Increase in pulse pressure on administration of a dental local anesthetic solution, prilocaine hydrochloride with felypressin in male diabetic patients with coronary heart disease

  • Kazumasa KubotaEmail author
  • Yuka Kyosaka
  • Kaori Ueda
  • Shunsuke Minakuchi
Original Article



This study aimed to evaluate pulse pressure fluctuation on dental local anesthetic administration in diabetic patients with and without coronary heart disease undergoing tooth extraction.

Materials and methods

This retrospective study in diabetic patients undergoing tooth extraction included 33 patients with coronary heart disease (mean age 79.3 ± 7.4, 64% male) and 49 patients without coronary heart disease (mean age 78.6 ± 6.5, 29% male). The increase in pulse pressure before and after administration of local anesthetics was compared between diabetic patients with and without coronary heart disease.


Pulse pressure was increased in male diabetic patients with coronary heart disease compared with those without coronary heart disease following administration of 3% prilocaine hydrochloride with felypressin 0.03 IU/mL (prilocaine) (15.6 ± 15.4 mmHg in those with coronary heart disease (n = 11) versus 4.3 ± 10.9 mmHg in those without coronary heart disease (n = 13), p = 0.03).


Prilocaine administration increased pulse pressure in male diabetic patients with coronary heart disease compared with those without coronary heart disease. Further study is needed to reveal the mechanisms involved in the increase in pulse pressure.

Clinical relevance

This is the first study of pulse pressure fluctuation in diabetic patients with and without coronary heart disease following administration of local anesthetics. Our findings can help guide the choice of local anesthetics and serve as a predictor of coronary vascular condition in diabetic patients during dental treatment.


Pulse pressure Male diabetic patients Coronary heart disease Prilocaine with felypressin Tooth extraction 



We thank all of members in the Special Care 1 Outpatient at the Department of Gerontology and Gerodontology to support clinics during our study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the ethical committee at Tokyo Medical and Dental University (No. D2017-20).

Informed consent

Informed consent was obtained from all individual participants in this study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Kazumasa Kubota
    • 1
    Email author
  • Yuka Kyosaka
    • 1
  • Kaori Ueda
    • 1
  • Shunsuke Minakuchi
    • 1
  1. 1.Department of Gerontology and Gerodontology, Gerodontology and Oral Rehabilitation, Graduate SchoolTokyo Medical and Dental UniversityTokyoJapan

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