1. Epinephrine may cause acute hypertensive crisis (dangerously high blood pressure)
2. Interaction of epinephrine and some antihypertensive medications may cause acute hypertensive or hypotensive crisis.
We can use epinephrine with hypertensive patients however we should adjust the doses
the aim in hypertensive patients is to make your procedure painless as stress and pain result in release of endogenous adrenaline which is more important as its amount is much more larger than that involved in the Carpule
I use anesthetic with 1:200000 epinephrine and is no problem to control the bleeding and the pain. The endogenous adrenaline is impossible to control as long as we don't know the quantity released by the body.
When treating patients with cardiac conditions, epinephrine-free local anesthetics may be used. Prilocaine/felypressin is the most commonly selected for patients with a history of hypertension. Prilocaine with felypressin is used predominantly in patients with known medical conditions, including cardiovascular disease, asthma and diabetes.
Anesthetic agents whether it is Lidocaine, Prilocaine, Mepivacaine solution with vasoconstrictor can be used safely in hypertensive patients attending dental clinic. However It is of utmost importance that dental clinicians need to select anesthetic solution in hypertensive patients considering their cardiovascular effect in order to provide comfort to the patients and knowing safety
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