After administering local anesthesia, an anxious patient develops tachycardia (heart rate ~100 bpm). What is the MOST appropriate next step?

Correct answer: C. Monitor and continue treatment — tachycardia is likely due to patient anxiety and the epinephrine in the local anesthetic

• A. Beta-blockers are not administered chairside for post-LA tachycardia in a stable patient.
• B. Calling 911 is excessive for mild tachycardia in an anxious patient with LA — it does not meet emergency criteria.
• C. Correct. Mild tachycardia (100 bpm) after local anesthetic administration in an anxious dental patient is most likely due to: (1) patient anxiety (sympathetic activation), (2) intravascular absorption of epinephrine from the local anesthetic. If the patient is otherwise stable (no chest pain, no significant BP change, no other symptoms), monitoring and continuing treatment is appropriate.
• D. Deferring treatment is not necessary if the tachycardia is explained by anxiety and LA epinephrine without other concerning symptoms.