Articaine Outperforms Lidocaine in Maintaining Hemodynamic Stability During Dental Anesthesia

Background: Almost 33% of adults above the age of 45 suffer from hypertension in Pakistan; lidocaine is not the best option. While Lidocaine with epinephrine is a gold standard local anesthesia, it is still contraindicated in patients with cardiovascular diseases and hypertension. FDA revises the data for the safer use of any local anesthetic on an annual basis, but the clinical data for Articaine is lacking. The research aimed to emphasize articaine as a safer option for hypertensive patients. Methods: This Quasi-Controlled Trial aimed to compare the hemodynamic effects of lidocaine and articaine in adults undergoing dental procedures. This was a 6-month study (Oct 2022 to April 2023) conducted at the Department of Endodontics and Maxillofacial Surgery, SBDC and Hospital, Gandhara University, Peshawar, Khyber Pakhtunkhwa, Pakistan. 114 adult patients aged 30 years and above were selected using block randomization. Of these, 57 patients in the control group received lidocaine, while 57 patients in the experimental group were administered articaine. Blood pressure was recorded at five-minute intervals to monitor hemodynamic changes before and after administering the anesthetic agents. The study utilized SPSS 21.0 for data analysis, applying a 95% confidence interval and a significance level of p < 0.05. A two-way ANOVA and t-tests revealed that lidocaine had a greater impact on systolic and diastolic blood pressure. Results: Statistically significant effects between time and treatment were found (F=8.11, df1,112 p<0.01) for the articaine and lidocaine groups. According to the two-way ANOVA performed, lidocaine dropped the diastolic blood pressure in 52.6% of participants. The drop in systolic blood pressure in 45% of participants. While for articaine, diastolic blood pressure decreased only in 10% of the participants. Systolic blood pressure decreased by approximately in 4.75% of participants. Conclusion: Articaine demonstrated superior efficacy in maintaining hemodynamic stability compared to lidocaine during dental anesthesia, as evidenced by its minimal impact on both systolic and diastolic blood pressure.