Use of Local Anesthetics Associated with Vasoconstrictors in Dentistry. Is it a Safe Treatment? A Literature Update

Abstract

The use of local anesthetics associated with vasoconstrictors offers advantages and disadvantages associated to its sympathomi- metic effect and it should be considered during the dental treatment. This effect should be taken into consideration especially when the patient has a cardiovascular, endocrine or respiratory compromise. Objective: Perform a bibliographical update on the use of local anesthetics with vasoconstrictors in 'risk' patients. Conclusion: The use of local anesthetics associated with vasoconstrictors is safe in patients with cardiovascular compromise as well as in controlled diabetic patients as long as a correct anesthetic technique is performed (avoiding intravascular anesthetic infiltra - tion), the dose is not superior to 5.4 ml (equivalent to 3 vials of anesthetic with 1:100000 epinephrine), the analgesia maintenance and the behavioral management of the patient are appropriate during the treatment. In the case of patients with endocrine disorders such as decompensated diabetes mellitus, uncontrolled hyperthyroidism or pheochromocytoma the use of vasoconstrictors is con- traindicated, independently of the dose and/or the anesthetic technique.