Faraco Fátima N, Kawakami Paulo Y, Mestnik Maria J, Ferrari Daniel S, Shibli Jamil A
Department of Peridontics and Implantology, School of Dentistry, University of Santo Amaro, SP, Brazil.
J Oral Implantol. 2007;33(2):84-8. doi: 10.1563/0.845.1.
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.
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。
