Evaluation of Anxiety, Pain, and Hemodynamic Changes during Surgical Removal of Lower Third Molar under Local Anesthesia

AIM: The aim of this study are to determine the hemodynamic changes in healthy patients during the surgical removal of lower third molar and to evaluate whether these variations are attributable to patient anxiety and pain experienced during surgical procedure. MATERIALS AND METHODS: Sixty healthy patients were evaluated (i) to determine the hemodynamic changes (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and oxygen saturation) at nine occasions: before starting the surgical procedure, 1 min and 4 min after local anesthetic injection, during the incision, at the time of ostectomy, at the completion of tooth removal, at the start and completion of suturing, and finally, after completion of surgery and (ii) to evaluate whether these variations are attributable to patient anxiety and pain experienced during the surgical procedure. Hemodynamic variables were compared between the gender and at different time points by performing two-way analysis of variance for repeated measures. Global mean values of hemodynamic variables were compared between male and female using unpaired t-test. Categorical variables were compared by Chi-square test. All the tests were two-sided. P < 0.05 was considered statistically significant. RESULTS: SBP and DBP showed significant changes; the highest value was recorded at the time of ostectomy/tooth sectioning. Maximum HR was observed 4 min after local anesthetic injection and the lowest HR was recorded after completion of tooth extraction, i.e., during the suturing. In females, mean HR was significantly increased. CONCLUSION: The present study suggests that dental anxiety impacts the effect of delivery of local anesthesia on blood pressure and is significantly associated with increased HR.