Effect on the autonomic nervous response of informing patients about changes in anesthetic procedures

Abstract

We investigated the relationship between emotional stress and autonomic nervous response during gingival infiltration anesthesia. Twenty-four healthy subjects were divided into two groups that group consisted of six low dental anxiety subjects and six high dental anxiety subjects. A dental health questionnaire was used to determine the anxiety of the subjects before the experiment. For both groups the dentist administering the gingival infiltration anesthesia was changed just before administration. One group was informed this change would be made, and the other was not. Tonometry systolic blood pressure (SBP) and heart rate (HR) were measured continuously by a monitoring system (BP-508, COLIN, Aichi-ken, Japan) in all subjects. The average and coefficiency of variation (CV) was calculated for SBP and HR for eight periods of 30 seconds each during the experiment. The average SBP and HR were also calculated for twelve periods of 3 seconds each during administering the anesthesia. The results were compared by using repeated measure ANOVA. We found that anxiety induced by the change of dentist influenced SBP and HR more among the patients who were not informed of the change. This suggests that it is important to inform the patient of procedural changes he does not anticipate.