Efeitos cardiovasculares da epinefrina contida no anestésico local em pacientes hipertensos na odontologia: revisão de literatura

Abstract

Systemic arterial hypertension is considered one of the main public health problems in Brazil. The Ministry of Health showed that approximately 25% of the brazilian urban population has a diagnosis of arterial hypertension. The diagnosis of this disease may be unknown to the patient, as it is a silent disease. Therefore, the professional must recognize their signs and symptoms from the anamnesis, in order to carry out an appropriate therapeutic protocol for the patient. The aim of this research is to address the cardiovascular effects in hypertensive patients after injection of local anesthetic with the vasoconstrictor adrenaline. It is a narrative literature review, through a descriptive approach of the proposed theme, in which the databases were: Academic Google, Pubmed, Lilacs and Scielo. The main changes occurred briefly during the transoperative period, the main ones were arrhythmias and tachycardias. Literature still diverges as to the ideal protocol, but it is evident that local anesthetics with vasoconstrictors can be used safely, as long as guidelines are adopted regarding the maximum dose and constant checking of blood pressure. It was noted that lower concentrations such as 1:200,000 are more suitable for patients with heart disease or the elderly, as the risk of complications is reduced compared to higher concentrations. Still, it is necessary to know the technique and anatomy, in order to avoid the injection into the bloodstream, which can lead to an increase in the levels of catecholamines and, consequently, a hypertensive crisis.