Effect of 4% articaine and 2% lidocaine both with 1:100,000 epinephrine on hemodynamic changes in impacted mandibular third molar surgery: prospective, double-blinded, randomized clinical trial

Hemodynamic effect of local anestheticshould be investigated to prevent unwantedcomplications. The presentstudy assessed the hemodynamic alterations after injectingtwo of the most commonly used local anestheticformulations for impacted mandibular third molar surgery.A prospective, double-blinded, randomized clinicaltrial were designed, and patients that attended theoral and maxillofacial surgery department for surgicalremoval of impacted mandibular third molar were askedto participate. Patients were divided into two groups andrandomly received one of the two interventions; 2% lidocainewith 1:100,000 epinephrine (LE) and group 2: 4%articaine with 1: 100,000 epinephrine (AE). Pulse rate,oxygen saturation, and systolic/diastolic blood pressurewere assessed at three different times: before the procedure,five minutes after injecting local anesthetics, andafter finishing the surgery. Eighty patients between theage of 18 to 45 years old participated in the study which44 (55%) were female, and 36 (45%) male. The pulserate significantly increased when comparing three differentmeasurement intervals for each local anesthetic.Oxygen saturation in the LE group was statistically differentcomparing each interval, but there was no significantdifference in the AE group. There were changes insystolic and diastolic blood pressure at each measurementpoint, but it was not statistically significant. Therewas no significant difference in hemodynamic changesbetween the two groups. Hemodynamic alteration afterlocal anesthetic administration should be expected. Thetwo formulations were safe and showed no statisticallysignificant hemodynamic changes in healthy patients