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含利多卡因和肾上腺素的麻醉剂对牙种植手术期间心血管变化的影响。

Effect of anesthetics containing lidocaine and epinephrine on cardiovascular changes during dental implant surgery.

作者信息

Faraco Fátima N, Kawakami Paulo Y, Mestnik Maria J, Ferrari Daniel S, Shibli Jamil A

机构信息

Department of Peridontics and Implantology, School of Dentistry, University of Santo Amaro, SP, Brazil.

出版信息

J Oral Implantol. 2007;33(2):84-8. doi: 10.1563/0.845.1.

Abstract

The purpose of this study was to evaluate cardiovascular changes during dental implant surgery using 2% lidocaine with 1:80 000 epinephrine. Eleven normotensive subjects, ranging from 18 to 56 years, were selected to undergo dental implant surgery in the jaw. They were monitored in the pre-, intra-, and postsurgical periods by continuous noninvasive automatic arterial pressure and cardiac frequency measurements taken every 2 minutes. Parameter scores were obtained for the following phases: P1, 15 minutes during preparation of the patient (control period); P2, before anesthesia; P3, immediately after anesthesia; P4, 2 minutes into anesthesia; P5, during incision and detachment; P6, during perforation; P7, during implant placement; P8, during suturing; P9, on completion; and P10, 10 minutes after termination. Individualized statistical analysis for each group during the pre-, intra-, and postoperative periods were performed by analysis of variance. The greatest variations in systolic pressure were increases of 2.29% during phase P2 and 2.59% in phase P5. Diastolic pressure decreased during phase P6 (-2.58%) and increased in P10 (3.27%). The greatest changes in heart rate occurred in phase P10 (-3.24%). There were no statistically significant changes among the evaluated phases (P > .05). In conclusion, there were no changes in the analyzed cardiocirculatory parameters during dental implant surgery (systolic, diastolic, and mean arterial blood pressures and heart rate) in normotensive subjects anesthetized with 2% lidocaine with epinephrine 1:80000.

摘要

本研究的目的是评估在使用含1:80 000肾上腺素的2%利多卡因进行牙种植手术期间的心血管变化。选取了11名年龄在18至56岁之间的血压正常受试者,在颌骨进行牙种植手术。在术前、术中和术后期间,通过每2分钟进行一次连续无创自动动脉压和心率测量对他们进行监测。获取了以下各阶段的参数评分:P1,患者准备期间15分钟(对照期);P2,麻醉前;P3,麻醉后即刻;P4,麻醉2分钟后;P5,切开和分离期间;P6,钻孔期间;P7,植入种植体期间;P8,缝合期间;P9,完成时;以及P10,结束后10分钟。通过方差分析对术前、术中和术后各阶段的每组进行个体化统计分析。收缩压的最大变化是在P2阶段升高2.29%,在P5阶段升高2.59%。舒张压在P6阶段下降(-2.58%),在P10阶段升高(3.27%)。心率的最大变化发生在P10阶段(-3.24%)。在评估的各阶段之间没有统计学上的显著变化(P>0.05)。总之,在用含1:80 000肾上腺素的2%利多卡因麻醉的血压正常受试者进行牙种植手术期间(收缩压、舒张压、平均动脉血压和心率),所分析的心脏循环参数没有变化。

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