Evaluating Glycemic Response to Lidocaine with Two Different Vasoconstrictors in Diabetic Patients Undergoing Tooth Extraction: Crossover Randomized Clinical Study

Objective: This study aimed to evaluate the epinephrine-containing and norepinephrine-containing local anesthetic solutions effects on blood glucose levels of type II diabetic patients undergoing dental extractions. Materials and Methods: A total of 60 simple extractions (n=60), performed on teeth of 30 patients with type II diabetes mellitus, were included in the study. The sample was divided according to the used anesthetic solutions into two groups: Group A (lidocaine with epinephrine group; n=30) and Group B (lidocaine with norepinephrine group; n=30). A vasoconstrictor concentration of 1:100,000 was applied in both groups. Consistently with each extraction, blood glucose levels measurements, using portable glucometer, were done three times: immediately before local anesthesia administration, 5 minutes after local anesthesia, and 5 minutes after tooth extraction. Results: The change in blood glucose concentration following the administration of local anesthesia was not statistically significant in both Group A and Group B (P>0.05). No significant change in this parameter was found after teeth extractions in both groups (P>0.05). There were also no significant differences in the glycemic response between Group A and B (P>0.05). Conclusion: Administration of 4 ml of 2% lidocaine with epinephrine 1:100,000 or 2% lidocaine with norepinephrine 1:100,000 in the context of simple dental extraction did not strikingly increase nor decrease the blood glucose levels in patients with type II diabetes. According to the results of this study, both local anesthetics may be used safely in type II diabetics, with no preference for one over the other