There is a dentist think that the adrenaline in LA usually have no serious adverse effects on the hypertensive patient.what do you think?

It is a serious issue,as u are dealing with a human body.so as its contraindicated using adrenaline LA in hypertensive pt.we should not use it. Also concentration and technique matters as in infiltration it may not be much risk but in nerve block its highly risk

The concentration of adrenaline that is used in the LA is what is important. Usually the concentration ranges from1:50000 to1:200000.

Nowadays use of1:50000 concentration is extremely rare, as most dentists prefer to use1:80000 concentration.

 

In hypertensive patients, there have been many well controlled studies documenting the increase in systolic pressure after administration of1:80000 Adrenaline containing LA. Generally this increase is only about6-10 mm of Hg, thus in most cases it is manageable. 

However, in patients who have uncontrolled hypertension, or with underlying cardiac disorders, the standard of care is to use1/4th the dose of Adrenaline used in a otherwise healthy patient, or to avoid use of Adrenaline containing LA entirely.