Evaluation of Anxiety Induced Cardiovascular Response in known Hypertensive Patients Undergoing Exodontia - A Prospective Study
Introduction: Anxiety towards exodontic procedures is a common occurrence in dental practice. In hypertensive patients this anxiety induced stress may have an effect on cardiovascular system which may be clinically significant. Aim: To evaluate the cardiovascular changes in hypertensive patient...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8391/19685_CE(Ra1)_F(AK)_PF1(ACAK)_PFA(AK)_PF2(PEK).pdf |
| Summary: | Introduction: Anxiety towards exodontic procedures is a
common occurrence in dental practice. In hypertensive patients
this anxiety induced stress may have an effect on cardiovascular
system which may be clinically significant.
Aim: To evaluate the cardiovascular changes in hypertensive
patients that may manifest following anxiety induced stress
in patients undergoing exodontic procedures under local
anaesthesia.
Materials and Methods: Eighty known hypertensive patients
under medication reporting to Department of Oral and
Maxillofacial surgery, Dayananda Sagar College of Dental
Sciences Bangalore, Karnataka, India for extraction of teeth
were taken up for the study. Anxiety was measured before local
anaesthetic delivery using Amsterdam Pre-operative Anxiety
and Information Scale (APAIS). Cardiovascular response
data including blood pressure, heart rate, pulse rate, oxygen
saturation and electrocardiographic changes were measured pre-operatively, immediately after local anaesthesia
administration and Post-operatively at five, ten and fifteen
minutes interval. Kruskal-Wallis test was used to compare
continuous variables before and after the injection of local
anaesthesia including heart rate, pulse rate, oxygen saturation,
and blood pressure. Repeated-measures analysis of variance
(ANOVA) was used to analyse the significance of changes in
heart rate, pulse rate, blood pressure, and oxygen saturation
over time between groups. Chi-square test was used to analyse
the significance of electrocardiographic changes.
Results: The results revealed that the mean anxiety score
before administration of local anaesthetic was 9.91(S.D ±2.9)
with a range 4-20. Severe preoperative anxiety (<12) was
associated with significantly increased heart rate, pulse rate,
systolic blood pressure. At the pre-injection phase the mean
values were systolic blood pressure (130.72±9.2), diastolic
blood pressure (81.6±7.7), heart rate (72.7±11.9) and oxygen
saturation (95.2±1.9). These values were increased immediately
after local anaesthetic delivery and this relation was statistically
significant for all parameters except oxygen saturation.
Electrocardiographic abnormalities were found before and after
injection of local anaesthetic (p>0.001). One patient showed
right bundle branch block pattern.
Conclusion: Dental anxiety impacts the effects of delivery
of local anaesthesia on blood pressure, heart rate, pulse rate
and electrocardiograph and is significantly associated with the
increase in systolic blood pressure, heart rate, pulse rate and
changes in electrocardiograph. Thus, present study supported
that increased anxiety in hypertensive patients who underwent
extraction is associated with cardiovascular changes. |
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| ISSN: | 2249-782X 0973-709X |