The oral surgical anaesthesia is field in which usually long-acting local anaesthetics are being used. Some of the currently used acting local anaesthetics as Levobupivacaine or Ropivacaine have reduced cardiac toxicity. The aim of this review is to provide an overview of acting mechanisms when anaesthetic agents are applied in oral surgery and the effect that they may have in patients with chronic concurrent cardiac conditions. There are notable linking the property of the local anaesthetics lipid solubility and the potency of local anaesthetic-induced vasoconstriction which can additionally compromise cardiac function in patients with previously impaired cardiac function.