Bader James D, Bonito Arthur J, Shugars Daniel A
School of Dentistry, Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC 27599, USA. jim_baderunc.edu
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jun;93(6):647-53. doi: 10.1067/moe.2002.123866.
A systematic review was conducted to identify any additional risks of adverse cardiovascular outcomes to hypertensive individuals represented by use of epinephrine-containing anesthetic solutions and epinephrine-impregnated retraction cords.
Two searches identified 373 local anesthetic and 33 retraction cord reports; 6 local anesthetic reports met inclusion criteria.
Use of epinephrine in uncontrolled hypertensive patients was associated with small, nonsignificant increases in systolic and diastolic blood pressure. No adverse outcomes were reported. Only one study examined effects of epinephrine on controlled hypertensive patients, in whom additional risks due to interactions with antihypertensive medication are possible. Available studies did not address effects of gingival retraction cord on hypertensive patients.
Although the increased risk for adverse events among uncontrolled hypertensive patients was found to be low and the reported occurrence of adverse events in hypertensive patients associated with the use of epinephrine in local anesthetics was minimal, the quantity and quality of the pertinent literature is problematic.
进行一项系统评价，以确定使用含肾上腺素的麻醉溶液和肾上腺素浸渍的牙龈收缩线对高血压患者心血管不良结局是否存在任何额外风险。
两项检索共识别出373篇局部麻醉报告和33篇牙龈收缩线报告；6篇局部麻醉报告符合纳入标准。
在未控制的高血压患者中使用肾上腺素与收缩压和舒张压小幅、无显著升高相关。未报告不良结局。仅有一项研究考察了肾上腺素对血压得到控制的高血压患者的影响，这类患者可能因与抗高血压药物相互作用而存在额外风险。现有研究未涉及牙龈收缩线对高血压患者的影响。
尽管发现未控制的高血压患者不良事件风险增加程度较低，且报告显示局部麻醉中使用肾上腺素的高血压患者不良事件发生率极低，但相关文献的数量和质量存在问题。
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