygmomanometer did not register changes in the initial blood pressure. None of the patients reported pain during the intervention . Conclusion. Based on this study involving a cohort of 14 patients with hyper tension, the use of high-quality anesthetics that ensure operator comfort is rec ommended. These include "Septanest" (articaine 4% with adrenaline concentration 1:200,000) and vasocon strictor-free anesthetic "Scandonest" (mepivacaine 3% without adrenaline content) f or local anesthesia in patients with hypertension.