Leviner E, Tzukert A A, Mosseri M, Fisher D, Yossipovitch O, Pisanty S, Markitziu A
Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel.
Spec Care Dentist. 1992 Mar-Apr;12(2):84-8. doi: 10.1111/j.1754-4505.1992.tb00418.x.
Twenty patients with stable ischemic heart disease in functional capacity Class II-IV underwent dental treatment. Scaling was performed in seven patients without local anesthesia. In the remaining 13 patients, pain control for restoration placement was obtained by local anesthesia: in seven patients, the anesthetics contained epinephrine, while in six this drug was omitted. Heart rate, blood pressure, and electrocardiograph were continuously monitored during the dental session. All patients had elevated systolic blood pressure and rate pressure product during treatment. In the patients who received plain local anesthetics only, the elevation in systolic blood and rate pressures was, however, significantly lower than the ischemic threshold. Arrhythmia or ST segment depression of > or = 1 millimeter were not recorded in any of the subjects. In severely compromised ischemic heart disease patients undergoing routine dental procedures of limited chair time, plain local anesthesia seems to be the preferred analgesic modality.
20名功能能力为II-IV级的稳定型缺血性心脏病患者接受了牙科治疗。7名患者在未进行局部麻醉的情况下进行了洗牙。其余13名患者通过局部麻醉实现了修复体放置时的疼痛控制：7名患者使用的麻醉剂中含有肾上腺素，而另外6名患者未使用该药物。在牙科治疗过程中持续监测心率、血压和心电图。所有患者在治疗期间收缩压和心率血压乘积均升高。然而，仅接受普通局部麻醉剂的患者，其收缩压和心率血压的升高显著低于缺血阈值。所有受试者均未记录到心律失常或ST段压低≥1毫米。对于接受椅旁时间有限的常规牙科手术的严重缺血性心脏病患者，普通局部麻醉似乎是首选的镇痛方式。
