Hemodynamic variations and anxiety during the surgical extraction of impacted lower third molars.

Background: The surgical removal of an impacted third molar can cause patient anxiety. Such anxiety and the use of vasoconstrictor drugs and local anesthetics in turn can induce hemodynamic variations during the operation. A study is made of the variations in hemodynamic parameters (systolic and diastolic blood pressure and heart rate) and their correlation to patient gender and anxiety during surgical removal of an impacted lower third molar.

Material and Methods: A prospective study was carried out in the Oral Surgery Unit of a university clinic, with the inclusion of 125 patients (mean age 24.9 years). Anesthesia was administered in the form of 4% articaine and adrenalin 1:200,000 for surgical removal of the impacted lower third molars.

Results: Women experienced greater anxiety than men. Systolic blood pressure showed few changes - the maximum and minimum values being recorded at the time of incision and upon suturing, respectively. Diastolic blood pressure in turn showed maximum and minimum values before the start of surgery and during extraction, respectively, while heart rate proved maximum during incision and minimum upon suturing. The differences in systolic and diastolic blood pressure, and heart rate, between men and women, and between patients with and without anxiety, failed to reach statistical significance.

Conclusions: The fact that these were young patients could contribute to explain the absence of significant hemodynamic changes in our study. Key words: Anxiety, third molars, extraction, surgery.