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A clinical study to assess the hemodynamic changes occurs during dental extractions

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Dr. Vanisha Kumar1* , Dr. Raunaque Saba2 , Dr. Kundan Shah3 , Dr. Shashwat Kumar4

Abstract

Abstract Aims: The aim of the study was evaluation of Hemodynamic Changes Caused during Dental Extractions. Methods: The study included 100 patients who underwent dental extraction at Department of Dentistry, Jawaharlal Nehru Medical College and Hospital, Bhagalpur, Bihar, India, for 1 year. The patients indicated for tooth extraction under local anesthesia and age between 18-55 years was included in this study. The SpO2 was recorded using a non-invasive GIBSON infrared digital pulse oximeter placed on the patient's index finger. Change in Heart Rate (HR), Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) during Dental Extraction from the baseline was measured recorded. Results: The study included 100 patients with mean age of 42.3± 3.5 years. Among them, there were 44 men and 56 women. Baseline pulse rate (mean ± S.D) of patients before the procedure was 83.7±12 beats/min which has risen to 90.2±12 beats/min after administration of local anesthesia and reduced to 86.7 ± 17 beats/min, 5 minutes after the dental extraction. Mean Percentage Oxygen saturation in patients before procedure was 98.4± 2.6%, which slightly increased to 98.9 ± 1.3% after injecting local anesthesia and then reduced back to 96.6 ±2.3% after completion of the procedure. The average baseline systolic blood pressure for all of the patients were 125 ± 24 mm Hg. Administration of local anesthetics and tooth extraction caused increases in both systolic blood pressure and pulse rate, and the peak systolic blood pressure occurred after tooth extraction (132 ± 32 mm Hg). After injecting local anesthesia, the mean systolic blood pressure was 130± 12 mm Hg. However, diastolic blood pressure did not change significantly during the entire treatment period (baseline= 79 ± 7 mm Hg, post anesthetic= 80.8 ± 11 mm Hg and post extraction= 83.1 ± 9.7 mm Hg). Whereas significant increase in blood pressure was seen in 65% patients after administration of local anesthesia and in 72% patients after dental extraction. (p < 0.001). Conclusion: Systolic blood pressure is increased due to increased sympathetic activity which is due to local anesthesia injection and dental extractions. Pulse rate and oxygen saturation vary in anxiety. Any major fluctuation in these variables which is noted early, may alert us to prevent any medical emergency during routine dental procedures.

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